Dense Clinical Contrasts Enhance Medical Knowledge Updating in Large Language Models
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arXiv:2607. 20453v1 Announce Type: cross Abstract: Large language models show promise for clinical prediction, but zero-shot performance on specialized tasks is limited by incomplete domain knowledge, especially for smaller locally deployable models.
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.
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The paper introduces CAST, a concept-guided artifact suppression tuning framework that uses sparse autoencoders to identify and suppress note-specific artifacts in clinical language models. CAST labels latent features with an LLM-assisted pipeline and ICD‑10 constraints, then fine‑tunes the model while providing post‑hoc per‑concept attributions for auditability. In experiments on MIMIC‑IV discharge‑note mortality prediction, CAST outperforms standard fine‑tuned encoders and competes with strong LLM baselines while offering a feature‑level audit trail of clinical concepts and suppressed artifacts.
arXiv:2607. 24838v1 Announce Type: cross Abstract: In medical multiple-choice question answering (MCQA), Retrieval-Augmented Generation (RAG) can supplement the domain knowledge of language models (LMs).