Proactive Knowledge Inquiry in Doctor-Patient Dialogue: Stateful Extraction, Belief Updating, and Path-Aware Action Planning
- URL: http://arxiv.org/abs/2603.17425v1
- Date: Wed, 18 Mar 2026 07:03:50 GMT
- Title: Proactive Knowledge Inquiry in Doctor-Patient Dialogue: Stateful Extraction, Belief Updating, and Path-Aware Action Planning
- Abstract summary: We formulate doctor-patient dialogue as a proactive knowledge-inquiry problem under partial observability.<n>The proposed framework combines stateful extraction, sequential belief updating, gap-aware state modeling, hybrid retrieval over objectified medical knowledge, and a POMDP-lite action planner.
- Score: 4.321699303483216
- License: http://arxiv.org/licenses/nonexclusive-distrib/1.0/
- Abstract: Most automated electronic medical record (EMR) pipelines remain output-oriented: they transcribe, extract, and summarize after the consultation, but they do not explicitly model what is already known, what is still missing, which uncertainty matters most, or what question or recommendation should come next. We formulate doctor-patient dialogue as a proactive knowledge-inquiry problem under partial observability. The proposed framework combines stateful extraction, sequential belief updating, gap-aware state modeling, hybrid retrieval over objectified medical knowledge, and a POMDP-lite action planner. Instead of treating the EMR as the only target artifact, the framework treats documentation as the structured projection of an ongoing inquiry loop. To make the formulation concrete, we report a controlled pilot evaluation on ten standardized multi-turn dialogues together with a 300-query retrieval benchmark aggregated across dialogues. On this pilot protocol, the full framework reaches 83.3% coverage, 80.0% risk recall, 81.4% structural completeness, and lower redundancy than the chunk-only and template-heavy interactive baselines. These pilot results do not establish clinical generalization; rather, they suggest that proactive inquiry may be methodologically interesting under tightly controlled conditions and can be viewed as a conceptually appealing formulation worth further investigation for dialogue-based EMR generation. This work should be read as a pilot concept demonstration under a controlled simulated setting rather than as evidence of clinical deployment readiness. No implication of clinical deployment readiness, clinical safety, or real-world clinical utility should be inferred from this pilot protocol.
Related papers
- Evaluating Large Language Models in Dynamic Clinical Decision-Making with Standardized Patient Cases [71.12461204050985]
MedSP1000 is an SP-derived interactive benchmark for clinical-agent evaluation.<n>It converts peer-reviewed SP teaching cases into executable scenarios with defined SP case scripts, clinical environment contexts, and human-validated structured rubrics.<n>Applying MedSP1000 to a range of general-purpose and medically specialized LLMs, we find that performance on static benchmarks does not reliably translate to such educational scenarios.
arXiv Detail & Related papers (2026-06-03T17:17:16Z) - MedConceal: A Benchmark for Clinical Hidden-Concern Reasoning Under Partial Observability [17.806376792868416]
We present MedConceal, a benchmark with an interactive patient simulator for evaluating hidden-concern reasoning in medical dialogue.<n>Built from clinician-answered online health discussions, each case pairs clinician-visible context with simulator-internal hidden concerns.<n>We study two abilities: confirmation, surfacing hidden concerns through multi-turn dialogue, and intervention, addressing the primary concern and guiding the patient toward a target plan.
arXiv Detail & Related papers (2026-04-09T21:51:02Z) - Agentic Cognitive Profiling: Realigning Automated Alzheimer's Disease Detection with Clinical Construct Validity [66.94391219005291]
This paper proposes Agentic Cognitive Profiling (ACP), an agentic framework that realigns automated screening with clinical protocol logic.<n>Central to our design is decoupling semantic understanding from measurement by delegating all quantification to deterministic function calling.<n>ACP achieves 90.5% score match rate in task examination and 85.3% accuracy in AD prediction, surpassing popular baselines.
arXiv Detail & Related papers (2026-03-18T06:15:35Z) - A Proactive EMR Assistant for Doctor-Patient Dialogue: Streaming ASR, Belief Stabilization, and Preliminary Controlled Evaluation [4.321699303483216]
We present an end-to-end proactive EMR assistant built around streaming speech recognition, punctuation restoration, stateful extraction, belief stabilization, objectified retrieval, action planning, and replayable report generation.<n>The full system reaches state-event F1 of 0.84, retrieval Recall@5 of 0.87, and end-to-end pilot scores of 83.3% coverage, 81.4% structural, completeness, and 80.0% risk recall.
