# MediQ: Question-Asking LLMs and a Benchmark for Reliable Interactive Clinical Reasoning

arXiv: https://arxiv.org/abs/2406.00922 · HTML: https://mlsanity.com/paper/2406.00922/

## Key facts

- Cited by 154 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 27 of its 47 references that are in the map.
- First posted on arXiv 3 Jun 2024.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)

## Builds on (most cited first, 27 of 27)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [Measuring Massive Multitask Language Understanding](https://mlsanity.com/paper/2009.03300/) (2020)
- [Self-Consistency Improves Chain of Thought Reasoning in Language Models](https://mlsanity.com/paper/2203.11171/) (2022)
- [Beyond the Imitation Game: Quantifying and extrapolating the capabilities of language models](https://mlsanity.com/paper/2206.04615/) (2022)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [FActScore: Fine-grained Atomic Evaluation of Factual Precision in Long Form Text Generation](https://mlsanity.com/paper/2305.14251/) (2023)
- [Quantifying Language Models' Sensitivity to Spurious Features in Prompt Design or: How I learned to start worrying about prompt formatting](https://mlsanity.com/paper/2310.11324/) (2023)
- [Just Ask for Calibration: Strategies for Eliciting Calibrated Confidence Scores from Language Models Fine-Tuned with Human Feedback](https://mlsanity.com/paper/2305.14975/) (2023)
- [MedMCQA : A Large-scale Multi-Subject Multi-Choice Dataset for Medical domain Question Answering](https://mlsanity.com/paper/2203.14371/) (2022)
- [Towards Expert-Level Medical Question Answering with Large Language Models](https://mlsanity.com/paper/2305.09617/) (2023)
- [A Survey of Hallucination in Large Foundation Models](https://mlsanity.com/paper/2309.05922/) (2023)
- [Multi-Agent Collaboration: Harnessing the Power of Intelligent LLM Agents](https://mlsanity.com/paper/2306.03314/) (2023)
- [Decoupling Strategy and Generation in Negotiation Dialogues](https://mlsanity.com/paper/1808.09637/) (2018)
- [Med-HALT: Medical Domain Hallucination Test for Large Language Models](https://mlsanity.com/paper/2307.15343/) (2023)
- [Deep Bidirectional Language-Knowledge Graph Pretraining](https://mlsanity.com/paper/2210.09338/) (2022)
- [Eliciting Human Preferences with Language Models](https://mlsanity.com/paper/2310.11589/) (2023)
- [DDXPlus: A New Dataset For Automatic Medical Diagnosis](https://mlsanity.com/paper/2205.09148/) (2022)
- [PMC-LLaMA: Towards Building Open-source Language Models for Medicine](https://mlsanity.com/paper/2304.14454/) (2023)
- [Few-Shot Self-Rationalization with Natural Language Prompts](https://mlsanity.com/paper/2111.08284/) (2021)
- [Knowledge Card: Filling LLMs' Knowledge Gaps with Plug-in Specialized Language Models](https://mlsanity.com/paper/2305.09955/) (2023)
- [Uncertainty of Thoughts: Uncertainty-Aware Planning Enhances Information Seeking in Large Language Models](https://mlsanity.com/paper/2402.03271/) (2024)
- [Semi-Supervised Variational Reasoning for Medical Dialogue Generation](https://mlsanity.com/paper/2105.06071/) (2021)
- [Confidence Calibration and Rationalization for LLMs via Multi-Agent Deliberation](https://mlsanity.com/paper/2404.09127/) (2024)
- [Your Co-Workers Matter: Evaluating Collaborative Capabilities of Language Models in Blocks World](https://mlsanity.com/paper/2404.00246/) (2024)

