arXiv subjects

Tong Ruan

Publications and source records attributed to Tong Ruan.

At least 19 recordsLinked to original sources

arXiv2026

MedCalc-Pro: Solving Complex Medical Calculations with LLM Agents

Current benchmarks for evaluating large language models (LLMs) in medical calculation are largely based on simplified settings, where each patient case corresponds to a single calculator and the required tool is explicitly specified in the query. However, real clinical scenarios often require multiple calculators for joint evaluation, nested-scale calculation, and fuzzy queries that do not directly specify the target calculator. To this end, we propose a new medical calculation benchmark, MedCalc-Pro, which covers three progressively challenging task settings: single-calculator, multi-calculator, and nested-calculator calculation settings. MedCalc-Pro contains 2,268 real-world clinical cases, covering 77 medical calculators across 14 clinical departments. Meanwhile, to address the limited performance of existing frameworks and methods in complex clinical scenarios, we further propose a more generalizable agent framework that supports multi-tool selection and nested-tool calling, while suppressing parameter error propagation through structured validation and evidence review. We conduct systematic comparisons across open-source, closed-source, and medical-specialized LLMs, and the results show that our framework achieves the best performance across all three task settings. This work provides a new benchmark and method for evaluating and applying LLMs in challenging medical calculation scenarios.

cs.AI↗

arXiv2026

ClinicalMC: A Benchmark for Multi-Course Clinical Decision-Making with Large Language Models

Large language models (LLMs) have been widely adopted in healthcare, yet they still encounter significant challenges in complex clinical decision-making scenarios. Existing benchmarks primarily assess LLM performance in single-course settings and lack systematic evaluation in multi-course scenarios, where a patient's condition evolves over time. To address this gap, we propose ClinicalMC, a benchmark for multi-course clinical decision-making. It includes 1,275 Chinese and 5,804 English samples across four stages from admission to discharge. These stages cover triage, first-course examination/diagnosis/treatment, subsequent multi-course examination/assessment/treatment, and final diagnosis. In ClinicalMC, patients in the English dataset undergo an average of 5.11 clinical courses, whereas those in the Chinese dataset undergo 3.42. To assess LLM performance, we construct a multi-agent evaluation framework that includes patient, examiner, and doctor agents. Based on the benchmark and framework, we design two experimental settings -- a single-turn static setting and a multi-turn dynamic setting -- and assess three categories of LLMs: 1) closed-source LLMs like GPT5-mini; 2) open-source LLMs like DeepSeek-V3.2; and 3) medical LLMs like HuatuoGPT-o1. Through extensive evaluation, we aim to better understand LLM performance in the medical domain and support its effective deployment in healthcare.

cs.AI↗

arXiv2026

CAREAgent: Clinical Agent with Structured Reasoning and Tool-Integrated for Order Generation

Clinical order generation serves as a critical bridge between clinical decision-making and real-world practice, translating medical decisions into concrete and executable orders. Existing agents mainly focus on coarse-grained decisions and overlook the fine-grained, executable information required for clinical orders. To address this gap, we propose CAREAgent, an agent for clinical order generation. To support its training, we introduce a two-stage agentic reasoning data construction method. First, we design an agent framework that constructs verifiable reasoning trajectories aligned with realistic clinical tool usage. Second, we filter reasoning trajectories by format compliance, order validity, and clinical plausibility. Building on the constructed data, the model is first trained via supervised fine-tuning to acquire fundamental reasoning formats and medical knowledge, and is subsequently optimized through reinforcement learning with multi-dimensional reward functions to enhance complex clinical reasoning capabilities. Experiments on multiple benchmarks demonstrate the effectiveness of CAREAgent. On ClinicalBench (unseen during training), CAREAgent improves the F1 score by 5.05%, 2.09%, and 0.86% over the single-agent, multi-agent, and agentic reasoning methods, respectively.

cs.AI↗

arXiv2026

Psych\=eChat: An Empathic Framework Focused on Emotion Shift Tracking and Safety Risk Analysis in Psychological Counseling

