From Uncertainty to Clinical Risk: Severity-Aware Conformal Planning for Interactive Medical Diagnosis

Interactive medical diagnosis dynamically acquires patient information through multiple rounds of questioning, supporting accurate, efficient, and safe clinical decisions under incomplete evidence. Existing methods commonly guide information acquisition with predictive uncertainty or label ambiguity, but overlook the asymmetric clinical risk of missing severe diseases and lack unified long-horizon planning over whether to continue asking questions or commit to a diagnosis. To address these limitations, we propose Severity-Aware Conformal Clinical Planning, which formulates interactive diagnosis as a risk-sensitive sequential decision problem. The framework maintains complementary diagnostic, safety, and masked-evidence beliefs; calibrates turn-specific diagnostic prediction sets and severity-weighted differential-diagnosis risk on held-out diagnostic trajectories; and introduces the calibrated clinical risk into Monte Carlo Tree Search to jointly evaluate long-horizon Ask and Commit trajectories. Experiments on DDXPlus and MediQ show that our method achieves more accurate diagnoses with fewer questions across multiple large language models, while improving differential-diagnosis quality and reducing high-risk errors in severe cases. These findings validate the value of using clinical risk, rather than predictive uncertainty alone, as a planning signal and demonstrate the effectiveness of the proposed framework for information acquisition and risk-aware diagnostic decision making. They also motivate future work on clinical-risk-oriented interactive diagnosis and information-acquisition methods.

From Triage to Discharge: A Survey of NLP Tasks, Methods, and Open Challenges in the Emergency Department

Emergency departments (EDs) operate under time pressure, generating multimodal data such as clinical conversations, triage notes, and discharge documents. Recent advances in natural language processing (NLP), particularly pretrained transformers and large language models, have created new opportunities to support language and time-intensive stages of emergency care. Yet existing surveys map clinical NLP across the broader hospital workflow or focus on specific tasks. This survey analyses 46 papers spanning the three phases of ED: triage, diagnosis, and disposition, covering tasks such as triage classification, clinical summarisation, automatic diagnosis, report generation, and discharge documentation. We examine modelling paradigms, evaluation practices, and emerging benchmarks and shared tasks. Across tasks, we identify common trends, including a shift from task-specific neural architectures to pretrained language models, growing interest in interactive clinical systems, and increasing attention to clinically grounded evaluation. Finally, we detail open challenges such as limited generalisability, noisy clinical inputs, and workflow constraints that inform future ED-NLP research.

A Neurosymbolic Approach for Constructing Planning Domain Models from Clinical Narratives

Surgical procedures such as laparoscopic appendectomy are complex, high-stakes processes, yet formalizing their workflows for decision support remains a significant challenge. Inducing probabilistic planning domain models in this setting is particularly difficult due to the lack of structured event data and the prevalence of implicit actions in clinical narratives, which neither empirical symbolic methods nor Large Language Models (LLMs) can adequately address on their own. We introduce NSPIN, a neurosymbolic framework for inducing probabilistic planning domain models from unstructured clinical narratives. Our method extracts and imputes structured event sequences from raw text using a pretrained LLM, then induces a PPDDL model and refines its preconditions with LLM-proposed revisions, guided by empirical validation. We evaluate the approach on 2,660 laparoscopic appendectomy notes written by 9 surgeons. NSPIN yields models that generalize to unseen notes, and expert clinical review indicates its induced knowledge is largely consistent with surgical practice.

H2: A Dual Hybrid Semantic Data Lake Architecture for Medical Data Harmonization with Human-In-the-Loop verified, LLM Driven Metadata Annotation System

Medical data, by its nature, exhibit a high degree of heterogeneity on multiple levels ranging from (a) different modalities like images, text and time series, (b) diverse tabular schemata introduced by institutions and (c) completely unstructured textual information data provided by healthcare professionals. Data lakes are often used in medical data storage to consolidate all heterogeneous diverse data in a single, central location, where it can be saved "as is", without the need to impose a schema like a data warehouse does. Despite their flexibility, though, data lakes are notorious for the "data swamp" failure. Thus, providing a reliable data harmonization mechanism through metadata, without compromising integrity or flexibility, is a real challenge. To this end, knowledge graphs have attracted attention since they provide a dynamic way to depict relationships without a rigid schema-on-write approach. Additionally, another rigorous task relies on the interoperability of data: application of appropriate ML techniques on such a diverse nature of data is not an easy task, as a domain expert must decide the efficacy of a method to a specific data type or dataset. Metadata annotation can aid by tagging applicable operations, however this requires manual intervention, not to mention the plethora of existing datasets which lack such information. To tackle both challenges, in this paper, we propose a semantic data lake architecture that promotes data harmonization and incorporates a generative annotation process (i.e. LLMs) of non-labeled metadata collections to support the application of meaningful ML techniques. Building on top of this approach, we create a higher level of knowledge, identifying suitability of data with respect to applicable ML operations based on their data nature...

