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This study addresses the critical gap in medical AI by combining deep learning image classifiers with large language models to generate structured clinical reasoning for gastrointestinal diagnoses. While the hybrid framework successfully improves explanation quality, the research highlights that current LLMs still lack the stability required for high-stakes medical decisions, as their outputs vary significantly with prompt changes. The work provides essential benchmarks and source code to guide future development of safer, more reliable vision-language systems in healthcare.
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DL$^3$M: A Vision-to-Language Framework for Expert-Level Medical Reasoning through Deep Learning and Large Language Models

arXiv2 min read

arXiv:2512.13742v3 Announce Type: replace-cross Abstract: Medical image classifiers detect gastrointestinal diseases well, but they do not explain their decisions. Large language models can generate clinical text, yet they struggle with visual reasoning and often produce unstable or incorrect explanations. This leaves a gap between what a model sees and the type of reasoning a clinician expects. We introduce a framework that links image classification with structured clinical reasoning. A new hybrid model, MobileCoAtNet, is designed for endoscopic images and achieves high accuracy across eight stomach-related classes. Its outputs are then used to drive reasoning by several LLMs. To judge this reasoning, we build two expert-verified benchmarks covering causes, symptoms, treatment, lifestyle, and follow-up care. Thirty-two LLMs are evaluated against these gold standards. Strong classification improves the quality of their explanations, but none of the models reach human-level stability. Even the best LLMs change their reasoning when prompts vary. Our study shows that combining DL with LLMs can produce useful clinical narratives, but current LLMs remain unreliable for high-stakes medical decisions. The framework provides a clearer view of their limits and a path for building safer reasoning systems. The complete source code and datasets used in this study are available at https://github.com/souravbasakshuvo/DL3M.

Authors:Md. Najib Hasan (1), Imran Ahmad (1), Sourav Basak Shuvo (2), Md. Mahadi Hasan Ankon (2), Nazmul Siddique (3), Hui Wang (4) ((1) Wichita State University, USA, (2) Khulna University of Engineering and Technology, Bangladesh, (3) Ulster University, UK, (4) Queen's University Belfast, UK)

Abstract:Medical image classifiers detect gastrointestinal diseases well, but they do not explain their decisions. Large language models can generate clinical text, yet they struggle with visual reasoning and often produce unstable or incorrect explanations. This leaves a gap between what a model sees and the type of reasoning a clinician expects. We introduce a framework that links image classification with structured clinical reasoning. A new hybrid model, MobileCoAtNet, is designed for endoscopic images and achieves high accuracy across eight stomach-related classes. Its outputs are then used to drive reasoning by several LLMs. To judge this reasoning, we build two expert-verified benchmarks covering causes, symptoms, treatment, lifestyle, and follow-up care. Thirty-two LLMs are evaluated against these gold standards. Strong classification improves the quality of their explanations, but none of the models reach human-level stability. Even the best LLMs change their reasoning when prompts vary. Our study shows that combining DL with LLMs can produce useful clinical narratives, but current LLMs remain unreliable for high-stakes medical decisions. The framework provides a clearer view of their limits and a path for building safer reasoning systems. The complete source code and datasets used in this study are available at this https URL.

Computer Vision and Pattern Recognition (cs.CV); Artificial Intelligence (cs.AI)

arXiv:2512.13742 [cs.CV]

(or arXiv:2512.13742v3 [cs.CV] for this version)

From: Md. Najib Hasan [view email] [v1] Sun, 14 Dec 2025 21:20:15 UTC (5,322 KB) [v2] Sun, 22 Feb 2026 17:20:12 UTC (1 KB) (withdrawn) [v3] Sun, 6 Sep 2026 04:46:52 UTC (5,127 KB)

Full text under the publisher's open licence · 293 words

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