Timely Clinical Diagnosis through Active Test Selection

• URL: http://arxiv.org/abs/2510.18988v3
• Date: Fri, 24 Oct 2025 12:05:14 GMT
• Title: Timely Clinical Diagnosis through Active Test Selection
• Authors: Silas Ruhrberg Estévez, Nicolás Astorga, Mihaela van der Schaar,
• Abstract summary: We propose ACTMED (Adaptive Clinical Test selection via Model-based Experimental Design) to better emulate real-world diagnostic reasoning.<n>LLMs act as flexible simulators, generating plausible patient state distributions and supporting belief updates without requiring structured, task-specific training data.<n>We evaluate ACTMED on real-world datasets and show it can optimize test selection to improve diagnostic accuracy, interpretability, and resource use.
• Score: 49.091903570068155
• License: http://creativecommons.org/licenses/by/4.0/
• Abstract: There is growing interest in using machine learning (ML) to support clinical diagnosis, but most approaches rely on static, fully observed datasets and fail to reflect the sequential, resource-aware reasoning clinicians use in practice. Diagnosis remains complex and error prone, especially in high-pressure or resource-limited settings, underscoring the need for frameworks that help clinicians make timely and cost-effective decisions. We propose ACTMED (Adaptive Clinical Test selection via Model-based Experimental Design), a diagnostic framework that integrates Bayesian Experimental Design (BED) with large language models (LLMs) to better emulate real-world diagnostic reasoning. At each step, ACTMED selects the test expected to yield the greatest reduction in diagnostic uncertainty for a given patient. LLMs act as flexible simulators, generating plausible patient state distributions and supporting belief updates without requiring structured, task-specific training data. Clinicians can remain in the loop; reviewing test suggestions, interpreting intermediate outputs, and applying clinical judgment throughout. We evaluate ACTMED on real-world datasets and show it can optimize test selection to improve diagnostic accuracy, interpretability, and resource use. This represents a step toward transparent, adaptive, and clinician-aligned diagnostic systems that generalize across settings with reduced reliance on domain-specific data.

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