Large language models (LLMs) have demonstrated notable advancements in psychological counseling. However, existing models generally do not explicitly model seekers' emotion shifts across counseling sessions, a core focus in classical psychological schools. Moreover, how to align counselor models' responses with these emotion shifts while proactively mitigating safety risks remains underexplored. To bridge these gaps, we propose Psych\=eChat, which explicitly integrates emotion shift tracking and safety risk analysis for psychological counseling. Specifically, we employ interactive role-playing to synthesize counselor--seeker dialogues, incorporating two modules: Emotion Management Module, to capture seekers' current emotions and emotion shifts; and Risk Control Module, to anticipate seekers' subsequent reactions and identify potential risks. Furthermore, we introduce two modeling paradigms. The Agent Mode structures emotion management, risk control, and counselor responses into a collaborative multi-agent pipeline. The LLM Mode integrates these stages into a unified chain-of-thought for end-to-end inference, balancing efficiency and performance. Extensive experiments, including interactive scoring, dialogue-level evaluation, and human assessment, demonstrate that Psych\=eChat outperforms existing methods for emotional insight and safety control.

cs.AI↗

arXiv2026

Rank4Gen: RAG-Preference-Aligned Document Set Selection and Ranking

In the RAG paradigm, document ranking determines the evidence available to downstream generators. Through controlled analysis, we identify two phenomena underexplored by existing rankers: (i) downstream response quality depends not only on relevance but also on the composition and ordering of selected documents, and (ii) such preferences differ systematically across generators. However, existing rankers are trained purely on query--document relevance, leaving both phenomena unmodeled. To close this gap, we construct \textbf{PRISM}, a bilingual preference-aligned dataset built through a four-stage pipeline that compresses the combinatorial subset-and-ordering space by roughly four orders of magnitude and produces response-quality preference supervision conditioned on seven downstream generators. On a 13k-query subset of PRISM, we train \textbf{Rank4Gen}, a generator-aware ranker that performs joint document set selection and ordering. Experiments on five challenging RAG benchmarks show that Rank4Gen improves downstream QA quality on most evaluated generators, with per-generator F1 gains of up to $+2.08$ over the strongest set-selection baseline. Code is available at https://github.com/JOHNNY-fans/Rank4Gen.

cs.IR↗

arXiv2025

TFRank: Think-Free Reasoning Enables Practical Pointwise LLM Ranking

Reasoning-intensive ranking models built on Large Language Models (LLMs) have made notable progress. However, existing approaches often rely on large-scale LLMs and explicit Chain-of-Thought (CoT) reasoning, resulting in high computational cost and latency that limit real-world use. To address this, we propose \textbf{TFRank}, an efficient pointwise reasoning ranker based on small-scale LLMs. To improve ranking performance, TFRank effectively integrates CoT data, fine-grained score supervision, and multi-task training. Furthermore, it achieves an efficient ``\textbf{T}hink-\textbf{F}ree" reasoning capability by employing a ``think-mode switch'' and pointwise format constraints. Specifically, this allows the model to leverage explicit reasoning during training while delivering precise relevance scores for complex queries at inference without generating any reasoning chains. Experiments show that TFRank achieves performance comparable to models with four times more parameters on the BRIGHT benchmark and demonstrates strong competitiveness on the BEIR benchmark. Further analysis shows that TFRank achieves an effective balance between performance and efficiency, providing a practical solution for integrating advanced reasoning into real-world systems. Our code and data are released in the repository: https://github.com/JOHNNY-fans/TFRank.

cs.IR↗

arXiv2025

KG-o1: Enhancing Multi-hop Question Answering in Large Language Models via Knowledge Graph Integration

Large Language Models (LLMs) face challenges in knowledge-intensive reasoning tasks like classic multi-hop question and answering, which involves reasoning across multiple facts. This difficulty arises because the chain of thoughts (CoTs) generated by LLMs in such tasks often deviate from real or a priori reasoning paths. In contrast, knowledge graphs (KGs) explicitly represent the logical connections between facts through entities and relationships. This reflects a significant gap. Meanwhile, large reasoning models (LRMs), such as o1, have demonstrated that long-step reasoning significantly enhances the performance of LLMs. Building on these insights, we propose KG-o1, a four-stage approach that integrates KGs to enhance the multi-hop reasoning abilities of LLMs. We first filter out initial entities and generate complex subgraphs. Secondly, we construct logical paths for subgraphs and then use knowledge graphs to build a dataset with a complex and extended brainstorming process, which trains LLMs to imitate long-term reasoning. Finally, we employ rejection sampling to generate a self-improving corpus for direct preference optimization (DPO), further refining the LLMs reasoning abilities. We conducted experiments on two simple and two complex datasets. The results show that KG-o1 models exhibit superior performance across all tasks compared to existing LRMs.