Adaptive Arena-based Contestable Argumentative Network-of-Experts for Open-Ended Care Plan Coordination

Care plan coordination demands synthesizing heterogeneous clinical, functional, and psychosocial information across multiple professional disciplines, where monolithic LLM pipelines cannot perform in a transparent or safe manner. We present CANOE (Contestable Argumentative Network-of-Experts), a multi-agent neuro-symbolic framework that addresses these limitations through five modules: complexity assessment, adaptive team recruitment, role-based argumentative computation via an Arena-based Quantitative Bipolar Argumentation Framework (A-QBAF), human-in-the-loop contestation, and care-plan synthesis. Role-specialized agents generate supporting and attacking arguments for candidate interventions; conflicts are resolved through arena-based clash resolution before acceptability scores propagate across the argumentation graph. Care planners may accept, reject, edit, or add arguments, and the framework will deterministically recompute the final plan. Evaluation on Discharge Me! and MedicalRAG using ROUGE-L, AlignScore, MEDCON F1, FKGL, and LLM-as-a-judge shows that medically fine-tuned models achieve the strongest clinical correctness and safety, while CANOE's argumentative structure provides faithful explanation and human contestability.

ANCHOR-RE: An Agentic Neuro-Symbolic Framework for Grounded Biomedical Relation Extraction

Biomedical relation extraction (BioRE) extracts structured knowledge from biomedical literature for applications such as knowledge base construction and hypothesis generation. Traditional symbolic systems such as SemRep provide high precision but limited recall, while large language models (LLMs) offer stronger contextual reasoning but remain prone to false-positive predictions. We developed ANCHOR-RE, a framework that integrates ontology-guided reasoning, external knowledge grounding, and data-driven verification rules into LLM inference. We evaluated it on three BioRE benchmarks (SemRepGS, DDI, and ChemProt) using both proprietary and open-weight LLMs. To assess generalizability beyond benchmark datasets while reducing potential evaluation bias from LLM pretraining contamination, we conducted a temporal evaluation using 100 biomedical articles published in 2026. With the proprietary backbone, ANCHOR-RE outperformed direct LLM prompting, improving micro-F1 from 0.654 to 0.676 on SemRepGS, from 0.769 to 0.872 on DDI, and from 0.939 to 0.941 on ChemProt. On DDI and ChemProt, it also outperformed previously reported inference-only methods and approached fine-tuned or instruction-tuned systems without parameter updates. Similar performance gains observed with open-weight LLMs indicate that the benefits were not limited to the proprietary backbone. On the post-cutoff set, manual assessment of 500 randomly sampled predictions yielded a precision of 69%, maintaining consistent precision on previously unseen biomedical literature. Neuro-symbolic reasoning can improve the reliability of LLM-based BioRE without fine-tuning. Results across multiple benchmarks, model families, and post-cutoff literature support ANCHOR-RE as a practical training-free approach to biomedical literature mining.

Cardiologent: Multi-Agent Clinical Decision Support for Patient-Level Arrhythmia Assessment, Urgency, and Management

The same episode of atrial fibrillation is a minor finding in a healthy adult and grounds for anticoagulation in an elderly patient with hypertension: identical signal, opposite decision. Naming the rhythm is only the start; what determines a patient's outcome is the judgement that follows -- what the arrhythmia is across the whole record, what it means for this patient, and what should be done about it. Recent work pairing large language models with the ECG stops short of this, reading one recording without assembling a patient-level finding; and agentic systems built around it either receive the arrhythmia a device has already detected or target a different diagnostic task, stopping before the decision this task requires. We formulate patient-level arrhythmia decision support as a task and present Cardiologent, a multi-agent system that spans it from detection to decision. An agent for each signal -- a single ECG lead and the photoplethysmogram a wearable acquires -- grounds its window reading in measured features rather than a bare label; the readings are assembled into the patient's rhythm profile and, with the patient's own data, reasoned against clinical guidelines retrieved for the case, with a critic checking each conclusion against the guideline it cites. We evaluate the clinical decision rather than the report, across integrated diagnosis, clinical significance, and urgency and management. Cardiologent scores highest on every axis, first on every patient-level task under both cardiologists and an at-scale LLM judge -- whose agreement with the cardiologists (ICC 0.74, 0.66) matches theirs with each other (0.67). Because each conclusion traces to a cited guideline and is validated against expert cardiologists, it yields decisions a clinician can audit rather than act on blindly -- a step toward use in continuous monitoring.

