Optimizing Medical Question-Answering Systems: A Comparative Study of Fine-Tuned and Zero-Shot Large Language Models with RAG Framework

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Autori principali: Hassan, Tasnimul, Karim, Md Faisal, Jeelani, Haziq, Behnam, Elham, Green, Robert, Syed, Fayeq Jeelani
Natura: Preprint
Pubblicazione: 2025
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author Hassan, Tasnimul
Karim, Md Faisal
Jeelani, Haziq
Behnam, Elham
Green, Robert
Syed, Fayeq Jeelani
author_facet Hassan, Tasnimul
Karim, Md Faisal
Jeelani, Haziq
Behnam, Elham
Green, Robert
Syed, Fayeq Jeelani
contents Medical question-answering (QA) systems can benefit from advances in large language models (LLMs), but directly applying LLMs to the clinical domain poses challenges such as maintaining factual accuracy and avoiding hallucinations. In this paper, we present a retrieval-augmented generation (RAG) based medical QA system that combines domain-specific knowledge retrieval with open-source LLMs to answer medical questions. We fine-tune two state-of-the-art open LLMs (LLaMA~2 and Falcon) using Low-Rank Adaptation (LoRA) for efficient domain specialization. The system retrieves relevant medical literature to ground the LLM's answers, thereby improving factual correctness and reducing hallucinations. We evaluate the approach on benchmark datasets (PubMedQA and MedMCQA) and show that retrieval augmentation yields measurable improvements in answer accuracy compared to using LLMs alone. Our fine-tuned LLaMA~2 model achieves 71.8% accuracy on PubMedQA, substantially improving over the 55.4% zero-shot baseline, while maintaining transparency by providing source references. We also detail the system design and fine-tuning methodology, demonstrating that grounding answers in retrieved evidence reduces unsupported content by approximately 60%. These results highlight the potential of RAG-augmented open-source LLMs for reliable biomedical QA, pointing toward practical clinical informatics applications.
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publishDate 2025
record_format arxiv
spellingShingle Optimizing Medical Question-Answering Systems: A Comparative Study of Fine-Tuned and Zero-Shot Large Language Models with RAG Framework
Hassan, Tasnimul
Karim, Md Faisal
Jeelani, Haziq
Behnam, Elham
Green, Robert
Syed, Fayeq Jeelani
Computation and Language
Artificial Intelligence
Medical question-answering (QA) systems can benefit from advances in large language models (LLMs), but directly applying LLMs to the clinical domain poses challenges such as maintaining factual accuracy and avoiding hallucinations. In this paper, we present a retrieval-augmented generation (RAG) based medical QA system that combines domain-specific knowledge retrieval with open-source LLMs to answer medical questions. We fine-tune two state-of-the-art open LLMs (LLaMA~2 and Falcon) using Low-Rank Adaptation (LoRA) for efficient domain specialization. The system retrieves relevant medical literature to ground the LLM's answers, thereby improving factual correctness and reducing hallucinations. We evaluate the approach on benchmark datasets (PubMedQA and MedMCQA) and show that retrieval augmentation yields measurable improvements in answer accuracy compared to using LLMs alone. Our fine-tuned LLaMA~2 model achieves 71.8% accuracy on PubMedQA, substantially improving over the 55.4% zero-shot baseline, while maintaining transparency by providing source references. We also detail the system design and fine-tuning methodology, demonstrating that grounding answers in retrieved evidence reduces unsupported content by approximately 60%. These results highlight the potential of RAG-augmented open-source LLMs for reliable biomedical QA, pointing toward practical clinical informatics applications.
title Optimizing Medical Question-Answering Systems: A Comparative Study of Fine-Tuned and Zero-Shot Large Language Models with RAG Framework
topic Computation and Language
Artificial Intelligence
url https://arxiv.org/abs/2512.05863