Saurabh Srivastava, Chengyue Huang, Weiguo Fan, Ziyu Yao. Findings of the Association for Computational Linguistics ACL 2024. 2024.

We present HiRMed (Hierarchical RAG-enhanced Medical Test Recommendation), a novel tree-structured recommendation system that leverages Retrieval-Augmented Generation (RAG) for intelligent medical test recommendations. Unlike traditional vector similarity-based approaches, our system performs medical reasoning at each tree node through a specialized RAG process. Starting from the root node with initial symptoms, the system conducts step-wise medical analysis to identify potential underlying conditions and their corresponding diagnostic requirements. At each level, instead of simple matching, our RAG-enhanced nodes analyze retrieved medical knowledge to understand symptom-disease relationships and determine the most appropriate diagnostic path. The system dynamically adjusts its recommendation strategy based on medical reasoning results, considering factors such as urgency levels and diagnostic uncertainty. Experimental results demonstrate that our approach achieves superior performance in terms of coverage rate, accuracy, and miss rate compared to conventional retrieval-based methods. This work represents a significant advance in medical test recommendation by introducing medical reasoning capabilities into the traditional tree-based retrieval structure.

This study introduces an evaluation framework for multimodal models in medical imaging diagnostics. We developed a pipeline incorporating data preprocessing, model inference, and preference-based evaluation, expanding an initial set of 500 clinical cases to 3,000 through controlled augmentation. Our method combined medical images with clinical observations to generate assessments, using Claude 3.5 Sonnet for independent evaluation against physician-authored diagnoses. The results indicated varying performance across models, with Llama 3.2-90B outperforming human diagnoses in 85.27% of cases. In contrast, specialized vision models like BLIP2 and Llava showed preferences in 41.36% and 46.77% of cases, respectively. This framework highlights the potential of large multimodal models to outperform human diagnostics in certain tasks.