Retrieval-Augmented Generation in LLMs for Mental Health: Quantifying the Incremental Contribution of Retrieval Within a Layered Safety Architecture

Digital mental health interventions (DMHIs) offer scalable support, but ensuring they accurately detect users' intent during volatile situations can be challenging. Pure parametric Large Language models (LLMs) do not contain specific safety critical architecture, and can miss critical cues, or hallucinate, undermining reliability. Retrieval Augmented Generation (RAG), which supplements an LLM with retrieved context, could enhance intent detection during volatile situations. Commercially available DMHIs typically combine multiple independent safety layers like rule-based filters, symbolic escalation protocols, and neural classification. The incremental contribution of any single layer, however, remains unquantified. This paper evaluates six LLM models within a DMHI called Wysa, via a controlled comparison of RAG-enabled versus RAG-disabled modes. Anonymized real and synthetic user-chatbot exchanges were annotated by a qualified clinical team against multi-class intent categories (e.g. self-harm, abuse, panic). The study computed classification accuracy, recall, precision and F1 scores against ground truth labels and tested differences for statistical significance. Performance was also examined by risk category and inter-model agreement. While RAG caused a rise in false alarms, the trade-off is consistent with safety-critical design principles that prioritize sensitivity, where flagged cases are routed to additional review rather than acted on directly. Overall, these findings support RAG as a promising approach to improve the accuracy, consistency and safety of LLM-driven DMHIs. Keywords: Digital Mental Health Intervention, Large Language Model, Retrieval Augmented Generation, Accuracy, Recall, Precision

WPG-MoE: Weak-Prior-Guided Dense Mixture-of-Experts for User-Level Social Media Depression Detection

Online social media posts provide scalable signals for early depression screening, and recent studies mainly improve pre-classification evidence through risk-post selection, symptom grounding, and clinically informed feature construction. However, these screening-stage designs often leave final decisions to a single detector, overlooking how users heterogeneously express depressive risk after screening. A monolithic classifier must average across heterogeneous users, which may dilute localized evidence and cause misclassification, especially for non-self-disclosing users. To address this issue, we propose WPG-MoE, a weak-prior-guided dense mixture-of-experts framework built on a shared large language model (LLM) backbone. WPG-MoE derives user-level weak semantic priors to softly route users to experts matched to different evidence layouts. We formulate this process as learning using privileged information (LUPI): rich LLM-extracted structured evidence guides training-time routing, while inference retains only Patient Health Questionnaire-9 (PHQ-9) template screening and the deployable backbone. Experiments on Chinese and English datasets show that WPG-MoE outperforms strong baselines with interpretable routing behavior.

CARE: Causally-Aligned Reasoning Exploration for Medical Large Language Models

Large Language Models (LLMs) have shown strong potential for medical reasoning, yet the scarcity and cost of expert-annotated data constrain their progress. While reinforcement learning offers a scalable alternative, standard outcome-based methods in medicine often suffer from autoregressive credit assignment failure and gradient variance explosion. This leads to the "Right Answer, Wrong Reason" trap, where models inadvertently reinforce spurious correlations and dataset shortcuts rather than valid clinical deduction. In this work, we propose Causally-Aligned Reasoning Exploration (CARE), a theoretically grounded framework for intrinsic experience curation. CARE is built upon two rigorous conditions for high-quality training trajectories: Causal Sufficiency, which utilizes an agreement-based self-verification mechanism to mimic $do$-calculus interventions and effectively debias gradients; and Proximal Learnability, which employs dynamic entropy bounds to select experiences within the model's zone of proximal development for variance-bounded optimization. These rigorously filtered experiences are optimized via a dual-stream objective that combines on-policy group-relative exploration with difficulty-weighted experience replay. Extensive experiments on diverse medical multimodal and text-only benchmarks demonstrate that CARE consistently outperforms other strong competitors, substantially reducing correct-but-inconsistent reasoning and improving training stability.

