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Apr 16

MedDialogRubrics: A Comprehensive Benchmark and Evaluation Framework for Multi-turn Medical Consultations in Large Language Models

Medical conversational AI (AI) plays a pivotal role in the development of safer and more effective medical dialogue systems. However, existing benchmarks and evaluation frameworks for assessing the information-gathering and diagnostic reasoning abilities of medical large language models (LLMs) have not been rigorously evaluated. To address these gaps, we present MedDialogRubrics, a novel benchmark comprising 5,200 synthetically constructed patient cases and over 60,000 fine-grained evaluation rubrics generated by LLMs and subsequently refined by clinical experts, specifically designed to assess the multi-turn diagnostic capabilities of LLM. Our framework employs a multi-agent system to synthesize realistic patient records and chief complaints from underlying disease knowledge without accessing real-world electronic health records, thereby mitigating privacy and data-governance concerns. We design a robust Patient Agent that is limited to a set of atomic medical facts and augmented with a dynamic guidance mechanism that continuously detects and corrects hallucinations throughout the dialogue, ensuring internal coherence and clinical plausibility of the simulated cases. Furthermore, we propose a structured LLM-based and expert-annotated rubric-generation pipeline that retrieves Evidence-Based Medicine (EBM) guidelines and utilizes the reject sampling to derive a prioritized set of rubric items ("must-ask" items) for each case. We perform a comprehensive evaluation of state-of-the-art models and demonstrate that, across multiple assessment dimensions, current models face substantial challenges. Our results indicate that improving medical dialogue will require advances in dialogue management architectures, not just incremental tuning of the base-model.

  • 12 authors
·
Jan 6

Small Language Models for Privacy-Preserving Clinical Information Extraction in Low-Resource Languages

Extracting clinical information from medical transcripts in low-resource languages remains a significant challenge in healthcare natural language processing (NLP). This study evaluates a two-step pipeline combining Aya-expanse-8B as a Persian-to-English translation model with five open-source small language models (SLMs) -- Qwen2.5-7B-Instruct, Llama-3.1-8B-Instruct, Llama-3.2-3B-Instruct, Qwen2.5-1.5B-Instruct, and Gemma-3-1B-it -- for binary extraction of 13 clinical features from 1,221 anonymized Persian transcripts collected at a cancer palliative care call center. Using a few-shot prompting strategy without fine-tuning, models were assessed on macro-averaged F1-score, Matthews Correlation Coefficient (MCC), sensitivity, and specificity to account for class imbalance. Qwen2.5-7B-Instruct achieved the highest overall performance (median macro-F1: 0.899; MCC: 0.797), while Gemma-3-1B-it showed the weakest results. Larger models (7B--8B parameters) consistently outperformed smaller counterparts in sensitivity and MCC. A bilingual analysis of Aya-expanse-8B revealed that translating Persian transcripts to English improved sensitivity, reduced missing outputs, and boosted metrics robust to class imbalance, though at the cost of slightly lower specificity and precision. Feature-level results showed reliable extraction of physiological symptoms across most models, whereas psychological complaints, administrative requests, and complex somatic features remained challenging. These findings establish a practical, privacy-preserving blueprint for deploying open-source SLMs in multilingual clinical NLP settings with limited infrastructure and annotation resources, and highlight the importance of jointly optimizing model scale and input language strategy for sensitive healthcare applications.

  • 7 authors
·
Feb 24 2

DoctorAgent-RL: A Multi-Agent Collaborative Reinforcement Learning System for Multi-Turn Clinical Dialogue

Large language models (LLMs) have demonstrated excellent capabilities in the field of biomedical question answering, but their application in real-world clinical consultations still faces core challenges. Existing systems rely on a one-way information transmission mode where patients must fully describe their symptoms in a single round, leading to nonspecific diagnostic recommendations when complaints are vague. Traditional multi-turn dialogue methods based on supervised learning are constrained by static data-driven paradigms, lacking generalizability and struggling to intelligently extract key clinical information. To address these limitations, we propose DoctorAgent-RL, a reinforcement learning (RL)-based multi-agent collaborative framework that models medical consultations as a dynamic decision-making process under uncertainty. The doctor agent continuously optimizes its questioning strategy within the RL framework through multi-turn interactions with the patient agent, dynamically adjusting its information-gathering path based on comprehensive rewards from the Consultation Evaluator. This RL fine-tuning mechanism enables LLMs to autonomously develop interaction strategies aligned with clinical reasoning logic, rather than superficially imitating patterns in existing dialogue data. Notably, we constructed MTMedDialog, the first English multi-turn medical consultation dataset capable of simulating patient interactions. Experiments demonstrate that DoctorAgent-RL outperforms existing models in both multi-turn reasoning capability and final diagnostic performance, demonstrating practical value in assisting clinical consultations. https://github.com/JarvisUSTC/DoctorAgent-RL

