TRUMEDIQA: A Modular Trustworthy RAG Pipeline for Multilingual Medical Question Answering

Meryem El Fatimi, Ayoub Nainia, Jihad Zahir


Abstract
Medical question answering systems must balance usefulness with safety, particularly in low-resource linguistic settings where robustness is limited and hallucinations can cause harm. We present TRUMEDIQA, a reproducible multilingual medical QA pipeline for Moroccan Darija, Arabic, French, and English, deployed on WhatsApp with text and voice interactions. TRUMEDIQA uses layered decision-making: (i) language identification, (ii) a pre-retrieval intent router that maps queries to one of 38 clinical FAQ categories to constrain retrieval, and (iii) post-retrieval LLM-based re-ranking that selects the best candidate answer or returns a null decision to trigger a safe fallback (abstention). Answers are retrieved from a curated FAQ knowledge base validated by medical professionals. We evaluate TRUMEDIQA with 21 participants submitting 290 questions across four languages. An expert annotator labels each interaction as relevant, acceptable, or irrelevant, and we also measure correct abstentions when no suitable answer exists in the knowledge base. An ablation study shows that routing and re-ranking improve the weighted relevance score from 0.25 to 0.94 and precision from 0.53 to 0.98 versus a naïve retrieval baseline, while increasing correct abstention on unanswerable queries from 4.38% to 69.77%.
Anthology ID:
2026.clinicalnlp-1.6
Volume:
Proceedings of the 8th Workshop on Clinical Natural Language Processing (Clinical NLP) @ LREC 2026
Month:
May
Year:
2026
Address:
Palma, Mallorca (Spain)
Editors:
Asma Ben Abacha, Steven Bethard, Danielle Bitterman, Tristan Naumann, Kirk Roberts
Venues:
ClinicalNLP | WS
SIG:
Publisher:
ELRA Language Resources Association (ELRA)
Note:
Pages:
49–56
Language:
External URL:
https://lrec.elra.info/lrec2026-ws-clinicalnlp-06
DOI:
10.63317/4emkg4hncbzi
Bibkey:
Cite (ACL):
Meryem El Fatimi, Ayoub Nainia, and Jihad Zahir. 2026. TRUMEDIQA: A Modular Trustworthy RAG Pipeline for Multilingual Medical Question Answering. In Proceedings of the 8th Workshop on Clinical Natural Language Processing (Clinical NLP) @ LREC 2026, pages 49–56, Palma, Mallorca (Spain). ELRA Language Resources Association (ELRA).
Cite (Informal):
TRUMEDIQA: A Modular Trustworthy RAG Pipeline for Multilingual Medical Question Answering (El Fatimi et al., ClinicalNLP 2026)
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