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.
arXiv:2606. 02802v1 Announce Type: new Abstract: Large language models (LLMs) exhibit strong natural-language reasoning abilities for clinical decision support, but struggle to effectively model structured longitudinal electronic health records (EHRs).
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.
arXiv:2602. 00541v2 Announce Type: replace Abstract: Clinical events captured in Electronic Health Records (EHR) are irregularly sampled and may consist of a mixture of discrete events and numerical measurements, such as laboratory values or treatment dosages.
arXiv:2606. 05994v1 Announce Type: new Abstract: Medical knowledge graphs (MKGs) infused with clinical knowledge have been increasingly used to model electronic health records (EHRs) to support interpretable predictions in healthcare domain.
arXiv:2607. 02983v1 Announce Type: new Abstract: Recent reasoning-centric Large Language Models (LLMs) have made significant strides, yet they predominantly operate on a passive-inference pattern that assumes complete information.
arXiv:2607. 15447v1 Announce Type: new Abstract: Recent research in clinical machine learning, focusing on outcome predictions in intensive care unit (ICU), has shifted from bespoke supervised models to foundation models, utilising modern representation learning methods.
arXiv:2604. 06684v2 Announce Type: replace Abstract: Clinical reasoning over electronic health records (EHRs) is a fundamental yet challenging task in modern healthcare.
arXiv:2506. 04831v3 Announce Type: replace Abstract: Forecasting how a patient's condition is likely to evolve, including possible deterioration, recovery, treatment needs, and care transitions, could support more proactive and personalized care, but requires modeling heterogeneous and longitudinal electronic health record (EHR) data.
arXiv:2607. 08793v1 Announce Type: cross Abstract: Sepsis is a leading cause of mortality, yet optimal treatment policies remain contested.
arXiv:2510. 17532v2 Announce Type: replace-cross Abstract: Predicting cancer treatment outcomes requires models that are both accurate and interpretable, particularly in the presence of heterogeneous clinical data.
arXiv:2608. 20315v1 Announce Type: new Abstract: Predictive models over structured electronic health records (EHRs) remain central to machine learning for healthcare, but few have jointly emphasized quantitative laboratory information and interpretability with respect to input medical events.
REFINE is a framework that refines medical concept representations by creating patient‑specific temporal graphs from a global text‑attributed knowledge graph. It uses a reinforcement learning policy to allocate a personalized graph expansion budget for each observed code, then processes the resulting graph with a heterogeneous GNN and a frozen LLM that refines representations via graph‑aware soft prompts. Experiments on MIMIC‑III and MIMIC‑IV demonstrate that REFINE consistently improves various EHR prediction backbones, surpasses strong baselines, and shows robust gains across ablation studies, KG selection, and data insufficiency scenarios.