arXiv:2607. 08793v1 Announce Type: cross Abstract: Sepsis is a leading cause of mortality, yet optimal treatment policies remain contested.
arXiv:2606. 17405v1 Announce Type: new Abstract: Clinical decision support AI systems (CDSASs) must adapt to evolving patient conditions in real-time while adhering to strict safety constraints.
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.
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.
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. 04632v1 Announce Type: new Abstract: Mechanical ventilation for Acute Respiratory Distress Syndrome (ARDS) requires balancing competing physiological goals, including oxygenation, lung protection, and acid-base homeostasis.
arXiv:2609.36144v1 Announce Type: new Abstract: Electronic health records provide irregular observations of latent patient states that evolve continuously over time. Recent autoregressive models cond...
arXiv:2606. 19481v1 Announce Type: new Abstract: Offline reinforcement learning (ORL) offers the potential to improve the quality of clinical decision-making using historical electronic health record (EHR) data.
The dosing of intravenous fluids and vasopressors in sepsis is a sequential decision made under uncertainty and guided largely by clinical judgment, which makes it a natural target for reinforcement learning from historical care. Because a learned policy cannot be trialed on patients, its value must be estimated off-policy, and such estimates can be fragile and optimistic.
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.
arXiv:2608. 16482v1 Announce Type: new Abstract: The dosing of intravenous fluids and vasopressors in sepsis is a sequential decision made under uncertainty and guided largely by clinical judgment, which makes it a natural target for reinforcement learning from historical care.
arXiv:2606. 01051v1 Announce Type: new Abstract: Dynamic medical treatment requires deciding treatment intensity and intervention timing, while patient states evolve continuously and adverse events may occur between clinical interactions.
arXiv:2608. 11410v1 Announce Type: new Abstract: Offline reinforcement learning (RL) offers considerable promise for optimizing ICU treatment decisions, yet standard evaluation metrics Mean Squared Error (MSE) and Fitted Q-Evaluation (FQE) assess only behavioral imitation and cannot detect Toxic Mimicry, a failure mode in which agents replicate harmful patterns such as treatment withdrawal during comfort-care transitions.