In the past decade a surge in the amount of electronic health record (EHR) data in the United States, attributed to a favorable policy environment created by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 and the 21st Century Cures Act of 2016. Clinical notes for patients' assessments, diagnoses, and treatments are captured in these EHRs in free-form text by physicians, who spend a considerable amount of time entering and editing them. Manually writing clinical notes takes a considerable amount of a doctor's valuable time, increasing the patient's waiting time and possibly delaying diagnoses. Large language models (LLMs) possess the ability to generate news articles that closely resemble human-written ones. We investigate the usage of Chain-of-Thought (CoT) prompt engineering to improve the LLM's response in clinical note generation. In our prompts, we use as input International Classification of Diseases (ICD) codes and basic patient information. We investigate a strategy that combines the traditional CoT with semantic search results to improve the quality of generated clinical notes. Additionally, we infuse a knowledge graph (KG) built from clinical ontology to further enrich the domain-specific knowledge of generated clinical notes. We test our prompting technique on six clinical cases from the CodiEsp test dataset using GPT-4 and our results show that it outperformed the clinical notes generated by standard one-shot prompts.

Drug recommendation (DR) systems aim to support healthcare professionals in selecting appropriate medications based on patients' medical conditions. State-of-the-art approaches utilize deep learning techniques for improving DR, but fall short in providing any insights on the derivation process of recommendations -- a critical limitation in such high-stake applications. We propose TraceDR, a novel DR system operating over a medical knowledge graph (MKG), which ensures access to large-scale and high-quality information. TraceDR simultaneously predicts drug recommendations and related evidence within a multi-task learning framework, enabling traceability of medication recommendations. For covering a more diverse set of diseases and drugs than existing works, we devise a framework for automatically constructing patient health records and release DrugRec, a new large-scale testbed for DR.

An effective physician should possess a combination of empathy, expertise, patience, and clear communication when treating a patient. Recent advances have successfully endowed AI doctors with expert diagnostic skills, particularly the ability to actively seek information through inquiry. However, other essential qualities of a good doctor remain overlooked. It features 3,000 realistically simulated patient agents that exhibit diverse linguistic patterns, cognitive limitations, emotional responses, and tendencies for passive disclosure. We also introduce a multi-faceted evaluation framework, covering task success, inquiry proficiency, dialogue competence, inquiry efficiency, and patient experience. Experiments on different LLMs reveal substantial challenges across the evaluation aspects. Even state-of-the-art models show significant room for improvement in their inquiry capabilities. These models are highly sensitive to variations in realistic patient behavior, which considerably impacts diagnostic accuracy. Furthermore, our fine-grained metrics expose trade-offs between different evaluation perspectives, highlighting the challenge of balancing performance and practicality in real-world clinical settings.Figure 1: Comparison between MAQ E enables more realistic patient simulation by integrating diverse behaviors and evaluates doctor inquiries from more comprehensive and fine-grained perspectives. A medical career is among the most demanding professions to master. A physician's role extends far beyond treating diseases; it also involves employing nuanced conversational skills to understand a patient's condition and guide them through moments of vulnerability. Current Large Language Models (LLMs) have reached the initial stage of this journey by grasping extensive medical knowledge and expertise in clinical examinations (Nori et al., 2023; Wang et al., 2023; Saab et al., 2024; Singhal et al., 2025; Dou et al., 2025). However, their passive, response-driven nature (Li et al., 2024)--an inherent tendency to answer user queries directly rather than to engage in goal-oriented dialogue--limits their practical utility. This shortcoming is particularly critical in clinical consultation, the focus of this work, where an LLM must proactively converse with patients to gather information through thoughtful and compassionate inquiry. Existing studies (Liao et al., 2023; Li et al., 2024; Schmidgall et al., 2024; Nori et al., 2025) have proposed several benchmarks to evaluate the inquiry capabilities of LLMs. A prevalent method is to develop a virtual interaction environment in which a patient is simulated by an LLM based on a synthesized profile.

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In clinical practice, physicians refrain from making decisions when patient information is insufficient. This behavior, known as abstention, is a critical safety mechanism preventing potentially harmful misdiagnoses. Recent investigations have reported the application of large language models (LLMs) in medical scenarios. However, existing LLMs struggle with the abstentions, frequently providing overconfident responses despite incomplete information. This limitation stems from conventional abstention methods relying solely on model self-assessments, which lack systematic strategies to identify knowledge boundaries with external medical evidences. To address this, we propose \textbf{KnowGuard}, a novel \textit{investigate-before-abstain} paradigm that integrates systematic knowledge graph exploration for clinical decision-making. Our approach consists of two key stages operating on a shared contextualized evidence pool: 1) an evidence discovery stage that systematically explores the medical knowledge space through graph expansion and direct retrieval, and 2) an evidence evaluation stage that ranks evidence using multiple factors to adapt exploration based on patient context and conversation history. This two-stage approach enables systematic knowledge graph exploration, allowing models to trace structured reasoning paths and recognize insufficient medical evidence. We evaluate our abstention approach using open-ended multi-round clinical benchmarks that mimic realistic diagnostic scenarios, assessing abstention quality through accuracy-efficiency trade-offs beyond existing closed-form evaluations. Experimental evidences clearly demonstrate that KnowGuard outperforms state-of-the-art abstention approaches, improving diagnostic accuracy by 3.93\% while reducing unnecessary interaction by 7.27 turns on average.