Managing Map Cardinality in Automatic Disease Classification Mapping: Balancing Precision, Recall and Coverage

Automatic mapping between disease classification systems, such as the International Classification of Diseases (ICD), is a challenging yet essential task for integrating health data and conducting longitudinal data analysis. Existing embedding-based methods primarily focus on \emph{one-to-one} mappings, overlooking more complex \emph{one-to-many} scenarios. The threshold-based and top-K methods offer natural extensions; however, they involve inherent trade-offs between \emph{precision}, \emph{recall} and \emph{mapping coverage} -- the proportion of source codes with at least one mapping to a target code. To address this challenge, we introduce a novel method, which is inspired by the \emph{blocking-and-matching} pipeline commonly used in \emph{entity resolution}. In particular, we first generate a block of candidate matches (\emph{blocking}) and then employ a large language model (LLM) to identify all valid mappings within each block (\emph{matching}). Empirically, we show that the proposed method achieves higher precision with comparable recall and broader coverage across multiple ICD version pairs (ICD-9-CM$\leftrightarrow$ICD-10-CM and ICD-10-AM$\leftrightarrow$ICD-11). Our source code and dataset is available at: https://tinyurl.com/46kyn7wp.

Language-Based Digital Twins for Elderly Cognitive Assistance

Digital twins have emerged as a promising paradigm for personalized healthcare, enabling modeling of individual behavior and health trajectories. In cognitive health, early detection of Mild Cognitive Impairment (MCI) remains challenging, where language and conversational patterns serve as non-invasive biomarkers. In this work, we propose a language-based digital twin framework that leverages large language models (LLMs) to mimic the conversational behavior of elderly individuals by incorporating stylometric cues and contextual metadata. To evaluate fidelity and cognitive consistency, we introduce a multi-head conditional variational autoencoder (cVAE) that jointly measures reconstruction quality and predicts cognitive scores. Experiments on the I-CONECT dataset show that the digital twin preserves identity-specific characteristics and achieves reconstruction and MoCA prediction errors comparable to real data, while outperforming baseline GPT-generated responses. These results highlight the potential of language-based digital twins as a scalable and non-invasive approach for personalized and continuous cognitive health monitoring.

DMT-CBT: Longitudinal Therapeutic State Modeling for CBT Counseling

Large language models (LLMs) have shown growing potential for Cognitive Behavioral Therapy (CBT) counseling. However, most existing approaches still formulate counseling as a local response generation problem, focusing on empathetic replies within short, text-only, or single-session interactions. We argue that this formulation fundamentally mismatches the nature of real psychotherapy. In clinical CBT, therapy is a longitudinal process in which therapists continuously infer, update, and intervene on evolving therapeutic states across sessions. Realistic CBT further involves multimodal inference and delayed cross-session intervention effects, requiring models to capture longitudinal therapeutic state evolution under partial observability. We propose DMT-CBT, a framework for Dynamic Modeling of evolving Therapeutic states in CBT counseling. DMT-CBT maintains structured therapeutic states across sessions while incorporating multimodal behavioral grounding and tool-augmented intervention to support adaptive therapeutic reasoning. Based on this framework, we construct DMTCorpus, a synthetic multi-session multimodal CBT counseling dataset featuring evolving therapeutic states, image-grounded client behaviors, and cross-session intervention continuity. Experimental results show that DMT-CBT improves counseling fidelity and therapeutic alliance, produces more favorable longitudinal affective trajectories, and preserves therapeutic states more faithfully than post-hoc extraction approaches.

MultiDx: A Multi-Source Knowledge Integration Framework towards Diagnostic Reasoning

Diagnostic prediction and clinical reasoning are critical tasks in healthcare applications. While Large Language Models (LLMs) have shown strong capabilities in commonsense reasoning, they still struggle with diagnostic reasoning due to limited domain knowledge. Existing approaches often rely on internal model knowledge or static knowledge bases, resulting in knowledge insufficiency and limited adaptability, which hinder their capacity to perform diagnostic reasoning. Moreover, these methods focus solely on the accuracy of final predictions, overlooking alignment with standard clinical reasoning trajectories. To this end, we propose MultiDx, a two-stage diagnostic reasoning framework that performs differential diagnosis by analyzing evidence collected from multiple knowledge sources. Specifically, it first generates suspected diagnoses and reasoning paths by leveraging knowledge from web search, SOAP-formatted case, and clinical case database. Then it integrates multi-perspective evidence through matching, voting, and differential diagnosis to generate the final prediction.~Extensive experiments on two public benchmarks demonstrate the effectiveness of our approach.