This study focuses on evaluating proactive communication and diagnostic capabilities of medical Large Language Models (LLMs), which directly impact their effectiveness in patient consultations. In typical medical scenarios, doctors often ask a set of questions to gain a comprehensive understanding of patients’ conditions. We argue that single-turn question-answering tasks such as MultiMedQA are insufficient for evaluating LLMs’ medical consultation abilities. To address this limitation, we developed an evaluation benchmark called Multi-turn Medical Dialogue Evaluation (MMD-Eval), specifically designed to evaluate the proactive communication and diagnostic capabilities of medical LLMs during consultations. Considering the high cost and potential for hallucinations in LLMs, we innovatively trained a task-oriented dialogue system to simulate patients engaging in dialogues with the medical LLMs using our structured medical records dataset. This approach enabled us to generate multi-turn dialogue data. Subsequently, we evaluate the communication skills and medical expertise of the medical LLMs. All resources associated with this study will be made publicly available.

Biomedical Terminology Normalization aims to identify the standard term in a specified termbase for non-standardized mentions from social media or clinical texts, employing the mainstream “Recall and Re-rank” framework. Instead of the traditional pretraining-finetuning paradigm, we would like to explore the possibility of accomplishing this task through a tuning-free paradigm using powerful Large Language Models (LLMs), hoping to address the costs of re-training due to discrepancies of both standard termbases and annotation protocols. Another major obstacle in this task is that both mentions and terms are short texts. Short texts contain an insufficient amount of information that can introduce ambiguity, especially in a biomedical context. Therefore, besides using the advanced embedding model, we implement a Retrieval-Augmented Generation (RAG) based knowledge card generation module. This module introduces an LLM agent that expands the short texts into accurate, harmonized, and more informative descriptions using a search engine and a domain knowledge base. Furthermore, we present an innovative tuning-free agent collaboration framework for the biomedical terminology normalization task in social media. By leveraging the internal knowledge and the reasoning capabilities of LLM, our framework conducts more sophisticated recall, ranking and re-ranking processes with the collaboration of different LLM agents. Experimental results across multiple datasets indicate that our approach exhibits competitive performance. We release our code and data on the github repository JOHNNY-fans/RankNorm.

The Clinical Terminology Normalization aims at finding standard terms from a given termbase for mentions extracted from clinical texts. However, we found that extracted mentions suffer from the multi-implication problem, especially disease diagnoses. The reason for this is that physicians often use abbreviations, conjunctions, and juxtapositions when writing diagnoses, and it is difficult to manually decompose. To address this problem, we propose a Terminology Component Recognition and Reconstruction strategy that leverages the reasoning capability of large language models (LLMs) to recognize the components of terms, enabling automated decomposition and transforming original mentions into multiple atomic mentions. Furthermore, we adopt the mainstream “Recall and Rank” framework to apply the benefits of the above strategy to the task flow. By leveraging the LLM incorporating the advanced sampling strategies, we design a sampling algorithm for atomic mentions and train the recall model using contrastive learning. Besides the information about the components is also used as knowledge to guide the final term ranking and selection. The experimental results show that our proposed strategy effectively improves the performance of the terminology normalization task and our proposed approach achieves state-of-the-art on the experimental dataset. We release our code and data on the repository https://github.com/yuugaochyan/RRNorm.

Most medical dialogue systems assume that patients have clear goals (seeking a diagnosis, medicine querying, etc.) before medical consultation. However, in many real situations, due to the lack of medical knowledge, it is usually difficult for patients to determine clear goals with all necessary slots. In this paper, we identify this challenge as how to construct medical consultation dialogue systems to help patients clarify their goals. For further study, we create a novel human-to-human mixed-type medical consultation dialogue corpus, termed MidMed, covering four dialogue types: task-oriented dialogue for diagnosis, recommendation, QA, and chitchat. MidMed covers four departments (otorhinolaryngology, ophthalmology, skin, and digestive system), with 8,309 dialogues. Furthermore, we build benchmarking baselines on MidMed and propose an instruction-guiding medical dialogue generation framework, termed InsMed, to handle mixed-type dialogues. Experimental results show the effectiveness of InsMed.