## Built on by (most cited first, 30 of 154)

- [AbstentionBench: Reasoning LLMs Fail on Unanswerable Questions](https://mlsanity.com/paper/2506.09038/) (2025)
- [Sequential Diagnosis with Language Models](https://mlsanity.com/paper/2506.22405/) (2025)
- [Mind the Sim2Real Gap in User Simulation for Agentic Tasks](https://mlsanity.com/paper/2603.11245/) (2026)
- [ConfTuner: Training Large Language Models to Express Their Confidence Verbally](https://mlsanity.com/paper/2508.18847/) (2025)
- [Ambig-SWE: Interactive Agents to Overcome Underspecificity in Software Engineering](https://mlsanity.com/paper/2502.13069/) (2025)
- [QoQ-Med: Building Multimodal Clinical Foundation Models with Domain-Aware GRPO Training](https://mlsanity.com/paper/2506.00711/) (2025)
- [ChatBench: From Static Benchmarks to Human-AI Evaluation](https://mlsanity.com/paper/2504.07114/) (2025)
- [PatientSim: A Persona-Driven Simulator for Realistic Doctor-Patient Interactions](https://mlsanity.com/paper/2505.17818/) (2025)
- [HealthQ: Unveiling Questioning Capabilities of LLM Chains in Healthcare Conversations](https://mlsanity.com/paper/2409.19487/) (2024)
- [Limitations of Large Language Models in Clinical Problem-Solving Arising from Inflexible Reasoning](https://mlsanity.com/paper/2502.04381/) (2025)
- [MEDDxAgent: A Unified Modular Agent Framework for Explainable Automatic Differential Diagnosis](https://mlsanity.com/paper/2502.19175/) (2025)
- [MedAgentGym: A Scalable Agentic Training Environment for Code-Centric Reasoning in Biomedical Data Science](https://mlsanity.com/paper/2506.04405/) (2025)
- [From Passive to Active Reasoning: Can Large Language Models Ask the Right Questions under Incomplete Information?](https://mlsanity.com/paper/2506.08295/) (2025)
- [3MDBench: Medical Multimodal Multi-agent Dialogue Benchmark](https://mlsanity.com/paper/2504.13861/) (2025)
- [Cancer-Myth: Evaluating Large Language Models on Patient Questions with False Presuppositions](https://mlsanity.com/paper/2504.11373/) (2025)
- [Language Agents for Hypothesis-driven Clinical Decision Making with Reinforcement Learning](https://mlsanity.com/paper/2506.13474/) (2025)
- [Agentic Abstention: Do Agents Know When to Stop Instead of Act?](https://mlsanity.com/paper/2606.28733/) (2026)
- [Abstain-R1: Calibrated Abstention and Post-Refusal Clarification via Verifiable RL](https://mlsanity.com/paper/2604.17073/) (2026)
- [ProMed: Shapley Information Gain Guided Reinforcement Learning for Proactive Medical LLMs](https://mlsanity.com/paper/2508.13514/) (2025)
- [MedDialogRubrics: A Comprehensive Benchmark and Evaluation Framework for Multi-turn Medical Consultations in Large Language Models](https://mlsanity.com/paper/2601.03023/) (2026)
- [From Scores to Steps: Diagnosing and Improving LLM Performance in Evidence-Based Medical Calculations](https://mlsanity.com/paper/2509.16584/) (2025)
- [Over-Searching in Search-Augmented Large Language Models](https://mlsanity.com/paper/2601.05503/) (2026)
- [Follow-up Question Generation For Enhanced Patient-Provider Conversations](https://mlsanity.com/paper/2503.17509/) (2025)
- [The Dialogue That Heals: A Comprehensive Evaluation of Doctor Agents' Inquiry Capability](https://mlsanity.com/paper/2509.24958/) (2025)
- [TALES: A Taxonomy and Analysis of Cultural Representations in LLM-generated Stories](https://mlsanity.com/paper/2511.21322/) (2025)
- [When Agents Say One Thing and Do Another: Validating Elicited Beliefs from LLMs](https://mlsanity.com/paper/2602.06286/) (2026)
- [RefusalBench: Generative Evaluation of Selective Refusal in Grounded Language Models](https://mlsanity.com/paper/2510.10390/) (2025)
- [Exploring the Inquiry-Diagnosis Relationship with Advanced Patient Simulators](https://mlsanity.com/paper/2501.09484/) (2025)
- [EvoClinician: A Self-Evolving Agent for Multi-Turn Medical Diagnosis via Test-Time Evolutionary Learning](https://mlsanity.com/paper/2601.22964/) (2026)
- [MT-PingEval: Evaluating Multi-Turn Collaboration with Private Information Games](https://mlsanity.com/paper/2602.24188/) (2026)

## Abstract (arXiv)

Users typically engage with LLMs interactively, yet most existing benchmarks evaluate them in a static, single-turn format, posing reliability concerns in interactive scenarios. We identify a key obstacle towards reliability: LLMs are trained to answer any question, even with incomplete context or insufficient knowledge. In this paper, we propose to change the static paradigm to an interactive one, develop systems that proactively ask questions to gather more information and respond reliably, and introduce an benchmark - MediQ - to evaluate question-asking ability in LLMs. MediQ simulates clinical interactions consisting of a Patient System and an adaptive Expert System; with potentially incomplete initial information, the Expert refrains from making diagnostic decisions when unconfident, and instead elicits missing details via follow-up questions. We provide a pipeline to convert single-turn medical benchmarks into an interactive format. Our results show that directly prompting state-of-the-art LLMs to ask questions degrades performance, indicating that adapting LLMs to proactive information-seeking settings is nontrivial. We experiment with abstention strategies to better estimate model confidence and decide when to ask questions, improving diagnostic accuracy by 22.3%; however, performance still lags compared to an (unrealistic in practice) upper bound with complete information upfront. Further analyses show improved interactive performance with filtering irrelevant contexts and reformatting conversations. Overall, we introduce a novel problem towards LLM reliability, an interactive MediQ benchmark and a novel question-asking system, and highlight directions to extend LLMs' information-seeking abilities in critical domains.