cs.CL↗

arXiv2025

I2CR: Intra- and Inter-modal Collaborative Reflections for Multimodal Entity Linking

Multimodal entity linking plays a crucial role in a wide range of applications. Recent advances in large language model-based methods have become the dominant paradigm for this task, effectively leveraging both textual and visual modalities to enhance performance. Despite their success, these methods still face two challenges, including unnecessary incorporation of image data in certain scenarios and the reliance only on a one-time extraction of visual features, which can undermine their effectiveness and accuracy. To address these challenges, we propose a novel LLM-based framework for the multimodal entity linking task, called Intra- and Inter-modal Collaborative Reflections. This framework prioritizes leveraging text information to address the task. When text alone is insufficient to link the correct entity through intra- and inter-modality evaluations, it employs a multi-round iterative strategy that integrates key visual clues from various aspects of the image to support reasoning and enhance matching accuracy. Extensive experiments on three widely used public datasets demonstrate that our framework consistently outperforms current state-of-the-art methods in the task, achieving improvements of 3.2%, 5.1%, and 1.6%, respectively. Our code is available at https://github.com/ziyan-xiaoyu/I2CR/.

cs.CV↗

arXiv2025

LCDS: A Logic-Controlled Discharge Summary Generation System Supporting Source Attribution and Expert Review

Despite the remarkable performance of Large Language Models (LLMs) in automated discharge summary generation, they still suffer from hallucination issues, such as generating inaccurate content or fabricating information without valid sources. In addition, electronic medical records (EMRs) typically consist of long-form data, making it challenging for LLMs to attribute the generated content to the sources. To address these challenges, we propose LCDS, a Logic-Controlled Discharge Summary generation system. LCDS constructs a source mapping table by calculating textual similarity between EMRs and discharge summaries to constrain the scope of summarized content. Moreover, LCDS incorporates a comprehensive set of logical rules, enabling it to generate more reliable silver discharge summaries tailored to different clinical fields. Furthermore, LCDS supports source attribution for generated content, allowing experts to efficiently review, provide feedback, and rectify errors. The resulting golden discharge summaries are subsequently recorded for incremental fine-tuning of LLMs. Our project and demo video are in the GitHub repository https://github.com/ycycyc02/LCDS.

cs.CL↗

arXiv2025

MinosEval: Distinguishing Factoid and Non-Factoid for Tailored Open-Ended QA Evaluation with LLMs

Open-ended question answering (QA) is a key task for evaluating the capabilities of large language models (LLMs). Compared to closed-ended QA, it demands longer answer statements, more nuanced reasoning processes, and diverse expressions, making refined and interpretable automatic evaluation both crucial and challenging. Traditional metrics like ROUGE and BERTScore struggle to capture semantic similarities due to different patterns between model responses and reference answers. Current LLM-based evaluation approaches, such as pairwise or listwise comparisons of candidate answers, lack intuitive interpretability. While pointwise scoring of each response provides some descriptions, it fails to adapt across different question contents. Most notably, existing methods overlook the distinction between factoid and non-factoid questions. To address these challenges, we propose \textbf{MinosEval}, a novel evaluation method that first distinguishes open-ended questions and then ranks candidate answers using different evaluation strategies. For factoid questions, it applies an adaptive key-point scoring strategy, while for non-factoid questions, it uses an instance-aware listwise ranking strategy. Experiments on multiple open-ended QA datasets, including self-built ones with more candidate responses to complement community resources, show that MinosEval better aligns with human annotations and offers more interpretable results.

cs.CL↗

arXiv2025

Can Multimodal Large Language Models Understand Spatial Relations?

