R2MED: A Benchmark for Reasoning-Driven Medical Retrieval

Xiangxu Zhang, Lei Li, Zheng Liu, Xiao Zhou


Abstract
Current medical retrieval benchmarks primarily emphasize lexical or shallow semantic similarity, overlooking the reasoning-intensive demands that are central to clinical decision-making. In practice, physicians often retrieve authoritative medical evidence to support diagnostic hypotheses. Such evidence typically aligns with an inferred diagnosis rather than the surface form of a patient’s symptoms, leading to low lexical or semantic overlap between queries and relevant documents. To address this gap, we introduce R2MED, the first benchmark explicitly designed for reasoning-driven medical retrieval. It comprises 876 queries spanning three tasks: Q A reference retrieval, clinical evidence retrieval, and clinical case retrieval. These tasks are drawn from five representative medical scenarios and twelve body systems, capturing the complexity and diversity of real-world medical information needs. We evaluate 15 widely-used retrieval systems on R2MED and find that even the best model achieves only 31.4 nDCG@10, demonstrating the benchmark’s difficulty. Classical re-ranking and generation-augmented retrieval methods offer only modest improvements. Although large reasoning models improve performance via intermediate inference generation, the best results still peak at 41.4 nDCG@10. These findings underscore a substantial gap between current retrieval techniques and the reasoning demands of real clinical tasks. We release R2MED as a challenging benchmark to foster the development of next-generation medical retrieval systems with enhanced reasoning capabilities.
Anthology ID:
2026.emnlp-main.2138
Volume:
Proceedings of the 2026 Conference on Empirical Methods in Natural Language Processing
Month:
October
Year:
2026
Address:
Budapest, Hungary
Editors:
Hung-Yi Lee, Sunipa Dev, Jessy Li, Desmond Elliott
Venue:
EMNLP
SIG:
SIGDAT
Publisher:
Association for Computational Linguistics
Note:
Pages:
48600–48637
Language:
URL:
https://aclanthology.org/2026.emnlp-main.2138/
DOI:
Bibkey:
Cite (ACL):
Xiangxu Zhang, Lei Li, Zheng Liu, and Xiao Zhou. 2026. R2MED: A Benchmark for Reasoning-Driven Medical Retrieval. In Proceedings of the 2026 Conference on Empirical Methods in Natural Language Processing, pages 48600–48637, Budapest, Hungary. Association for Computational Linguistics.
Cite (Informal):
R2MED: A Benchmark for Reasoning-Driven Medical Retrieval (Zhang et al., EMNLP 2026)
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PDF:
https://aclanthology.org/2026.emnlp-main.2138.pdf