arXiv AI

Temporal Evidence Allocation For Longitudinal Clinical Retrieval: A Position And Technical Report

arXiv AI
Jul 13

Evaluating Retrieval-Augmented Generation vs. Long-Context Input for Clinical Reasoning over EHRs

arXiv:2508. 14817v2 Announce Type: replace-cross Abstract: Objective: To evaluate whether retrieval-augmented generation (RAG) can serve as an efficient alternative to long-context prompting for clinical reasoning over electronic health records (EHRs).

By Skatje Myers, Dmitriy Dligach, Timothy A. Miller, Samantha Barr, James Landefeld, Yanjun Gao, Matthew Churpek, Anoop Mayampurath, Majid Afshar
arXiv Computation and Language
1d ago

How Ground Truth Shapes Retrieval Scores: Evidence-Aware Evaluation of a Retrieval-Augmented Generation System for Breast Lesions

The study introduces an evidence-aware evaluation protocol for a retrieval‑augmented generation system focused on breast lesion management literature. Using an 18‑document corpus and 18 queries, the authors compared dense embeddings, BM25, and cross‑encoder reranking across various chunk sizes and overlaps, finding that a hybrid retriever with 384‑token chunks and 20% overlap achieved top‑three retrieval success for 17 of 18 queries and high recall and precision metrics. Expanding ground‑truth relevance annotations increased recognized evidence spans and accepted chunk targets, though retrieval rankings remained unchanged, underscoring the sensitivity of evaluation to annotation coverage.

By Miguel Mochizuki Silva, Samuel Ismael, Mateus C. Dias, Tha\'is Gaud\^encio, Yuri Malheiros, Barufaldi
arXiv AI
Aug 11

CliniCARE-Bench: Clinical Calibrated Audit of Medical Reasoning in EHR

arXiv:2608. 07796v1 Announce Type: new Abstract: Large language models perform strongly on medical knowledge benchmarks, but reliable clinical deployment requires agents to conduct defensible investigations over heterogeneous, longitudinal records: determining what evidence is needed, retrieving and reconciling structured and free-text data, grounding conclusions in verifiable evidence, and deferring cases that cannot be resolved reliably.

By Veronica Chatrath, Bryan Zhu, George Pu, Jingxuan Fan, Apaar Shanker, Varun Ursekar, Anahita Sharma, Jason Qin, Keqi Han, Soham Dinesh Tiwari, Soham Dan, Vijay Kalmath, Yuan Li, Daniel Yue Zhang, Chenguang Wang, Zainab Doctor, Zhijun Yin, Nigam H. Shah, Yuan Xue
arXiv Computation and Language
Sep 7

CT-$\Delta$Bench: A Benchmark for Longitudinal 3D Medical Imaging Difference Reporting with Vision-Language Models

CT‑ΔBench is a new benchmark designed to evaluate vision‑language models on longitudinal 3D medical imaging difference reporting. It provides patient‑level split data, change‑aware metrics, and physician‑validated references to assess clinically meaningful interval changes between two CT scans. The paper also introduces DeltaMed, a baseline model that directly reasons over paired CT scans, and compares it to an indirect two‑stage approach that first generates single‑timepoint reports before differencing.

By Kegeng Tang, Jingbo Wang, Shaogang Ren, Zihao Wang
arXiv AI
Sep 18

CliniCIRCA: A Modular LLM Framework for Constructing Longitudinal Mental Health Patient Journeys from Raw EHR Narratives

CliniCIRCA is a modular large‑language‑model framework that reconstructs longitudinal mental‑health patient journeys from raw electronic health record narratives. It temporally classifies clinical events in unstructured discharge summaries without explicit timestamps, producing 15,891 tagged events from 52 summaries and correcting 629 errors to create verified gold‑standard timelines. The framework then generates temporally grounded summaries, compressing each source by 1.52×, and scales to produce 1,000 silver‑standard timelines for training, showing that instruction tuning improves event extraction, temporal tagging, and summarization across models.

By Aiwei Ivy Zhang, Nimra Ishfaq, Mohit Chandra, Santiago Alvarez Lesmes, Adam Coscia, Khatiya Chelidze Moon, Xiaohan Ding, Munmun De Choudhury
Hugging Face Trending Papers
Oct 5

Auditable Clinical Timeline Reconstruction with Provenance-Aware Evidence Graphs

The study evaluates an auditable patient‑timeline reconstruction system that tracks provenance, records revisions, and refuses to answer when evidence is missing. Using a synthetic corpus of 1,000 patients and 3,353 notes, two provenance‑aware Evidence Graph operators reduced graph size by 33–37% while preserving all answers across 6,813 query points; a fixed‑window baseline failed to answer over half of the points. The system’s evidence‑gating mechanisms (BioClinicalBERT and a zero‑shot LLM) responded appropriately to evidence‑unavailable controls, but performance varied on marker‑free controls, with BERT maintaining high accuracy but the LLM’s coverage dropping sharply. "whyItMatters":"The results demonstrate that provenance‑aware evidence graphs can significantly reduce data complexity while maintaining answer integrity, highlighting a practical approach to building auditable clinical NLP systems."

arXiv AI
Aug 19

Foundation Agents Meet Agentic Deep Research: Evidence-Grounded Clinical Code Forecasting

The paper introduces ICD-Deepresearch, a workflow that combines foundation models for electronic health records (EHR) and language models with medical search and ICD dictionaries to forecast future ICD codes for upcoming clinical encounters. It evaluates candidate code transitions by linking patient evidence, external clinical relations, and exact code semantics within a fixed top‑K budget, using SparseEHR for initial priors, GPT‑5 for complementary forecasts, and a final selection step that validates, deduplicates, and ranks candidates. The method achieves patient‑averaged precision/recall of 24.60/35.09% on MIMIC‑III and 25.14/48.32% on MIMIC‑IV, with physicians rating 51–68% of its retrieved documents as useful, outperforming standalone GPT‑5 web search and Medical Deep Research.

By Junda Wang, Meysam Ghaffari, Akshat Choube, Mohsen Sharifi Renani, Hong Yu, Carlos Morato