Mingrui Tan

Yang Zhou, Zhenting Sheng, Mingrui Tan et al.

Effective clinical history taking is a foundational yet underexplored component of clinical reasoning. While large language models (LLMs) have shown promise on static benchmarks, they often fall short in dynamic, multi-turn diagnostic settings that require iterative questioning and hypothesis refinement. To address this gap, we propose \method{}, a note-driven framework that trains LLMs to conduct structured history taking and diagnosis by learning from widely available medical notes. Instead of relying on scarce and sensitive dialogue data, we convert real-world medical notes into high-quality doctor-patient dialogues using a decision tree-guided generation and refinement pipeline. We then propose a three-stage fine-tuning strategy combining supervised learning, simulated data augmentation, and preference learning. Furthermore, we propose a novel single-turn reasoning paradigm that reframes history taking as a sequence of single-turn reasoning problems. This design enhances interpretability and enables local supervision, dynamic adaptation, and greater sample efficiency. Experimental results show that our method substantially improves clinical reasoning, achieving gains of +16.9 F1 and +21.0 Top-1 diagnostic accuracy over GPT-4o. Our code and dataset can be found at https://github.com/zhentingsheng/Note2Chat.

Tanvi Verma, Lukas Schwemer, Mingrui Tan et al.

Deep learning models are widely recognized for their effectiveness in identifying medical image findings in disease classification. However, their limitations become apparent in the dynamic and ever-changing clinical environment, characterized by the continuous influx of newly annotated medical data from diverse sources. In this context, the need for continual learning becomes particularly paramount, not only to adapt to evolving medical scenarios but also to ensure the privacy of healthcare data. In our research, we emphasize the utilization of a network comprising expert classifiers, where a new expert classifier is added each time a new task is introduced. We present CTP, a task-id predictor that utilizes confidence scores, leveraging the probability distribution (logits) of the classifier to accurately determine the task-id at inference time. Logits are adjusted to ensure that classifiers yield a high-entropy distribution for data associated with tasks other than their own. By defining a noise region in the distribution and computing confidence scores, CTP achieves superior performance when compared to other relevant continual learning methods. Additionally, the performance of CTP can be further improved by providing it with a continuum of data at the time of inference.