Improving Interactive Diagnostic Ability of a Large Language Model Agent Through Clinical Experience Learning

Fuente: arXiv
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Hauptverfasser: Sun, Zhoujian, Liu, Ziyi, Luo, Cheng, Chu, Jiebin, Huang, Zhengxing
Format: Preprint
Veröffentlicht: 2025
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author Sun, Zhoujian
Liu, Ziyi
Luo, Cheng
Chu, Jiebin
Huang, Zhengxing
author_facet Sun, Zhoujian
Liu, Ziyi
Luo, Cheng
Chu, Jiebin
Huang, Zhengxing
contents Recent advances in large language models (LLMs) have shown promising results in medical diagnosis, with some studies indicating superior performance compared to human physicians in specific scenarios. However, the diagnostic capabilities of LLMs are often overestimated, as their performance significantly deteriorates in interactive diagnostic settings that require active information gathering. This study investigates the underlying mechanisms behind the performance degradation phenomenon and proposes a solution. We identified that the primary deficiency of LLMs lies in the initial diagnosis phase, particularly in information-gathering efficiency and initial diagnosis formation, rather than in the subsequent differential diagnosis phase. To address this limitation, we developed a plug-and-play method enhanced (PPME) LLM agent, leveraging over 3.5 million electronic medical records from Chinese and American healthcare facilities. Our approach integrates specialized models for initial disease diagnosis and inquiry into the history of the present illness, trained through supervised and reinforcement learning techniques. The experimental results indicate that the PPME LLM achieved over 30% improvement compared to baselines. The final diagnostic accuracy of the PPME LLM in interactive diagnostic scenarios approached levels comparable to those achieved using complete clinical data. These findings suggest a promising potential for developing autonomous diagnostic systems, although further validation studies are needed.
format Preprint
id arxiv_https___arxiv_org_abs_2503_16463
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Improving Interactive Diagnostic Ability of a Large Language Model Agent Through Clinical Experience Learning
Sun, Zhoujian
Liu, Ziyi
Luo, Cheng
Chu, Jiebin
Huang, Zhengxing
Artificial Intelligence
Computation and Language
Human-Computer Interaction
Recent advances in large language models (LLMs) have shown promising results in medical diagnosis, with some studies indicating superior performance compared to human physicians in specific scenarios. However, the diagnostic capabilities of LLMs are often overestimated, as their performance significantly deteriorates in interactive diagnostic settings that require active information gathering. This study investigates the underlying mechanisms behind the performance degradation phenomenon and proposes a solution. We identified that the primary deficiency of LLMs lies in the initial diagnosis phase, particularly in information-gathering efficiency and initial diagnosis formation, rather than in the subsequent differential diagnosis phase. To address this limitation, we developed a plug-and-play method enhanced (PPME) LLM agent, leveraging over 3.5 million electronic medical records from Chinese and American healthcare facilities. Our approach integrates specialized models for initial disease diagnosis and inquiry into the history of the present illness, trained through supervised and reinforcement learning techniques. The experimental results indicate that the PPME LLM achieved over 30% improvement compared to baselines. The final diagnostic accuracy of the PPME LLM in interactive diagnostic scenarios approached levels comparable to those achieved using complete clinical data. These findings suggest a promising potential for developing autonomous diagnostic systems, although further validation studies are needed.
title Improving Interactive Diagnostic Ability of a Large Language Model Agent Through Clinical Experience Learning
topic Artificial Intelligence
Computation and Language
Human-Computer Interaction
url https://arxiv.org/abs/2503.16463