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.
Offline reinforcement learning enables policy learning from fixed datasets without additional environment interaction, making it appealing for safety-critical applications where online exploration is costly or unsafe. Diffusion-based decision-making methods have recently achieved strong performance in offline RL by modeling rich, multimodal trajectory distributions. However, existing diffusion planners are typically risk-neutral and therefore may overlook rare but catastrophic outcomes that are crucial in real-world deployment. In this work, we propose RS-Diffuser, a risk-sensitive offline diffusion planning framework that combines diffusion-based trajectory generation with distributional value critics. RS-Diffuser learns a diffusion planner over future state trajectories, a separate inverse dynamics model for action decoding, and a Monte Carlo distributional critic that estimates the full return distribution of candidate plans through quantile regression. At sampling time, we incorporate a risk-sensitive guidance signal into the denoising process, using gradients computed from tail-aware objectives such as Conditional Value at Risk to steer generation toward desired risk profiles. As a result, a single trained model can flexibly produce risk-averse, risk-neutral, or risk-seeking behaviors by changing only the inference-time risk parameter. Extensive experiments on risk-sensitive D4RL and risky robot navigation benchmarks demonstrate that RS-Diffuser achieves state-of-the-art performance, improving both overall return and worst-case robustness while reducing safety violations.