arXiv subjects

Irbaz Bin Riaz

Publications and source records attributed to Irbaz Bin Riaz.

8 recordsLinked to original sources

arXiv2026

Answering clinicians' questions over trial evidence tables with verifiable, feedback-driven language models

Systematic reviews condense clinical trials into evidence tables, yet clinicians can interrogate these tables only through database queries, and many questions concern attributes that the table does not record, such as a drug's target class or a harmonised endpoint. Here we introduce FD-SCoPE, a language-model framework that answers both kinds of question, exposes the query, the selected trials and the derivation rule behind every answer, and learns from expert corrections. On an oncology evidence table of 159 immune checkpoint inhibitor trial records, FD-SCoPE completed all 140 clinician-style tasks (alternatives, 90.7-97.9%). For questions needing derived attributes it retrieved 99.3% of relevant trial records at a positive predictive value of 89.8% and outperformed four alternative approaches (derived-value F1 77.7% versus 64.8-73.4%). Corrections on 299 questions, simulated from reference answers, raised F1 on 1,201 unseen questions from 77.9% to 84.9%. Language models coupled with executable queries, verified programs and expert feedback can give clinicians auditable access to trial evidence.

cs.AI↗

arXiv2026

EviSearch: Trustworthy Extraction and Synthesis of Clinical Trial Evidence with Agents that Improve with Use

Structured extraction of evidence from clinical trial publications underpins systematic reviews and clinical guidelines, yet large language models are adopted for it only hesitantly: their outputs are difficult to verify, their use commonly requires transmitting documents to proprietary services, and they do not improve from the corrections their users make. We present EviSearch, a multi-agent system that addresses these three obstacles. Three tool-augmented agents with complementary access to a publication extract every column of an evidence table, and a value is admitted only after an attribution verifier has read it on its cited page, so that every value carries a page-level attribution. Disagreement between independent agents directs human review to the cells most likely to be wrong, and reviewer feedback refines the schema definitions and a curation knowledge base without updating model parameters. The agentic system runs entirely offline on open-weight models. On a clinician-annotated benchmark of randomized-trial publications, EviSearch attributes 100.0% of its values, reaches 91.70% accuracy autonomously, and reaches 95.22% after review of 15.6% of cells, exceeding random review of the strongest single agent at equal effort by 1.75 points.

cs.CL↗

arXiv2026

SentryLine: Evidence-Grounded Question Answering over Evolving Documents in Oncology Care

Oncology care operates at constant pressure of absorbing rapidly evolving evidence base in biomedicine. The American Society of Clinical Oncology (ASCO) addresses this through living guidelines, but the format introduces a new burden: any recommendation can change at any point, across multiple versioned documents. We present SENTRYLINE, a living guideline-aware clinical question answering system. SENTRYLINE retrieves guideline passages through a vectorless hierarchical RAG pipeline and returns a role-specific answer with inline citations, factual and temporal verification reports, and drift detection notes that surface when a guideline has been updated. We construct ASCOBENCH, a benchmark of 405 three-turn conversations across four question categories with gold answers from expert annotators(clinicians), and use test set to evaluate SENTRYLINE against five baselines under an LLM-as-judge framework. Experiments across three generation backbones show consistent improvements over four retrieval baselines and ASCO's guideline assistant, with particularly strong gains on Reasoning and Role-Specific questions where multi-hop synthesis and register adaptation are required

cs.CL↗

arXiv2026

Evaluating Physician-AI Interaction for Cancer Management: Paving the Path towards Precision Oncology

As machine learning (ML)-based decision support tools proliferate in clinical practice, understanding how clinicians integrate personalized ML predictions alongside randomized controlled trial (RCT) evidence is critical. We designed a web-based clinical decision support system (CDSS) presenting survival and adverse event data from a simulated RCT and ML model across 12 synthetic multiple myeloma scenarios. In a within- subjects study with 32 physicians, we evaluated how clinicians synthesize competing evidence sources to make treatment decisions. When ML and RCT outputs were concordant, physicians reported greater confidence than with RCT data alone. When results were discordant, most physicians shifted toward the ML-supported treatment, often before reviewing any information about model training or validation, suggesting a tendency toward automation bias rather than algorithm avoidance. Despite reporting higher perceived reliability after viewing model quality disclosures, physicians were largely unable to describe the validation procedures they had reviewed. Taken together, these findings reveal that clinicians may over-rely on ML recommendations even when equipped with tools designed to support critical appraisal. We discuss implications for CDSS design, clinician training, and the institutional safeguards needed before ML-based systems are deployed in high-stakes oncology settings.

