arXiv Computation and Language
Sep 24

Beyond Information Seeking: Severity-Aware Question Supervision for Proactive Medical Dialogue

The paper introduces Expected‑Severity‑Risk (ESR), a new objective for selecting questions in proactive medical dialogue that prioritizes reducing the expected severity of diagnostic errors rather than merely uncertainty. ESR uses population statistics to marginalize over possible answers and distills its rankings into a prefix‑only language policy, enabling deployment without teacher‑side risk computation. Experiments on DDxPlus show ESR cuts high‑severity diagnostic misses by 29.5% and boosts accuracy while adding only 0.14 extra questions per dialogue.

By Chenxuan Li, Xinrong Chen, Luyan Zhang, Peidong Jia, Runfan Zheng, Zhongyu Zhao, Xuecheng Shang, Peixing Wan
arXiv Computation and Language
1d ago

TriageRA-CCF: Source-Side Clinical Confidence and Coverage Signals for Adaptive Rank Budgeting in Medical LLMs

The paper introduces TriageRA-CCF, a method for adaptively allocating low‑rank LoRA channels in medical large language models based on source‑side signals: answer confidence, clinical coverage, and a counterfactual close‑miss proxy. By supervising a budget router that selects among 2, 4, or 8 active ranks, the approach improves average accuracy over existing LoRA variants on Qwen3‑8B and Llama3.1‑8B, though gains vary across benchmarks. Ablation studies confirm that each signal contributes to better budget decisions, though their combined effect is not uniformly superior across all backbones.

By Shucan Ji, Yining Huang, Hongliang Guo