Interactive medical questioning is essential in real-world clinical consultations, where physicians must actively gather information from patients. While medical Large Language Models (LLMs) have shown impressive capabilities in static medical question answering, they predominantly operate under a reactive paradigm: generating answers directly without seeking additional information, which risks incorrect diagnoses in such interactive settings. To address this limitation, we propose ProMed, a reinforcement learning (RL) framework that transitions medical LLMs toward a proactive paradigm, equipping them with the ability to ask clinically valuable questions before decision-making. At the core of ProMed is the Shapley Information Gain (SIG) reward, which quantifies the clinical utility of each question by combining the amount of newly acquired information with its contextual importance, estimated via Shapley values. We integrate SIG into a two-stage training pipeline: (1) SIG-Guided Model Initialization uses Monte Carlo Tree Search (MCTS) to construct high-reward interaction trajectories to supervise the model, and (2) SIG-Augmented Policy Optimization, which integrates SIG and enhances RL with a novel SIG-guided Reward Distribution Mechanism that assigns higher rewards to informative questions for targeted optimization. Extensive experiments on two newly curated partial-information medical benchmarks demonstrate that ProMed significantly outperforms state-of-the-art methods by an average of 6.29% and delivers a 54.45% gain over the reactive paradigm, while also generalizing robustly to out-of-domain cases.

The rise of Large Language Models (LLMs) has enabled the development of specialized AI agents with domain-specific reasoning and interaction capabilities, particularly in healthcare. While recent frameworks simulate medical decision-making, they largely focus on single-turn tasks where a doctor agent receives full case information upfront -- diverging from the real-world diagnostic process, which is inherently uncertain, interactive, and iterative. In this paper, we introduce MIMIC-Patient, a structured dataset built from the MIMIC-III electronic health records (EHRs), designed to support dynamic, patient-level simulations. Building on this, we propose DynamiCare, a novel dynamic multi-agent framework that models clinical diagnosis as a multi-round, interactive loop, where a team of specialist agents iteratively queries the patient system, integrates new information, and dynamically adapts its composition and strategy. We demonstrate the feasibility and effectiveness of DynamiCare through extensive experiments, establishing the first benchmark for dynamic clinical decision-making with LLM-powered agents.

Despite the remarkable progress of deep-learning methods generating a target vital sign waveform from a source vital sign waveform, most existing models are designed exclusively for a specific source-to-target pair. This requires distinct model architectures, optimization procedures, and pre-processing pipelines, resulting in multiple models that hinder usability in clinical settings. To address this limitation, we propose the Multi-Directional Vital-Sign Converter (MD-ViSCo), a unified framework capable of generating any target waveform such as electrocardiogram (ECG), photoplethysmogram (PPG), or arterial blood pressure (ABP) from any single input waveform with a single model. MD-ViSCo employs a shallow 1-Dimensional U-Net integrated with a Swin Transformer that leverages Adaptive Instance Normalization (AdaIN) to capture distinct waveform styles. To evaluate the efficacy of MD-ViSCo, we conduct multi-directional waveform generation on two publicly available datasets. Our framework surpasses state-of-the-art baselines (NabNet & PPG2ABP) on average across all waveform types, lowering Mean absolute error (MAE) by 8.8% and improving Pearson correlation (PC) by 4.9% over two datasets. In addition, the generated ABP waveforms satisfy the Association for the Advancement of Medical Instrumentation (AAMI) criterion and achieve Grade B on the British Hypertension Society (BHS) standard, outperforming all baselines. By eliminating the need for developing a distinct model for each task, we believe that this work offers a unified framework that can deal with any kind of vital sign waveforms with a single model in healthcare monitoring.

Cardiovascular disease (CVD) risk prediction models are essential for identifying high-risk individuals and guiding preventive actions. However, existing models struggle with the challenges of real-world clinical practice as they oversimplify patient profiles, rely on rigid input schemas, and are sensitive to distribution shifts. We developed AdaCVD, an adaptable CVD risk prediction framework built on large language models extensively fine-tuned on over half a million participants from the UK Biobank. In benchmark comparisons, AdaCVD surpasses established risk scores and standard machine learning approaches, achieving state-of-the-art performance. Crucially, for the first time, it addresses key clinical challenges across three dimensions: it flexibly incorporates comprehensive yet variable patient information; it seamlessly integrates both structured data and unstructured text; and it rapidly adapts to new patient populations using minimal additional data. In stratified analyses, it demonstrates robust performance across demographic, socioeconomic, and clinical subgroups, including underrepresented cohorts. AdaCVD offers a promising path toward more flexible, AI-driven clinical decision support tools suited to the realities of heterogeneous and dynamic healthcare environments.