Jong Ha Lee

Eric Yang, Jonathan Amar, Jong Ha Lee et al. · deepmind

Deploying Large Language Models (LLMs) for healthcare question answering requires robust methods to ensure accuracy and reliability. This work introduces Query-Based Retrieval Augmented Generation (QB-RAG), a framework for enhancing Retrieval-Augmented Generation (RAG) systems in healthcare question-answering by pre-aligning user queries with a database of curated, answerable questions derived from healthcare content. A key component of QB-RAG is an LLM-based filtering mechanism that ensures that only relevant and answerable questions are included in the database, enabling reliable reference query generation at scale. We provide theoretical motivation for QB-RAG, conduct a comparative analysis of existing retrieval enhancement techniques, and introduce a generalizable, comprehensive evaluation framework that assesses both the retrieval effectiveness and the quality of the generated response based on faithfulness, relevance, and adherence to the guideline. Our empirical evaluation on a healthcare data set demonstrates the superior performance of QB-RAG compared to existing retrieval methods, highlighting its practical value in building trustworthy digital health applications for health question-answering.

Gyubok Lee, Elea Bach, Eric Yang et al.

The recent shift toward the Health Level Seven Fast Healthcare Interoperability Resources (HL7 FHIR) standard opens a new frontier for clinical AI, demanding LLM agents to navigate complex, resource-based data models instead of conventional structured health data. However, existing benchmarks have lagged behind this transition, lacking the realism needed to evaluate recent LLMs on interoperable clinical data. To bridge this gap, we introduce FHIR-AgentBench, a benchmark that grounds 2,931 real-world clinical questions in the HL7 FHIR standard. Using this benchmark, we systematically evaluate agentic frameworks, comparing different data retrieval strategies (direct FHIR API calls vs. specialized tools), interaction patterns (single-turn vs. multi-turn), and reasoning strategies (natural language vs. code generation). Our experiments highlight the practical challenges of retrieving data from intricate FHIR resources and the difficulty of reasoning over them, both of which critically affect question answering performance. We publicly release the FHIR-AgentBench dataset and evaluation suite (https://github.com/glee4810/FHIR-AgentBench) to promote reproducible research and the development of robust, reliable LLM agents for clinical applications.

Taedong Yun, Eric Yang, Mustafa Safdari et al. · berkeley

We present an end-to-end framework for generating synthetic users for evaluating interactive agents designed to encourage positive behavior changes, such as in health and lifestyle coaching. The synthetic users are grounded in health and lifestyle conditions, specifically sleep and diabetes management in this study, to ensure realistic interactions with the health coaching agent. Synthetic users are created in two stages: first, structured data are generated grounded in real-world health and lifestyle factors in addition to basic demographics and behavioral attributes; second, full profiles of the synthetic users are developed conditioned on the structured data. Interactions between synthetic users and the coaching agent are simulated using generative agent-based models such as Concordia, or directly by prompting a language model. Using two independently-developed agents for sleep and diabetes coaching as case studies, the validity of this framework is demonstrated by analyzing the coaching agent's understanding of the synthetic users' needs and challenges. Finally, through multiple blinded evaluations of user-coach interactions by human experts, we demonstrate that our synthetic users with health and behavioral attributes more accurately portray real human users with the same attributes, compared to generic synthetic users not grounded in such attributes. The proposed framework lays the foundation for efficient development of conversational agents through extensive, realistic, and grounded simulated interactions.

Eric Yang, Jong Ha Lee, Jonathan Amar et al.

Large Language Models (LLMs) trained for average correctness often exhibit mode collapse, producing narrow decision behaviors on tasks where multiple responses may be reasonable. This limitation is particularly problematic in ordinal decision settings such as clinical triage, where standard alignment removes the ability to trade off specificity and sensitivity (the ROC operating point) based on contextual constraints. We propose STEER (Steerable Tuning via Evolutionary Ensemble Refinement), a training-free framework that reintroduces this tunable control. STEER constructs a population of natural-language personas through an offline, constrained quality-diversity search that promotes behavioral coverage while enforcing minimum safety, reasoning, and stability thresholds. At inference time, STEER exposes a single, interpretable control parameter that maps a user-specified risk percentile to a selected persona, yielding a monotonic adjustment of decision conservativeness. On two clinical triage benchmarks, STEER achieves broader behavioral coverage compared to temperature-based sampling and static persona ensembles. Compared to a representative post-training method, STEER maintains substantially higher accuracy on unambiguous urgent cases while providing comparable control over ambiguous decisions. These results demonstrate STEER as a safety-preserving paradigm for risk control, capable of steering behavior without compromising domain competence.

Sina Rashidian, Nan Li, Jonathan Amar et al.

Background: We present a Patient Simulator that leverages real world patient encounters which cover a broad range of conditions and symptoms to provide synthetic test subjects for development and testing of healthcare agentic models. The simulator provides a realistic approach to patient presentation and multi-turn conversation with a symptom-checking agent. Objectives: (1) To construct and instantiate a Patient Simulator to train and test an AI health agent, based on patient vignettes derived from real EHR data. (2) To test the validity and alignment of the simulated encounters provided by the Patient Simulator to expert human clinical providers. (3) To illustrate the evaluation framework of such an LLM system on the generated realistic, data-driven simulations -- yielding a preliminary assessment of our proposed system. Methods: We first constructed realistic clinical scenarios by deriving patient vignettes from real-world EHR encounters. These vignettes cover a variety of presenting symptoms and underlying conditions. We then evaluate the performance of the Patient Simulator as a simulacrum of a real patient encounter across over 500 different patient vignettes. We leveraged a separate AI agent to provide multi-turn questions to obtain a history of present illness. The resulting multiturn conversations were evaluated by two expert clinicians. Results: Clinicians scored the Patient Simulator as consistent with the patient vignettes in those same 97.7% of cases. The extracted case summary based on the conversation history was 99% relevant. Conclusions: We developed a methodology to incorporate vignettes derived from real healthcare patient data to build a simulation of patient responses to symptom checking agents. The performance and alignment of this Patient Simulator could be used to train and test a multi-turn conversational AI agent at scale.