Wasserstein Equilibrium Decoding for Reliable Medical Visual Question Answering 文章

arXiv:2605.18313v2 Announce Type: replace Abstract: Small vision-language models (2-8B) are well-suited for clinical deployment due to privacy constraints, limited connectivity, and low-latency requirements favouring on-device or on-premise inference. However, their limited capacity exacerbates the generation of plausible but incorrect outputs. We extend game-theoretic decoding, previously restricted to text-only, closed-ended NLP tasks, to vision-language models for open-ended Medical VQA. We introduce a semantically aware Wasserstein stopping criterion that replaces lexical order matching, enabling convergence based on semantic consensus among near-synonymous candidate answers and avoiding unnecessary iterations caused by clinically equivalent ranking swaps. On VQA-RAD and PathVQA, we obtain consistent, statistically significant improvements over greedy and discriminative baselines. On VQA-RAD, we improve Qwen3-VL-2B by +3.5 percentage points (p < 0.