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Main Authors: Zhang, Hengyu, Zhang, Xuyun, Zhan, Pengxiang, Luo, Linhao, Lv, Hang, Tan, Yanchao, Pan, Shirui, Yang, Carl
Format: Preprint
Published: 2026
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Online Access:https://arxiv.org/abs/2604.10455
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author Zhang, Hengyu
Zhang, Xuyun
Zhan, Pengxiang
Luo, Linhao
Lv, Hang
Tan, Yanchao
Pan, Shirui
Yang, Carl
author_facet Zhang, Hengyu
Zhang, Xuyun
Zhan, Pengxiang
Luo, Linhao
Lv, Hang
Tan, Yanchao
Pan, Shirui
Yang, Carl
contents Recent advances in large language models (LLMs) have enabled promising progress in diagnosis prediction from electronic health records (EHRs). However, existing LLM-based approaches tend to overfit to historically observed diagnoses, often overlooking novel yet clinically important conditions that are critical for early intervention. To address this, we propose EviCare, an in-context reasoning framework that integrates deep model guidance into LLM-based diagnosis prediction. Rather than prompting LLMs directly with raw EHR inputs, EviCare performs (1) deep model inference for candidate selection, (2) evidential prioritization for set-based EHRs, and (3) relational evidence construction for novel diagnosis prediction. These signals are then composed into an adaptive in-context prompt to guide LLM reasoning in an accurate and interpretable manner. Extensive experiments on two real-world EHR benchmarks (MIMIC-III and MIMIC-IV) demonstrate that EviCare achieves significant performance gains, which consistently outperforms both LLM-only and deep model-only baselines by an average of 20.65\% across precision and accuracy metrics. The improvements are particularly notable in challenging novel diagnosis prediction, yielding average improvements of 30.97\%.
format Preprint
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institution arXiv
publishDate 2026
record_format arxiv
spellingShingle EviCare: Enhancing Diagnosis Prediction with Deep Model-Guided Evidence for In-Context Reasoning
Zhang, Hengyu
Zhang, Xuyun
Zhan, Pengxiang
Luo, Linhao
Lv, Hang
Tan, Yanchao
Pan, Shirui
Yang, Carl
Computation and Language
Recent advances in large language models (LLMs) have enabled promising progress in diagnosis prediction from electronic health records (EHRs). However, existing LLM-based approaches tend to overfit to historically observed diagnoses, often overlooking novel yet clinically important conditions that are critical for early intervention. To address this, we propose EviCare, an in-context reasoning framework that integrates deep model guidance into LLM-based diagnosis prediction. Rather than prompting LLMs directly with raw EHR inputs, EviCare performs (1) deep model inference for candidate selection, (2) evidential prioritization for set-based EHRs, and (3) relational evidence construction for novel diagnosis prediction. These signals are then composed into an adaptive in-context prompt to guide LLM reasoning in an accurate and interpretable manner. Extensive experiments on two real-world EHR benchmarks (MIMIC-III and MIMIC-IV) demonstrate that EviCare achieves significant performance gains, which consistently outperforms both LLM-only and deep model-only baselines by an average of 20.65\% across precision and accuracy metrics. The improvements are particularly notable in challenging novel diagnosis prediction, yielding average improvements of 30.97\%.
title EviCare: Enhancing Diagnosis Prediction with Deep Model-Guided Evidence for In-Context Reasoning
topic Computation and Language
url https://arxiv.org/abs/2604.10455