Better Eyes, Better Thoughts: Why Vision Chain-of-Thought Fails in Medicine
Large vision-language models (VLMs) often benefit from chain-of-thought (CoT) prompting in general domains, yet its efficacy in medical vision-language tasks remains underexplored. We report a counter-intuitive trend: on medical visual question answering, CoT frequently underperforms direct answering (DirA) across general-purpose and medical-specific models. We attribute this to a \emph{medical perception bottleneck}: subtle, domain-specific cues can weaken visual grounding, and CoT may compound early perceptual uncertainty rather than correct it. To probe this hypothesis, we introduce two training-free, inference-time grounding interventions: (i) \emph{perception anchoring} via region-of...
| Authors | Yuan Wu, Zongxian Yang, Jiayu Qian et al. |
|---|---|
| Primary category | cs.CV |
| Published | 2 March 2026 |
| Last updated at source | 10 April 2026 |
Silytics shows public metadata from arXiv and links to the original. Information may be incomplete or out of date. Last refreshed 17 October 2026. Licenses and terms of the original apply to the work itself. Not financial, legal or professional advice.