HeiCo-FOCUS: A Clinically Grounded Dataset for Long-Context Video Understanding

Leon Mayer, Lucas Luttner, Patrick Godau, Kai Fritzsche, Annika Reinke +40

Recent advances in Vision-Language Models (VLMs) have led to rapid progress in video understanding across a wide range of benchmark tasks. However, existing evaluations largely focus on short-term reasoning, failing to assess a critical capability: maintaining cumulative temporal consistency over extended time horizons. To close this evaluation gap, we introduce HeiCo-FOCUS, a clinically grounded dataset for evaluating long-context video understanding through the task of Foreign Object Contextual Understanding in Surgery. Built on a dataset of Heidelberg Colorectal surgeries, this task requires models to continuously track multiple objects as they are inserted, manipulated, occluded, and removed over procedures lasting up to hours. HeiCo-FOCUS comprises 30,000 visual question answering (VQA) pairs covering five core capabilities: object recognition, temporal grounding, aggregation, event and procedural understanding, and complex reasoning. The dataset was constructed through a rigorous multi-stage annotation pipeline involving large-scale crowd annotation and 39 surgical domain experts to ensure high quality and clinical relevance. To systematically probe model behavior, we…