  • 4 authors
·
May 26, 2025 2

OrgForge: A Multi-Agent Simulation Framework for Verifiable Synthetic Corporate Corpora

Evaluating retrieval-augmented generation (RAG) pipelines requires corpora where ground truth is knowable, temporally structured, and cross-artifact properties that real-world datasets rarely provide cleanly. Existing resources such as the Enron corpus carry legal ambiguity, demographic skew, and no structured ground truth. Purely LLM-generated synthetic data solves the legal problem but introduces a subtler one: the generating model cannot be prevented from hallucinating facts that contradict themselves across documents.We present OrgForge, an open-source multi-agent simulation framework that enforces a strict physics-cognition boundary: a deterministic Python engine maintains a SimEvent ground truth bus; large language models generate only surface prose, constrained by validated proposals. An actor-local clock enforces causal timestamp correctness across all artifact types, eliminating the class of timeline inconsistencies that arise when timestamps are sampled independently per document. We formalize three graph-dynamic subsystems stress propagation via betweenness centrality, temporal edge-weight decay, and Dijkstra escalation routing that govern organizational behavior independently of any LLM. Running a configurable N-day simulation, OrgForge produces interleaved Slack threads, JIRA tickets, Confluence pages, Git pull requests, and emails, all traceable to a shared, immutable event log. We additionally describe a causal chain tracking subsystem that accumulates cross-artifact evidence graphs per incident, a hybrid reciprocal-rank-fusion recurrence detector for identifying repeated failure classes, and an inbound/outbound email engine that routes vendor alerts, customer complaints, and HR correspondence through gated causal chains with probabilistic drop simulation. OrgForge is available under the MIT license.

  • 1 authors
·
Mar 16

Bridging the Gap in Ophthalmic AI: MM-Retinal-Reason Dataset and OphthaReason Model toward Dynamic Multimodal Reasoning

Multimodal large language models (MLLMs) have recently demonstrated remarkable reasoning abilities with reinforcement learning paradigm. Although several multimodal reasoning models have been explored in the medical domain, most of them focus exclusively on basic reasoning, which refers to shallow inference based on visual feature matching. However, real-world clinical diagnosis extends beyond basic reasoning, demanding reasoning processes that integrate heterogeneous clinical information (such as chief complaints and medical history) with multimodal medical imaging data. To bridge this gap, we introduce MM-Retinal-Reason, the first ophthalmic multimodal dataset with the full spectrum of perception and reasoning. It encompasses both basic reasoning tasks and complex reasoning tasks, aiming to enhance visual-centric fundamental reasoning capabilities and emulate realistic clinical thinking patterns. Building upon MM-Retinal-Reason, we propose OphthaReason, the first ophthalmology-specific multimodal reasoning model with step-by-step reasoning traces. To enable flexible adaptation to both basic and complex reasoning tasks, we specifically design a novel method called Uncertainty-Aware Dynamic Thinking (UADT), which estimates sample-level uncertainty via entropy and dynamically modulates the model's exploration depth using a shaped advantage mechanism. Comprehensive experiments demonstrate that our model achieves state-of-the-art performance on both basic and complex reasoning tasks, outperforming general-purpose MLLMs, medical MLLMs, RL-based medical MLLMs, and ophthalmic MLLMs by at least 24.92\%, 15.00\%, 21.20\%, and 17.66\%. Project Page: https://github.com/lxirich/OphthaReason{link}.

  • 9 authors
·
Aug 22, 2025

PromptMix: A Class Boundary Augmentation Method for Large Language Model Distillation

Data augmentation is a widely used technique to address the problem of text classification when there is a limited amount of training data. Recent work often tackles this problem using large language models (LLMs) like GPT3 that can generate new examples given already available ones. In this work, we propose a method to generate more helpful augmented data by utilizing the LLM's abilities to follow instructions and perform few-shot classifications. Our specific PromptMix method consists of two steps: 1) generate challenging text augmentations near class boundaries; however, generating borderline examples increases the risk of false positives in the dataset, so we 2) relabel the text augmentations using a prompting-based LLM classifier to enhance the correctness of labels in the generated data. We evaluate the proposed method in challenging 2-shot and zero-shot settings on four text classification datasets: Banking77, TREC6, Subjectivity (SUBJ), and Twitter Complaints. Our experiments show that generating and, crucially, relabeling borderline examples facilitates the transfer of knowledge of a massive LLM like GPT3.5-turbo into smaller and cheaper classifiers like DistilBERT_{base} and BERT_{base}. Furthermore, 2-shot PromptMix outperforms multiple 5-shot data augmentation methods on the four datasets. Our code is available at https://github.com/ServiceNow/PromptMix-EMNLP-2023.

  • 4 authors
·
Oct 22, 2023