arXiv Detail & Related papers (2026-03-18T05:54:01Z) - AgentsEval: Clinically Faithful Evaluation of Medical Imaging Reports via Multi-Agent Reasoning [73.50200033931148]
We introduce AgentsEval, a multi-agent stream reasoning framework that emulates the collaborative diagnostic workflow of radiologists.<n>By dividing the evaluation process into interpretable steps including criteria definition, evidence extraction, alignment, and consistency scoring, AgentsEval provides explicit reasoning traces and structured clinical feedback.<n> Experimental results demonstrate that AgentsEval delivers clinically aligned, semantically faithful, and interpretable evaluations that remain robust under paraphrastic, semantic, and stylistic perturbations.
arXiv Detail & Related papers (2026-01-23T11:59:13Z) - MedDialogRubrics: A Comprehensive Benchmark and Evaluation Framework for Multi-turn Medical Consultations in Large Language Models [15.91764739198419]
We present MedDialogRubrics, a novel benchmark comprising 5,200 synthetically constructed patient cases and over 60,000 fine-grained evaluation rubrics.<n>Our framework employs a multi-agent system to synthesize realistic patient records and chief complaints without accessing real-world electronic health records.
arXiv Detail & Related papers (2026-01-06T13:56:33Z) - CARE-RAG - Clinical Assessment and Reasoning in RAG [43.1450755645803]
We study the gap between retrieval and reasoning in large language models (LLMs)<n>We propose an evaluation framework that measures accuracy, consistency, and fidelity of reasoning.
arXiv Detail & Related papers (2025-11-20T02:44:55Z) - DispatchMAS: Fusing taxonomy and artificial intelligence agents for emergency medical services [49.70819009392778]
Large Language Models (LLMs) and Multi-Agent Systems (MAS) offer opportunities to augment dispatchers.<n>This study aimed to develop and evaluate a taxonomy-grounded, multi-agent system for simulating realistic scenarios.
arXiv Detail & Related papers (2025-10-24T08:01:21Z) - MedKGEval: A Knowledge Graph-Based Multi-Turn Evaluation Framework for Open-Ended Patient Interactions with Clinical LLMs [19.12790150016383]
We present MedKGEval, a novel multi-turn evaluation framework for clinical large language models.<n>A knowledge graph-driven patient simulation mechanism retrieves relevant medical facts from a curated knowledge graph.<n>A turn-level evaluation framework assesses each model response for clinical appropriateness, factual correctness, and safety.
arXiv Detail & Related papers (2025-10-14T07:22:26Z) - Demo: Healthcare Agent Orchestrator (HAO) for Patient Summarization in Molecular Tumor Boards [7.69748973216707]
We introduce the Healthcare Agent Orchestrator (HAO) to generate accurate and comprehensive patient summaries for Molecular Tumor Boards (MTBs)<n> evaluating predicted patient summaries against ground truth presents additional challenges due to stylistic variation, ordering, synonym usage, and phrasing differences.<n>We propose TBFact, a model-as-a-judge'' framework designed to assess the comprehensiveness and succinctness of generated summaries.
arXiv Detail & Related papers (2025-09-08T12:15:53Z) - Dialogue is Better Than Monologue: Instructing Medical LLMs via Strategical Conversations [74.83732294523402]
We introduce a novel benchmark that simulates real-world diagnostic scenarios, integrating noise and difficulty levels aligned with USMLE standards.<n>We also explore dialogue-based fine-tuning, which transforms static datasets into conversational formats to better capture iterative reasoning processes.<n>Experiments show that dialogue-tuned models outperform traditional methods, with improvements of $9.64%$ in multi-round reasoning scenarios and $6.18%$ in accuracy in a noisy environment.
arXiv Detail & Related papers (2025-01-29T18:58:48Z) - Informing clinical assessment by contextualizing post-hoc explanations
of risk prediction models in type-2 diabetes [50.8044927215346]
We consider a comorbidity risk prediction scenario and focus on contexts regarding the patients clinical state.
We employ several state-of-the-art LLMs to present contexts around risk prediction model inferences and evaluate their acceptability.
Our paper is one of the first end-to-end analyses identifying the feasibility and benefits of contextual explanations in a real-world clinical use case.
arXiv Detail & Related papers (2023-02-11T18:07:11Z) - Clinical Outcome Prediction from Admission Notes using Self-Supervised
Knowledge Integration [55.88616573143478]
Outcome prediction from clinical text can prevent doctors from overlooking possible risks.
Diagnoses at discharge, procedures performed, in-hospital mortality and length-of-stay prediction are four common outcome prediction targets.
We propose clinical outcome pre-training to integrate knowledge about patient outcomes from multiple public sources.
arXiv Detail & Related papers (2021-02-08T10:26:44Z)
This list is automatically generated from the titles and abstracts of the papers in this site.
This site does not guarantee the quality of this site (including all information) and is not responsible for any consequences.