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Few shot chain-of-thought driven reasoning to prompt LLMs for open ended medical question answering

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arxiv 2403.04890 v4 pith:G5QDK62S submitted 2024-03-07 cs.CL

classification cs.CL
keywords medicalpromptreasoningclinicalclinicrdrivenmcq-eliminativeprocess
verification ladder T0 review T1 audit T2 compute T3 formal
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In this paper, we propose a modified version of the MedQA-USMLE dataset, named MEDQA-OPEN, which contains open-ended medical questions without options to mimic clinical scenarios, along with clinician-approved reasoned answers. Additionally, we implement a prompt driven by Chain of Thought (CoT) reasoning, CLINICR, to mirror the prospective process of incremental reasoning, reaching a correct response to medical questions. We empirically demonstrate how CLINICR outperforms the state-of-the-art 5-shot CoT-based prompt (Li\'evin et al., 2022). We also present an approach that mirrors real-life clinical practice by first exploring multiple differential diagnoses through MCQ-CLINICR and subsequently narrowing down to a final diagnosis using MCQ-ELIMINATIVE. Finally, emphasizing the importance of response verification in medical settings, we utilize a reward model mechanism, replacing the elimination process performed by MCQ-ELIMINATIVE.

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Forward citations

Cited by 4 Pith papers

Reviewed papers in the Pith corpus that reference this work. Sorted by Pith novelty score. Full citation record

  1. Aligning Clinical Needs and AI Capabilities: A Survey on LLMs for Medical Reasoning

    cs.AI 2026-07 accept novelty 6.0 of 10

    A dual clinical-computational taxonomy for medical LLM reasoning plus a five-level 5k-sample benchmark showing specialists excel at diagnosis and general models at decision support/dialogue.

  2. 4KAgent: Agentic Any Image to 4K Super-Resolution

    cs.CV 2025-07 reject novelty 6.0 of 10

    An agentic pipeline that plans and executes image restoration from a toolbox of pretrained models to upscale arbitrary images to 4K, reporting state-of-the-art results on many benchmarks.

  3. AeroSpectra Sentinel: An Auditable LLM Prompt-Chaining Decision-Support Workflow for Acute Asthma Risk Assessment from Respiratory Sounds and Clinical Signals

    eess.AS 2026-06 unverdicted novelty 4.0 of 10

    Prototype workflow combining STFT audio analysis, ML screening on public respiratory dataset, and five-stage LLM prompt chaining with guardrails for asthma risk, reporting 91% binary accuracy and better simulated safe...

  4. A Framework for LLM-powered Design Assistants

    cs.HC 2025-02 conditional novelty 2.0 of 10

    LLMs are organized into a three-modality framework for design assistance, but no evidence is provided that the framework works.

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