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.

Multimodal large language models (MLLMs) have substantially advanced mobile agents, yet proactive mobile assistance remains challenging because agents must decide When to intervene before determining How to assist. Existing systems often implement these two decisions within a unified MLLM-based pipeline, causing goal misalignment between conservative intervention filtering and comprehensive assistance generation, as well as redundant inference when the agent should remain silent. To address these limitations, we propose the **Pre-Reasoning Perception Framework (PRPF)**, a two-stage framework built on perceiving before reasoning. PRPF introduces a lightweight Multimodal Proactive Perceptor (MPP) for intervention gating and context compression, and activates the Proactive Agent Reasoner (PAR) only when intervention is warranted. Experiments on the ProactiveMobile benchmark show that PRPF substantially reduces false trigger rates (FTR) while improving success rates (SR) and inference efficiency over the ProactiveMobile baseline.

Medical diagnostics is a high-stakes and complex domain that is critical to patient care. However, current evaluations of large language models (LLMs) remain limited in capturing key challenges of clinical diagnostic scenarios. Most rely on benchmarks derived from public exams, raising contamination bias that can inflate performance, and they overlook the confounded nature of real consultations beyond textbook cases. Recent dynamic evaluations offer a promising alternative, but often remain insufficient for diagnosis-oriented benchmarking, with limited coverage of clinically grounded confounders and trustworthiness beyond accuracy. To address these gaps, we propose DyReMe, a dynamic benchmark for medical diagnostics that provides a controlled and scalable stress test of diagnostic robustness. Unlike static exam-style questions, DyReMe generates fresh, consultation-style cases that incorporate clinically grounded confounders, such as differential diagnoses and common misdiagnosis factors. It also varies expression styles to capture heterogeneous patient-style descriptions. Beyond accuracy, DyReMe evaluates LLMs on three additional clinically relevant dimensions: veracity, helpfulness, and consistency. Our experiments show that this dynamic approach yields more challenging assessments and exposes substantial weaknesses of stateof-the-art LLMs under clinically confounded diagnostic settings. These findings highlight the urgent need for evaluation frameworks that better assess trustworthy medical diagnostics under clinically grounded confounders.

Medical information retrieval (MIR) is vital for accessing knowledge from electronic health records, scientific literature, and medical databases, supporting applications such as medical education, patient queries, and clinical diagnosis. However, effective zero-shot dense retrieval in the medical domain remains difficult due to the scarcity of relevance-labeled data. To address this challenge, we propose Self-Learning Hypothetical Document Embeddings (SL-HyDE), a framework that leverages large language models (LLMs) to generate hypothetical documents conditioned on a query. These documents encapsulate essential medical context, guiding dense retrievers toward the most relevant results. SL-HyDE further employs a self-learning mechanism that iteratively improves pseudo-document generation and retrieval using unlabeled corpora, eliminating the need for labeled data. In addition, we introduce the Chinese Medical Information Retrieval Benchmark (CMIRB), a comprehensive evaluation suite reflecting real-world medical scenarios, comprising five tasks and ten datasets. By benchmarking ten models on CMIRB, we provide a rigorous standard for evaluating MIR systems. Experimental results demonstrate that SL-HyDE significantly outperforms HyDE in retrieval accuracy, while exhibiting strong generalization and scalability across diverse LLM and retriever configurations. Our code and data are publicly available at: https://github.com/ll0ruc/AutoMIR.