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CORTEX: Clinically Organized Reasoning and sTructured EXplanation

Anonymous codebase submission for SAFER Workshop in MICCAI 2026.


Overview

Standard VQA models for radiology produce short, flat answers. CORTEX instead generates a four-step chain-of-thought that mirrors the diagnostic workflow of a board-certified radiologist:

Step Tag Description
1 <task> Restate the clinical question, modality, and available clinical context
2 <observation> Systematic visual assessment by anatomical region
3 <reason> Differential reasoning — evaluate each option or hypothesis
4 <answer> Final answer with rationale

Repository Structure

CORTEX/
│
├── prompts/
│   ├── generation/
│   │   ├── open_ended.md        # Prompt for generating open-ended reasoning traces
│   │   ├── closed_ended.md      # Prompt for generating closed-ended reasoning traces
│   │   └── report_gen.md        # Prompt for generating radiology report reasoning traces
│   │
│   └── validation/
│   ├   ├── open_ended.md        # Prompt for rubrics based scoring open-ended responses
│   ├   ├── closed_ended.md      # Prompt for rubrics based scoring closed-ended responses
│   ├   └── report_gen.md        # Prompt for rubrics based scoring report generation responses
│
└── dataset_samples/
│   ├── open_ended/              # Sample open-ended QA pairs with CORTEX reasoning
│   │   ├── 1.md
│   │   └── 2.md
│   ├── closed_ended/            # Sample closed-ended QA pairs with CORTEX reasoning
│   │   ├── 1.md
│   │   └── 2.md
│   └── report_gen/              # Sample report generation pairs with CORTEX reasoning
│        ├── 1.md
│        └── 2.md
│
├── expert_feedback/
│   ├── open_ended.md           # Clinical experts' feedback for open-ended VQA sample in CT-RATE and CORTEX
│   ├── closed_ended.md         # Clinical experts' feedback for closed-ended VQA sample in CT-RATE and CORTEX
│   └── report_gen.md           # Clinical experts' feedback for report generation VQA sample in CT-RATE and CORTEX
│
├── expert_feedback/
│   └── CTRATE_samples.md       # Sample CT-RATE (base dataset) QA pairs for different VQA categories in the base dataset.

Each sample file shows a side-by-side comparison of a baseline dataset response (CT-RATE) and the full CORTEX structured reasoning trace.

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