The paper introduces an evidence ladder for evaluating reinforcement learning (RL) in healthcare, outlining stages from problem formulation to lifecycle monitoring. It argues that success in historical data does not guarantee real‑world improvement and highlights assumptions and failure modes at each rung. The authors propose reporting practices to support cumulative evaluation and emphasize that RL should be tested as an intervention within a dynamic sociotechnical system.
By Yunfan Zhao
arXiv:2605. 19208v2 Announce Type: replace-cross Abstract: Physical activity (PA) plays an important role in maintaining and improving health.
By Gefei Lin, Rui Miao, Jennifer Sacheck, Xiaoke Zhang
arXiv:2508. 03875v2 Announce Type: replace Abstract: Many sequential decision problems offer qualitatively different ways of influencing the environment: some interventions act immediately, whereas others induce persistent effects that continue to shape future states long after the decision that initiated them.
By David Mguni, Wanrong Yang, Jing Dong, Ziquan Liu, Muhammad Salman Haleem, Baoxiang Wang, Dominik Wojtczak
arXiv:2608.22615v1 Announce Type: new
Abstract: Large Language Model (LLM)-based counseling agents can generate fluent and supportive responses, but they often lack the structured, goal-directed prog...
By Qi Zhang, Heajun An, Prakriti Dumaru, Sang Won Lee, Lifu Huang, Pamela J. Wisniewski, Jin-Hee Cho
arXiv:2601. 15353v2 Announce Type: replace-cross Abstract: Reinforcement learning (RL) has achieved remarkable success in real-world decision-making across diverse domains, including gaming, robotics, online advertising, public health, and natural language processing.
By Asim H. Gazi, Yongyi Guo, Daiqi Gao, Ziping Xu, Kelly W. Zhang, Susan A. Murphy
The paper introduces POROS, a framework that uses peer‑grounded counterfactual explanations to generate incremental behavioral steps for chronic disease management. POROS builds a directed acyclic graph of patient states where each edge represents a behavior change that peers have successfully achieved and that improves health outcomes. In two diabetes cohorts, POROS reduces the required improvement per step from over 25–30 percentage points to about 5–6, while most multi‑hop paths involve cross‑patient comparisons.
By Saman Khamesian, Hassan Ghasemzadeh
arXiv:2606. 01028v1 Announce Type: new Abstract: Medical treatment recommendation poses several challenges to reinforcement learning (RL): patient physiology evolves in continuous time, measurements and interventions are performed at irregular intervals, and treatment effects vary substantially across individuals.
By Yuepeng Wang, Ken Kawano, Yongqi Zhou, Yoshihiko Fujisawa, Richard Weiss, Akifumi Wachi, Katsuki Fujisawa, Ying Chen, Mehrshad Sadria, Xin Liu, Kyoung-Sook Kim, Xiao Hu, Sebastien Gros, Xun Shen
arXiv:2606. 16721v1 Announce Type: new Abstract: Medical diagnosis and treatment are dynamic processes in which patient states evolve over time and clinical interventions alter future outcomes.
By Ke Liu, Mengxuan Li, Yanyi Bao, Tianyun Zhang, Chong Chu, Jiajun Bu, Haishuai Wang
The paper proposes a reinforcement learning (RL) fine‑tuning framework for electronic health record (EHR) foundation models, treating them as generative policies over patient trajectories. By framing clinical prediction tasks such as hospital readmission as event‑conditioned, time‑windowed reasoning problems and designing time‑aware, rollout‑sensitive rewards, the authors show that RL fine‑tuning consistently outperforms pre‑trained backbones and strong baselines. The approach enables smaller models to surpass larger pre‑trained models in data‑limited settings, induces positive transfer across tasks, and produces trajectories with stronger structural and semantic alignment to ground truth, improving downstream utility.
By Yuxin Xiao, Sheng Zhang, Chandan Singh, Tristan Naumann, Hoifung Poon, Jianfeng Gao, Xiaodong Liu
arXiv:2606. 28900v1 Announce Type: new Abstract: Doctor agents are moving beyond single-turn answer generation toward evolving clinical decision systems.
By Hui Zhang
The paper introduces MedGym, a benchmark environment for dynamic medical treatment recommendation that models patient evolution in continuous time using Physics-Informed Neural Networks. It addresses gaps in existing reinforcement learning (RL) approaches by allowing evaluation of RL methods under irregular measurement intervals, personalized treatment responses, and safety considerations. MedGym enables direct comparison between discrete-time and continuous-time RL methods and supports clinically relevant metrics such as personalization and trajectory-level safety.
By Yuepeng Wang, Ken Kawano, Yoshihiko Fujisawa, Yongqi Zhou, Akifumi Wachi, Mehrshad Sadria, Lei Zhou, Richard Weiss, Katsuki Fujisawa, Ying Chen, Xin Liu, Kyoung-Sook Kim, Xiao Hu, Sebastien Gros, Xun Shen
CARE: Causally-Aligned Reasoning Exploration for Medical Large Language Models proposes a new framework to improve medical reasoning in LLMs. It introduces two key conditions—Causal Sufficiency and Proximal Learnability—to curate high-quality training trajectories, using agreement-based self-verification and dynamic entropy bounds. Experiments on medical multimodal and text-only benchmarks show that CARE outperforms competitors, reducing incorrect reasoning and enhancing training stability.
By Yucheng Zhou, Peng Luo, Qianning Wang, Chengzhong Xu, Jianbing Shen