Improving medical report generation and evaluation through prompt engineering

The advancement of vision language models (VLMs) has opened new avenues for automating complex clinical tasks such as medical report generation. However, challenges remain in generating clinically accurate and detailed reports and in evaluating them effectively. Our work investigates the role of prompt engineering in improving both the generation and evaluation of medical reports. We make three main contributions. First, we analyze the effect of various prompting strategies on the performance of different VLMs, including GPT-4o mini, LLaMA 11B, and LLaVA-Med. We introduce a structured prompt design based on clinically relevant anatomical checkpoints that significantly improve reports coherence and clinical fidelity. Second, we propose a novel LLM evaluation strategy that uses checkpoints to anchor the assessment of generated reports, providing an interpretable and clinically meaningful metric. Third, we explore two integrated frameworks that combine generation and evaluation, enabling iterative improvement through example-based and self-supervised prompt optimization. Experimental results on the CT-RATE dataset demonstrate that prompt engineering can substantially increase both the quality and the evaluability of medical reports. Our findings highlight the potential of prompt-based approaches as efficient and scalable alternatives to fine-tuning, bridging the gap between general-purpose models and specialized clinical applications.

Name thesis:degree_name

M.S.

Level thesis:degree_level

Thesis

Discipline thesis:degree_discipline

Electrical & Computer Engr

Grantor

University of Illinois Urbana-Champaign

Year dc:date

2025

Author dc:creator

• Li, Chenhao

Contributors dc:contributor

• Kindratenko, Volodymyr

• Medical Report Generation
• Medical Report Evaluation
• Prompt Engineering
• Vision Language Model

Statement dc:rights

• Copyright 2025 Chenhao Li

Language dc:language

en, eng

Handle dc:identifier

https://hdl.handle.net/2142/129604

OAI record oai:identifier

https://www.ideals.illinois.edu/oai-pmh?verb=GetRecord&metadataPrefix=etdms&identifier=oai%3Awww.ideals.illinois.edu%3A2142%2F129604