Spatial relation reasoning is a crucial task for multimodal large language models (MLLMs) to understand the objective world. However, current benchmarks have issues like relying on bounding boxes, ignoring perspective substitutions, or allowing questions to be answered using only the model's prior knowledge without image understanding. To address these issues, we introduce SpatialMQA, a human-annotated spatial relation reasoning benchmark based on COCO2017, which enables MLLMs to focus more on understanding images in the objective world. To ensure data quality, we design a well-tailored annotation procedure, resulting in SpatialMQA consisting of 5,392 samples. Based on this benchmark, a series of closed- and open-source MLLMs are implemented and the results indicate that the current state-of-the-art MLLM achieves only 48.14% accuracy, far below the human-level accuracy of 98.40%. Extensive experimental analyses are also conducted, suggesting the future research directions. The benchmark and codes are available at https://github.com/ziyan-xiaoyu/SpatialMQA.git.

cs.CV↗

arXiv2025

CMQCIC-Bench: A Chinese Benchmark for Evaluating Large Language Models in Medical Quality Control Indicator Calculation

Medical quality control indicators are essential to assess the qualifications of healthcare institutions for medical services. With the impressive performance of large language models (LLMs) like GPT-4 in the medical field, leveraging these technologies for the Medical Quality Control Indicator Calculation (MQCIC) presents a promising approach. In this work, (1) we introduce a real-world task MQCIC and propose an open-source Chinese electronic medical records (EMRs)-based dataset (CMQCIC-Bench) comprising 785 instances and 76 indicators. (2) We propose a semi-automatic method to enhance the rule representation. Then we propose the Clinical Facts-based Inferential Rule (CF-IR) method that disentangles the clinical fact verification and inferential rule reasoning actions. (3) We conduct comprehensive experiments on 20 representative LLMs, covering general and medical models. Our findings reveal that CF-IR outperforms Chain-of-Thought methods in MQCIC tasks. (4) We conduct an error analysis and investigate the capabilities of clinical fact verification and inferential rule reasoning, providing insights to improve performance in the MQCIC further. The dataset and code is available in this repository https://github.com/YuY-2001/C-MQCIC.

cs.CL↗

arXiv2024

MSDiagnosis: A Benchmark for Evaluating Large Language Models in Multi-Step Clinical Diagnosis

Clinical diagnosis is critical in medical practice, typically requiring a continuous and evolving process that includes primary diagnosis, differential diagnosis, and final diagnosis. However, most existing clinical diagnostic tasks are single-step processes, which does not align with the complex multi-step diagnostic procedures found in real-world clinical settings. In this paper, we propose a Chinese clinical diagnostic benchmark, called MSDiagnosis. This benchmark consists of 2,225 cases from 12 departments, covering tasks such as primary diagnosis, differential diagnosis, and final diagnosis. Additionally, we propose a novel and effective framework. This framework combines forward inference, backward inference, reflection, and refinement, enabling the large language model to self-evaluate and adjust its diagnostic results. To this end, we test open-source models, closed-source models, and our proposed framework.The experimental results demonstrate the effectiveness of the proposed method. We also provide a comprehensive experimental analysis and suggest future research directions for this task.

cs.AI↗

arXiv2024

MedBench: A Comprehensive, Standardized, and Reliable Benchmarking System for Evaluating Chinese Medical Large Language Models

Ensuring the general efficacy and goodness for human beings from medical large language models (LLM) before real-world deployment is crucial. However, a widely accepted and accessible evaluation process for medical LLM, especially in the Chinese context, remains to be established. In this work, we introduce "MedBench", a comprehensive, standardized, and reliable benchmarking system for Chinese medical LLM. First, MedBench assembles the currently largest evaluation dataset (300,901 questions) to cover 43 clinical specialties and performs multi-facet evaluation on medical LLM. Second, MedBench provides a standardized and fully automatic cloud-based evaluation infrastructure, with physical separations for question and ground truth. Third, MedBench implements dynamic evaluation mechanisms to prevent shortcut learning and answer remembering. Applying MedBench to popular general and medical LLMs, we observe unbiased, reproducible evaluation results largely aligning with medical professionals' perspectives. This study establishes a significant foundation for preparing the practical applications of Chinese medical LLMs. MedBench is publicly accessible at https://medbench.opencompass.org.cn.

cs.CL↗

arXiv2024

MedOdyssey: A Medical Domain Benchmark for Long Context Evaluation Up to 200K Tokens

