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Main Authors: Li, Chao, Liu, Cailiang, Gao, Ang, Deng, Kexin, Zhang, Shu, Xu, Langping, Shi, Xiaotong, Ding, Xionghao, Pei, Jian, Jiang, Xun
Format: Preprint
Published: 2026
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Online Access:https://arxiv.org/abs/2604.02834
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author Li, Chao
Liu, Cailiang
Gao, Ang
Deng, Kexin
Zhang, Shu
Xu, Langping
Shi, Xiaotong
Ding, Xionghao
Pei, Jian
Jiang, Xun
author_facet Li, Chao
Liu, Cailiang
Gao, Ang
Deng, Kexin
Zhang, Shu
Xu, Langping
Shi, Xiaotong
Ding, Xionghao
Pei, Jian
Jiang, Xun
contents Longitudinal health agents must reason across multi-source trajectories that combine continuous device streams, sparse clinical exams, and episodic life events - yet evaluating them is hard: real-world data cannot be released at scale, and temporally grounded attribution questions seldom admit definitive answers without structured ground truth. We present ESL-Bench, an event-driven synthesis framework and benchmark providing 100 synthetic users, each with a 1-5 year trajectory comprising a health profile, a multi-phase narrative plan, daily device measurements, periodic exam records, and an event log with explicit per-indicator impact parameters. Each indicator follows a baseline stochastic process driven by discrete events with sigmoid-onset, exponential-decay kernels under saturation and projection constraints; a hybrid pipeline delegates sparse semantic artifacts to LLM-based planning and dense indicator dynamics to algorithmic simulation with hard physiological bounds. Users are each paired with 100 evaluation queries across five dimensions - Lookup, Trend, Comparison, Anomaly, Explanation - stratified into Easy, Medium, and Hard tiers, with all ground-truth answers programmatically computable from the recorded event-indicator relationships. Evaluating 13 methods spanning LLMs with tools, DB-native agents, and memory-augmented RAG, we find that DB agents (48-58%) substantially outperform memory RAG baselines (30-38%), with the gap concentrated on Comparison and Explanation queries where multi-hop reasoning and evidence attribution are required.
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institution arXiv
publishDate 2026
record_format arxiv
spellingShingle ESL-Bench: An Event-Driven Synthetic Longitudinal Benchmark for Health Agents
Li, Chao
Liu, Cailiang
Gao, Ang
Deng, Kexin
Zhang, Shu
Xu, Langping
Shi, Xiaotong
Ding, Xionghao
Pei, Jian
Jiang, Xun
Artificial Intelligence
Longitudinal health agents must reason across multi-source trajectories that combine continuous device streams, sparse clinical exams, and episodic life events - yet evaluating them is hard: real-world data cannot be released at scale, and temporally grounded attribution questions seldom admit definitive answers without structured ground truth. We present ESL-Bench, an event-driven synthesis framework and benchmark providing 100 synthetic users, each with a 1-5 year trajectory comprising a health profile, a multi-phase narrative plan, daily device measurements, periodic exam records, and an event log with explicit per-indicator impact parameters. Each indicator follows a baseline stochastic process driven by discrete events with sigmoid-onset, exponential-decay kernels under saturation and projection constraints; a hybrid pipeline delegates sparse semantic artifacts to LLM-based planning and dense indicator dynamics to algorithmic simulation with hard physiological bounds. Users are each paired with 100 evaluation queries across five dimensions - Lookup, Trend, Comparison, Anomaly, Explanation - stratified into Easy, Medium, and Hard tiers, with all ground-truth answers programmatically computable from the recorded event-indicator relationships. Evaluating 13 methods spanning LLMs with tools, DB-native agents, and memory-augmented RAG, we find that DB agents (48-58%) substantially outperform memory RAG baselines (30-38%), with the gap concentrated on Comparison and Explanation queries where multi-hop reasoning and evidence attribution are required.
title ESL-Bench: An Event-Driven Synthetic Longitudinal Benchmark for Health Agents
topic Artificial Intelligence
url https://arxiv.org/abs/2604.02834