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arXiv 2603.23937cs.CLcs.LG
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对话到问题生成用于基于证据的医疗指南代理开发

Dialogue to Question Generation for Evidence-based Medical Guideline Agent Development

Google Research(谷歌研究);University of Toronto(多伦多大学);Vector Institute Canada(加拿大向量研究所);Emory University(埃默里大学)

Zongliang Ji, Ziyang Zhang, Xincheng Tan, Matthew Thompson, Anna Goldenberg, Carl Yang, Rahul G. Krishnan, Fan Zhang

AI总结:

本文探讨利用大语言模型生成基于证据的问题,以辅助医生在短时间内进行诊疗决策,通过两种提示策略评估模型效果,结果显示LLM能生成具有临床意义的问题,有助于减轻医生认知负担。

摘要:

基于循证医学(EBM)是高质量医疗护理的核心,但在快节奏的一线医疗环境中实施困难。医生面临短暂的咨询时间、患者数量增加和冗长的指南文档,难以实时查阅。为解决这一差距,我们研究了使用大语言模型(LLM)作为环境助手,在医生与患者互动中生成针对性、基于证据的问题的可行性。我们的研究聚焦于问题生成而非问答,旨在支撑医生推理并整合基于指南的实践进入简短咨询中。我们实现了两种提示策略,零样本基线和多阶段推理变体,使用Gemini 2.5作为基础模型。我们在包含80份去标识化临床互动转录文本的基准上进行了评估,六位经验丰富的医生贡献了超过90小时的结构化评审。结果显示,尽管通用LLM尚未完全可靠,但它们能够生成具有临床意义和指南相关性的问题,表明在诊疗点上使EBM更具操作性的巨大潜力。

英文摘要:

Evidence-based medicine (EBM) is central to high-quality care, but remains difficult to implement in fast-paced primary care settings. Physicians face short consultations, increasing patient loads, and lengthy guideline documents that are impractical to consult in real time. To address this gap, we investigate the feasibility of using large language models (LLMs) as ambient assistants that surface targeted, evidence-based questions during physician-patient encounters. Our study focuses on question generation rather than question answering, with the aim of scaffolding physician reasoning and integrating guideline-based practice into brief consultations. We implemented two prompting strategies, a zero-shot baseline and a multi-stage reasoning variant, using Gemini 2.5 as the backbone model. We evaluated on a benchmark of 80 de-identified transcripts from real clinical encounters, with six experienced physicians contributing over 90 hours of structured review. Results indicate that while general-purpose LLMs are not yet fully reliable, they can produce clinically meaningful and guideline-relevant questions, suggesting significant potential to reduce cognitive burden and make EBM more actionable at the point of care.

机构、总结、中文摘要均由AI分析而来,可能存在错误,请以论文正文为准。

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