Numerous advanced Large Language Models (LLMs) now support context lengths up to 128K, and some extend to 200K. Some benchmarks in the generic domain have also followed up on evaluating long-context capabilities. In the medical domain, tasks are distinctive due to the unique contexts and need for domain expertise, necessitating further evaluation. However, despite the frequent presence of long texts in medical scenarios, evaluation benchmarks of long-context capabilities for LLMs in this field are still rare. In this paper, we propose MedOdyssey, the first medical long-context benchmark with seven length levels ranging from 4K to 200K tokens. MedOdyssey consists of two primary components: the medical-context "needles in a haystack" task and a series of tasks specific to medical applications, together comprising 10 datasets. The first component includes challenges such as counter-intuitive reasoning and novel (unknown) facts injection to mitigate knowledge leakage and data contamination of LLMs. The second component confronts the challenge of requiring professional medical expertise. Especially, we design the ``Maximum Identical Context'' principle to improve fairness by guaranteeing that different LLMs observe as many identical contexts as possible. Our experiment evaluates advanced proprietary and open-source LLMs tailored for processing long contexts and presents detailed performance analyses. This highlights that LLMs still face challenges and need for further research in this area. Our code and data are released in the repository: \url{https://github.com/JOHNNY-fans/MedOdyssey.}

cs.CL↗

arXiv2024

Medical Dialogue: A Survey of Categories, Methods, Evaluation and Challenges

This paper surveys and organizes research works on medical dialog systems, which is an important yet challenging task. Although these systems have been surveyed in the medical community from an application perspective, a systematic review from a rigorous technical perspective has to date remained noticeably absent. As a result, an overview of the categories, methods, and evaluation of medical dialogue systems remain limited and underspecified, hindering the further improvement of this area. To fill this gap, we investigate an initial pool of 325 papers from well-known computer science, and natural language processing conferences and journals, and make an overview. Recently, large language models have shown strong model capacity on downstream tasks, which also reshaped medical dialog systems' foundation. Despite the alluring practical application value, current medical dialogue systems still suffer from problems. To this end, this paper lists the grand challenges of medical dialog systems, especially of large language models.

cs.CL↗

arXiv2024

Tool Calling: Enhancing Medication Consultation via Retrieval-Augmented Large Language Models

Large-scale language models (LLMs) have achieved remarkable success across various language tasks but suffer from hallucinations and temporal misalignment. To mitigate these shortcomings, Retrieval-augmented generation (RAG) has been utilized to provide external knowledge to facilitate the answer generation. However, applying such models to the medical domain faces several challenges due to the lack of domain-specific knowledge and the intricacy of real-world scenarios. In this study, we explore LLMs with RAG framework for knowledge-intensive tasks in the medical field. To evaluate the capabilities of LLMs, we introduce MedicineQA, a multi-round dialogue benchmark that simulates the real-world medication consultation scenario and requires LLMs to answer with retrieved evidence from the medicine database. MedicineQA contains 300 multi-round question-answering pairs, each embedded within a detailed dialogue history, highlighting the challenge posed by this knowledge-intensive task to current LLMs. We further propose a new \textit{Distill-Retrieve-Read} framework instead of the previous \textit{Retrieve-then-Read}. Specifically, the distillation and retrieval process utilizes a tool calling mechanism to formulate search queries that emulate the keyword-based inquiries used by search engines. With experimental results, we show that our framework brings notable performance improvements and surpasses the previous counterparts in the evidence retrieval process in terms of evidence retrieval accuracy. This advancement sheds light on applying RAG to the medical domain.

cs.CL↗

arXiv2024

OpenMEDLab: An Open-source Platform for Multi-modality Foundation Models in Medicine

The emerging trend of advancing generalist artificial intelligence, such as GPTv4 and Gemini, has reshaped the landscape of research (academia and industry) in machine learning and many other research areas. However, domain-specific applications of such foundation models (e.g., in medicine) remain untouched or often at their very early stages. It will require an individual set of transfer learning and model adaptation techniques by further expanding and injecting these models with domain knowledge and data. The development of such technologies could be largely accelerated if the bundle of data, algorithms, and pre-trained foundation models were gathered together and open-sourced in an organized manner. In this work, we present OpenMEDLab, an open-source platform for multi-modality foundation models. It encapsulates not only solutions of pioneering attempts in prompting and fine-tuning large language and vision models for frontline clinical and bioinformatic applications but also building domain-specific foundation models with large-scale multi-modal medical data. Importantly, it opens access to a group of pre-trained foundation models for various medical image modalities, clinical text, protein engineering, etc. Inspiring and competitive results are also demonstrated for each collected approach and model in a variety of benchmarks for downstream tasks. We welcome researchers in the field of medical artificial intelligence to continuously contribute cutting-edge methods and models to OpenMEDLab, which can be accessed via https://github.com/openmedlab.

cs.CV↗