cs.HC↗

arXiv2026

SCOPE:Planning for Hybrid Querying over Clinical Trial Data

We study clinical trial table reasoning, where answers are not directly stored in visible cells but must be reasoned from semantic understanding through normalization, classification, extraction, or lightweight domain reasoning. Motivated by the observation that current LLM approaches often suffer from "bad reasoning" under implicit planning assumptions, we focus on settings in which the model must recover implicit attributes such as therapy type, added agents, endpoint roles, or follow-up status from partially observed clinical-trial tables. We propose SCOPE (Structured Clinical hybrid Planning for Evidence retrieval in clinical trials), a multi-LLM planner-based framework that decomposes the task into row selection, structured planning, and execution. The planner makes the source field, reasoning rules, and output constraints explicit before answer generation, reducing ambiguity relative to direct prompting. We evaluate SCOPE on 1,500 hybrid reasoning questions over oncology clinical-trial tables against zero-shot, few-shot, chain-of-thought, TableGPT2, Blend-SQL, and EHRAgent. Results show that explicit multi-LLM planning improves accuracy for reasoning-based questions while offering a stronger accuracy-efficiency tradeoff than heavier agentic baselines. Our findings position clinical trial reasoning as a distinct table understanding problem and highlight hybrid planner-based decomposition as an effective solution

cs.CL↗

arXiv2026

FD-NL2SQL: Feedback-Driven Clinical NL2SQL that Improves with Use

Clinicians exploring oncology trial repositories often need ad-hoc, multi-constraint queries over biomarkers, endpoints, interventions, and time, yet writing SQL requires schema expertise. We demo FD-NL2SQL, a feedback-driven clinical NL2SQL assistant for SQLite-based oncology databases. Given a natural-language question, a schema-aware LLM decomposes it into predicate-level sub-questions, retrieves semantically similar expert-verified NL2SQL exemplars via sentence embeddings, and synthesizes executable SQL conditioned on the decomposition, retrieved exemplars, and schema, with post-processing validity checks. To improve with use, FD-NL2SQL incorporates two update signals: (i) clinician edits of generated SQL are approved and added to the exemplar bank; and (ii) lightweight logic-based SQL augmentation applies a single atomic mutation (e.g., operator or column change), retaining variants only if they return non-empty results. A second LLM generates the corresponding natural-language question and predicate decomposition for accepted variants, automatically expanding the exemplar bank without additional annotation. The demo interface exposes decomposition, retrieval, synthesis, and execution results to support interactive refinement and continuous improvement.

cs.CL↗

arXiv2025

Cognitive bias in LLM reasoning compromises interpretation of clinical oncology notes

Despite high performance on clinical benchmarks, large language models may reach correct conclusions through faulty reasoning, a failure mode with safety implications for oncology decision support that is not captured by accuracy-based evaluation. In this two-cohort retrospective study, we developed a hierarchical taxonomy of reasoning errors from GPT-4 chain-of-thought responses to real oncology notes and tested its clinical relevance. Using breast and pancreatic cancer notes from the CORAL dataset, we annotated 600 reasoning traces to define a three-tier taxonomy mapping computational failures to cognitive bias frameworks. We validated the taxonomy on 822 responses from prostate cancer consult notes spanning localized through metastatic disease, simulating extraction, analysis, and clinical recommendation tasks. Reasoning errors occurred in 23 percent of interpretations and dominated overall errors, with confirmation bias and anchoring bias most common. Reasoning failures were associated with guideline-discordant and potentially harmful recommendations, particularly in advanced disease management. Automated evaluators using state-of-the-art language models detected error presence but could not reliably classify subtypes. These findings show that large language models may provide fluent but clinically unsafe recommendations when reasoning is flawed. The taxonomy provides a generalizable framework for evaluating and improving reasoning fidelity before clinical deployment.

cs.CL↗

arXiv2025

Evaluating Medical LLMs by Levels of Autonomy: A Survey Moving from Benchmarks to Applications

Medical Large language models achieve strong scores on standard benchmarks; however, the transfer of those results to safe and reliable performance in clinical workflows remains a challenge. This survey reframes evaluation through a levels-of-autonomy lens (L0-L3), spanning informational tools, information transformation and aggregation, decision support, and supervised agents. We align existing benchmarks and metrics with the actions permitted at each level and their associated risks, making the evaluation targets explicit. This motivates a level-conditioned blueprint for selecting metrics, assembling evidence, and reporting claims, alongside directions that link evaluation to oversight. By centering autonomy, the survey moves the field beyond score-based claims toward credible, risk-aware evidence for real clinical use.

cs.CL↗