GUIDE: Computationally Augmented Consensus for Trustworthy Clinical Practice Guidelines

Yuanfan Lin; Jie Di; Xujin He; Zhenzhe Lin; Jialing Chen; Ruiyang Li; Changyu Zheng; Yuanrui Shang; Weiqin Peng; Jingxi Qin; Xiong Wang; Dongxin Ye; Yining Huang; Guoqiang Li; Andi Xu; Sijia Yu; Ruixin Wang; Yahan Yang; Xiaohang Wu; Duoru Lin; Jingjing Chen; Zhenzhen Liu; Wenben Chen; Haotian Lin

arXiv · 2610.16108

GUIDE: Computationally Augmented Consensus for Trustworthy Clinical Practice Guidelines

View original source ↗Read source document ↗Export metadata ↓

Abstract

Maintaining up-to-date clinical practice guidelines (CPGs) is essential for evidence-based medicine, but rapid evidence growth and complex expert consensus formation limit timely updates. We developed GUIDE, a multi-agent copilot system for human-AI collaborative guideline generation and updating. GUIDE delegates labor-intensive tasks to specialized AI agents while preserving expert judgment and final arbitration. In 12 NICE ophthalmology datasets, GUIDE achieved 88.85% literature recall, 86.06% alignment in certainty-of-evidence ratings, and 91.67% recommendation agreement, requiring 162.17 minutes per dataset on average (28.68% human intervention). Performance remained stable across 20 additional datasets from cardiology, endocrinology, gastroenterology, and respiratory medicine. Ablation analysis showed that removing expert intervention reduced performance in judgment-intensive steps such as Risk-of-Bias assessment. In six post-cutoff datasets, GUIDE maintained robust end-to-end performance on unseen evidence. Prospective real-world validation showed that GUIDE reduced expert workload and produced more clinically acceptable recommendations than the original decade-old guideline (mean score, 3.73 vs. 1.53; agreement, 66.7% vs. 13.3%), with outcomes comparable to human-only updating (P = 0.588) but substantially less time and effort. GUIDE offers a practical framework for timely, trustworthy, expert-centric guideline development and validates computationally augmented consensus.

Explore related subjects

cs.AI cs.CL cs.HC cs.MA

Keep this discovery

Explore connections, maps & timelines

BibTeX RIS

Yuanfan Lin, Jie Di, Xujin He, Zhenzhe Lin, Jialing Chen, Ruiyang Li, Changyu Zheng, Yuanrui Shang, Weiqin Peng, Jingxi Qin, Xiong Wang, Dongxin Ye, Yining Huang, Guoqiang Li, Andi Xu, Sijia Yu, Ruixin Wang, Yahan Yang, Xiaohang Wu, Duoru Lin, Jingjing Chen, Zhenzhen Liu, Wenben Chen, Haotian Lin. 2026-10-12. GUIDE: Computationally Augmented Consensus for Trustworthy Clinical Practice Guidelines. https://arxiv.org/abs/2610.16108

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

arXiv2026

Agent-Environment Alignment via Automated Interface Generation

Large language model (LLM) agents have shown impressive reasoning capabilities in interactive decision-making tasks. These agents interact with environment through intermediate interfaces, such as predefined action spaces and interaction rules, which mediate the perception and action. However, mismatches often happen between the internal expectations of the agent regarding the influence of its issued actions and the actual state transitions in the environment, a phenomenon referred to as \textbf{agent-environment misalignment}. While prior work has invested substantially in improving agent strategies and environment design, the critical role of the interface still remains underexplored. In this work, we empirically demonstrate that agent-environment misalignment poses a significant bottleneck to agent performance. To mitigate this issue, we propose \textbf{ALIGN}, an \underline{A}uto-A\underline{l}igned \underline{I}nterface \underline{G}e\underline{n}eration framework that alleviates the misalignment by enriching the interface. Specifically, the ALIGN-generated interface enhances both the static information of the environment and the step-wise observations returned to the agent. Implemented as a lightweight wrapper, this interface achieves the alignment without modifying either the agent logic or the environment code. Experiments across multiple domains including embodied tasks, web navigation and tool-use, show consistent performance improvements, with up to a 45.67\% success rate improvement observed in ALFWorld. Meanwhile, ALIGN-generated interface can generalize across different agent architectures and LLM backbones without interface regeneration. Code and experimental results are available at https://github.com/THUNLP-MT/ALIGN.

cs.AI↗

arXiv2026

ROI-Reasoning: Rational Optimization for Inference via Pre-Computation Meta-Cognition

Large language models (LLMs) can achieve strong reasoning performance with sufficient computation, but they do not inherently know how much computation a task requires. We study budgeted inference-time reasoning for multiple problems under a strict global token constraint and formulate it as an Ordered Stochastic Multiple-Choice Knapsack Problem (OS-MCKP). This perspective highlights a meta-cognitive requirement---anticipating problem difficulty and allocating computation strategically. We propose ROI-Reasoning, a two-stage framework that endows LLMs with intrinsic, budget-aware rationality. First, Meta-Cognitive Fine-Tuning teaches models to predict reasoning cost levels and decide whether a problem is worth attempting before generation. Next, Rationality-Aware Reinforcement Learning optimizes sequential decision making under a hard token budget, allowing models to learn long-horizon allocation strategies. Experiments across mathematical reasoning, multiple-choice question answering, and code generation show that ROI-Reasoning improves scores and generally reduces reference-order regret under tight budgets, with up to a \textbf{417\%} relative score improvement over the strongest same-backbone baseline in mathematics.

cs.AI↗

arXiv2026

ReCreate: Reasoning and Creating Domain Agents Driven by Experience

Large Language Model (LLM) agents are reshaping the industrial landscape. However, most practical agents still rely on human-designed scaffolds, making their creation and adaptation across diverse domains labor-intensive. This situation poses a central question: can we automatically create and evolve domain agents through interaction experience in real-world environments? While recent approaches have sought to automate agent creation, several treat scaffold optimization as a black-box procedure guided primarily by final performance metrics. Such strategies overlook critical evidence explaining why an agent succeeds or fails and often incur high computational costs. To address these limitations, we propose ReCreate, an experience-driven framework for creating and evolving specialized domain agents. ReCreate systematically leverages agent interaction histories to identify the causes of success and failure and guide targeted scaffold updates. Specifically, we introduce an agent-as-optimizer paradigm in which an optimizer agent actively inspects execution experience and iteratively refines the task agent's scaffold through three key components: (i) an experience storage and retrieval mechanism for on-demand evidence inspection; (ii) a reasoning-creating synergy pipeline that translates execution evidence into updates to prompts, workflows, tools, and memory; and (iii) hierarchical updates that consolidate instance-level refinements into reusable domain-level improvements. Experiments across thirteen evaluation settings spanning four domains show that ReCreate consistently outperforms human-designed agents and existing automated agent generation and self-evolving baselines, even when evolving from minimal seed scaffolds.

cs.AI↗