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Main Authors: Li, Wenhao, Zhang, Hongkuan, Zhang, Hongwei, Li, Zhengxu, Dong, Zengjie, Chen, Yafan, Bidargaddi, Niranjan, Liu, Hong
Format: Preprint
Published: 2025
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Online Access:https://arxiv.org/abs/2506.21615
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author Li, Wenhao
Zhang, Hongkuan
Zhang, Hongwei
Li, Zhengxu
Dong, Zengjie
Chen, Yafan
Bidargaddi, Niranjan
Liu, Hong
author_facet Li, Wenhao
Zhang, Hongkuan
Zhang, Hongwei
Li, Zhengxu
Dong, Zengjie
Chen, Yafan
Bidargaddi, Niranjan
Liu, Hong
contents Current medical language models, adapted from large language models (LLMs), typically predict ICD code-based diagnosis from electronic health records (EHRs) because these labels are readily available. However, ICD codes do not capture the nuanced, context-rich reasoning clinicians use for diagnosis. Clinicians synthesize diverse patient data and reference clinical practice guidelines (CPGs) to make evidence-based decisions. This misalignment limits the clinical utility of existing models. We introduce GARMLE-G, a Generation-Augmented Retrieval framework that grounds medical language model outputs in authoritative CPGs. Unlike conventional Retrieval-Augmented Generation based approaches, GARMLE-G enables hallucination-free outputs by directly retrieving authoritative guideline content without relying on model-generated text. It (1) integrates LLM predictions with EHR data to create semantically rich queries, (2) retrieves relevant CPG knowledge snippets via embedding similarity, and (3) fuses guideline content with model output to generate clinically aligned recommendations. A prototype system for hypertension diagnosis was developed and evaluated on multiple metrics, demonstrating superior retrieval precision, semantic relevance, and clinical guideline adherence compared to RAG-based baselines, while maintaining a lightweight architecture suitable for localized healthcare deployment. This work provides a scalable, low-cost, and hallucination-free method for grounding medical language models in evidence-based clinical practice, with strong potential for broader clinical deployment.
format Preprint
id arxiv_https___arxiv_org_abs_2506_21615
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Refine Medical Diagnosis Using Generation Augmented Retrieval and Clinical Practice Guidelines
Li, Wenhao
Zhang, Hongkuan
Zhang, Hongwei
Li, Zhengxu
Dong, Zengjie
Chen, Yafan
Bidargaddi, Niranjan
Liu, Hong
Computation and Language
Artificial Intelligence
Information Retrieval
Current medical language models, adapted from large language models (LLMs), typically predict ICD code-based diagnosis from electronic health records (EHRs) because these labels are readily available. However, ICD codes do not capture the nuanced, context-rich reasoning clinicians use for diagnosis. Clinicians synthesize diverse patient data and reference clinical practice guidelines (CPGs) to make evidence-based decisions. This misalignment limits the clinical utility of existing models. We introduce GARMLE-G, a Generation-Augmented Retrieval framework that grounds medical language model outputs in authoritative CPGs. Unlike conventional Retrieval-Augmented Generation based approaches, GARMLE-G enables hallucination-free outputs by directly retrieving authoritative guideline content without relying on model-generated text. It (1) integrates LLM predictions with EHR data to create semantically rich queries, (2) retrieves relevant CPG knowledge snippets via embedding similarity, and (3) fuses guideline content with model output to generate clinically aligned recommendations. A prototype system for hypertension diagnosis was developed and evaluated on multiple metrics, demonstrating superior retrieval precision, semantic relevance, and clinical guideline adherence compared to RAG-based baselines, while maintaining a lightweight architecture suitable for localized healthcare deployment. This work provides a scalable, low-cost, and hallucination-free method for grounding medical language models in evidence-based clinical practice, with strong potential for broader clinical deployment.
title Refine Medical Diagnosis Using Generation Augmented Retrieval and Clinical Practice Guidelines
topic Computation and Language
Artificial Intelligence
Information Retrieval
url https://arxiv.org/abs/2506.21615