MedDialogRubrics: A Comprehensive Benchmark and Evaluation Framework for Multi-turn Medical Consultations in Large Language Models

Fuente: arXiv
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Autores principales: Gong, Lecheng, Fang, Weimin, Yang, Ting, Tao, Dongjie, Guo, Chunxiao, Wei, Peng, Xie, Bo, Guan, Jinqun, Chen, Zixiao, Shi, Fang, Gu, Jinjie, Liu, Junwei
Formato: Preprint
Publicado: 2026
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author Gong, Lecheng
Fang, Weimin
Yang, Ting
Tao, Dongjie
Guo, Chunxiao
Wei, Peng
Xie, Bo
Guan, Jinqun
Chen, Zixiao
Shi, Fang
Gu, Jinjie
Liu, Junwei
author_facet Gong, Lecheng
Fang, Weimin
Yang, Ting
Tao, Dongjie
Guo, Chunxiao
Wei, Peng
Xie, Bo
Guan, Jinqun
Chen, Zixiao
Shi, Fang
Gu, Jinjie
Liu, Junwei
contents Medical conversational AI (AI) plays a pivotal role in the development of safer and more effective medical dialogue systems. However, existing benchmarks and evaluation frameworks for assessing the information-gathering and diagnostic reasoning abilities of medical large language models (LLMs) have not been rigorously evaluated. To address these gaps, we present MedDialogRubrics, a novel benchmark comprising 5,200 synthetically constructed patient cases and over 60,000 fine-grained evaluation rubrics generated by LLMs and subsequently refined by clinical experts, specifically designed to assess the multi-turn diagnostic capabilities of LLM. Our framework employs a multi-agent system to synthesize realistic patient records and chief complaints from underlying disease knowledge without accessing real-world electronic health records, thereby mitigating privacy and data-governance concerns. We design a robust Patient Agent that is limited to a set of atomic medical facts and augmented with a dynamic guidance mechanism that continuously detects and corrects hallucinations throughout the dialogue, ensuring internal coherence and clinical plausibility of the simulated cases. Furthermore, we propose a structured LLM-based and expert-annotated rubric-generation pipeline that retrieves Evidence-Based Medicine (EBM) guidelines and utilizes the reject sampling to derive a prioritized set of rubric items ("must-ask" items) for each case. We perform a comprehensive evaluation of state-of-the-art models and demonstrate that, across multiple assessment dimensions, current models face substantial challenges. Our results indicate that improving medical dialogue will require advances in dialogue management architectures, not just incremental tuning of the base-model.
format Preprint
id arxiv_https___arxiv_org_abs_2601_03023
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle MedDialogRubrics: A Comprehensive Benchmark and Evaluation Framework for Multi-turn Medical Consultations in Large Language Models
Gong, Lecheng
Fang, Weimin
Yang, Ting
Tao, Dongjie
Guo, Chunxiao
Wei, Peng
Xie, Bo
Guan, Jinqun
Chen, Zixiao
Shi, Fang
Gu, Jinjie
Liu, Junwei
Computation and Language
Human-Computer Interaction
68T42
I.2.1
Medical conversational AI (AI) plays a pivotal role in the development of safer and more effective medical dialogue systems. However, existing benchmarks and evaluation frameworks for assessing the information-gathering and diagnostic reasoning abilities of medical large language models (LLMs) have not been rigorously evaluated. To address these gaps, we present MedDialogRubrics, a novel benchmark comprising 5,200 synthetically constructed patient cases and over 60,000 fine-grained evaluation rubrics generated by LLMs and subsequently refined by clinical experts, specifically designed to assess the multi-turn diagnostic capabilities of LLM. Our framework employs a multi-agent system to synthesize realistic patient records and chief complaints from underlying disease knowledge without accessing real-world electronic health records, thereby mitigating privacy and data-governance concerns. We design a robust Patient Agent that is limited to a set of atomic medical facts and augmented with a dynamic guidance mechanism that continuously detects and corrects hallucinations throughout the dialogue, ensuring internal coherence and clinical plausibility of the simulated cases. Furthermore, we propose a structured LLM-based and expert-annotated rubric-generation pipeline that retrieves Evidence-Based Medicine (EBM) guidelines and utilizes the reject sampling to derive a prioritized set of rubric items ("must-ask" items) for each case. We perform a comprehensive evaluation of state-of-the-art models and demonstrate that, across multiple assessment dimensions, current models face substantial challenges. Our results indicate that improving medical dialogue will require advances in dialogue management architectures, not just incremental tuning of the base-model.
title MedDialogRubrics: A Comprehensive Benchmark and Evaluation Framework for Multi-turn Medical Consultations in Large Language Models
topic Computation and Language
Human-Computer Interaction
68T42
I.2.1
url https://arxiv.org/abs/2601.03023