Current medical retrieval-augmented generation (RAG) approaches overlook evidence-based medicine (EBM) principles, leading to two key gaps: (1) the lack of PICO alignment between queries and retrieved evidence, and (2) the absence of evidence hierarchy considerations during reranking. We present SR-RAG, an EBM-adapted GraphRAG framework that integrates the PICO framework into knowledge graph construction and retrieval, and proposes Bayesian Evidence Tier Reranking (BETR) to calibrate ranking scores by evidence grade without predefined weights. Validated in sports rehabilitation, we release a knowledge graph (357,844 nodes, 371,226 edges) and a benchmark of 1,637 QA pairs. SR-RAG achieves 0.812 evidence recall@10, 0.830 nugget coverage, 0.819 answer faithfulness, 0.882 semantic similarity, and 0.788 PICOT match accuracy, substantially outperforming five baselines. Five expert clinicians rated the system 4.66--4.84 on a 5-point Likert scale, and system rankings are preserved on a human-verified gold subset (n=80).
Large Language Models (LLMs) have demonstrated remarkable capabilities in modern medicine, yet their application in Traditional Chinese Medicine (TCM) remains severely limited by the absence of standardized benchmarks and the scarcity of high-quality training data. To address these challenges, we introduce TCM-Eval, the first dynamic and extensible benchmark for TCM, meticulously curated from national medical licensing examinations and validated by TCM experts. Furthermore, we construct a large-scale training corpus and propose Self-Iterative Chain-of-Thought Enhancement (SI-CoTE) to autonomously enrich question-answer pairs with validated reasoning chains through rejection sampling, establishing a virtuous cycle of data and model co-evolution. Using this enriched training data, we develop ZhiMingTang (ZMT), a state-of-the-art LLM specifically designed for TCM, which significantly exceeds the passing threshold for human practitioners. To encourage future research and development, we release a public leaderboard, fostering community engagement and continuous improvement.
Despite the success of large language models (LLMs) in various domains, their potential in Traditional Chinese Medicine (TCM) remains largely underexplored due to two critical barriers: (1) the scarcity of high-quality TCM data and (2) the inherently multimodal nature of TCM diagnostics, which involve looking, listening, smelling, and pulse-taking. These sensory-rich modalities are beyond the scope of conventional LLMs. To address these challenges, we present ShizhenGPT, the first multimodal LLM tailored for TCM. To overcome data scarcity, we curate the largest TCM dataset to date, comprising 100GB+ of text and 200GB+ of multimodal data, including 1.2M images, 200 hours of audio, and physiological signals. ShizhenGPT is pretrained and instruction-tuned to achieve deep TCM knowledge and multimodal reasoning. For evaluation, we collect recent national TCM qualification exams and build a visual benchmark for Medicinal Recognition and Visual Diagnosis. Experiments demonstrate that ShizhenGPT outperforms comparable-scale LLMs and competes with larger proprietary models. Moreover, it leads in TCM visual understanding among existing multimodal LLMs and demonstrates unified perception across modalities like sound, pulse, smell, and vision, paving the way toward holistic multimodal perception and diagnosis in TCM. Datasets, models, and code are publicly available. We hope this work will inspire further exploration in this field.
Mahmoud Alwakeel, Aditya Nagori, An-Kwok Ian Wong
et al.
Large Language Models have been tested on medical student-level questions, but their performance in specialized fields like Critical Care Medicine (CCM) is less explored. This study evaluated Meta-Llama 3.1 models (8B and 70B parameters) on 871 CCM questions. Llama3.1:70B outperformed 8B by 30%, with 60% average accuracy. Performance varied across domains, highest in Research (68.4%) and lowest in Renal (47.9%), highlighting the need for broader future work to improve models across various subspecialty domains.
Objective To develop an LLM based realtime compound diagnostic medical AI interface and performed a clinical trial comparing this interface and physicians for common internal medicine cases based on the United States Medical License Exam (USMLE) Step 2 Clinical Skill (CS) style exams. Methods A nonrandomized clinical trial was conducted on August 20, 2024. We recruited one general physician, two internal medicine residents (2nd and 3rd year), and five simulated patients. The clinical vignettes were adapted from the USMLE Step 2 CS style exams. We developed 10 representative internal medicine cases based on actual patients and included information available on initial diagnostic evaluation. Primary outcome was the accuracy of the first differential diagnosis. Repeatability was evaluated based on the proportion of agreement. Results The accuracy of the physicians' first differential diagnosis ranged from 50% to 70%, whereas the realtime compound diagnostic medical AI interface achieved an accuracy of 80%. The proportion of agreement for the first differential diagnosis was 0.7. The accuracy of the first and second differential diagnoses ranged from 70% to 90% for physicians, whereas the AI interface achieved an accuracy rate of 100%. The average time for the AI interface (557 sec) was 44.6% shorter than that of the physicians (1006 sec). The AI interface ($0.08) also reduced costs by 98.1% compared to the physicians' average ($4.2). Patient satisfaction scores ranged from 4.2 to 4.3 for care by physicians and were 3.9 for the AI interface Conclusion An LLM based realtime compound diagnostic medical AI interface demonstrated diagnostic accuracy and patient satisfaction comparable to those of a physician, while requiring less time and lower costs. These findings suggest that AI interfaces may have the potential to assist primary care consultations for common internal medicine cases.
Precision Medicine (PM) transforms the traditional "one-drug-fits-all" paradigm by customising treatments based on individual characteristics, and is an emerging topic for HCI research on digital health. A key element of PM, the Polygenic Risk Score (PRS), uses genetic data to predict an individual's disease risk. Despite its potential, PRS faces barriers to adoption, such as data inclusivity, psychological impact, and public trust. We conducted a mixed-methods study to explore how people perceive PRS, formed of surveys (n=254) and interviews (n=11) with UK-based participants. The interviews were supplemented by interactive storyboards with the ContraVision technique to provoke deeper reflection and discussion. We identified ten key barriers and five themes to PRS adoption and proposed design implications for a responsible PRS framework. To address the complexities of PRS and enhance broader PM practices, we introduce the term Human-Precision Medicine Interaction (HPMI), which integrates, adapts, and extends HCI approaches to better meet these challenges.