# CoD, Towards an Interpretable Medical Agent using Chain of Diagnosis

arXiv: https://arxiv.org/abs/2407.13301 · HTML: https://mlsanity.com/paper/2407.13301/

## Key facts

- Cited by 43 papers in the map (data through 14 Oct 2026).
- Builds on 33 of its 55 references that are in the map.
- First posted on arXiv 18 Jul 2024.

## Builds on (most cited first, 30 of 33)

- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [Sentence-BERT: Sentence Embeddings using Siamese BERT-Networks](https://mlsanity.com/paper/1908.10084/) (2019)
- [ReAct: Synergizing Reasoning and Acting in Language Models](https://mlsanity.com/paper/2210.03629/) (2022)
- [Dense Passage Retrieval for Open-Domain Question Answering](https://mlsanity.com/paper/2004.04906/) (2020)
- [Gemini 1.5: Unlocking multimodal understanding across millions of tokens of context](https://mlsanity.com/paper/2403.05530/) (2024)
- [Tree of Thoughts: Deliberate Problem Solving with Large Language Models](https://mlsanity.com/paper/2305.10601/) (2023)
- [A Survey on Hallucination in Large Language Models: Principles, Taxonomy, Challenges, and Open Questions](https://mlsanity.com/paper/2311.05232/) (2023)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [Gemma: Open Models Based on Gemini Research and Technology](https://mlsanity.com/paper/2403.08295/) (2024)
- [Graph of Thoughts: Solving Elaborate Problems with Large Language Models](https://mlsanity.com/paper/2308.09687/) (2023)
- [Yi: Open Foundation Models by 01.AI](https://mlsanity.com/paper/2403.04652/) (2024)
- [ERNIE 3.0: Large-scale Knowledge Enhanced Pre-training for Language Understanding and Generation](https://mlsanity.com/paper/2107.02137/) (2021)
- [HuatuoGPT, towards Taming Language Model to Be a Doctor](https://mlsanity.com/paper/2305.15075/) (2023)
- [HuatuoGPT-Vision, Towards Injecting Medical Visual Knowledge into Multimodal LLMs at Scale](https://mlsanity.com/paper/2406.19280/) (2024)
- [MedDialog: Two Large-scale Medical Dialogue Datasets](https://mlsanity.com/paper/2004.03329/) (2020)
- [Optimizing Dense Retrieval Model Training with Hard Negatives](https://mlsanity.com/paper/2104.08051/) (2021)
- [DoctorGLM: Fine-tuning your Chinese Doctor is not a Herculean Task](https://mlsanity.com/paper/2304.01097/) (2023)
- [HuatuoGPT-II, One-stage Training for Medical Adaption of LLMs](https://mlsanity.com/paper/2311.09774/) (2023)
- [DDXPlus: A New Dataset For Automatic Medical Diagnosis](https://mlsanity.com/paper/2205.09148/) (2022)
- [OVM, Outcome-supervised Value Models for Planning in Mathematical Reasoning](https://mlsanity.com/paper/2311.09724/) (2023)
- [Diagnostic Reasoning Prompts Reveal the Potential for Large Language Model Interpretability in Medicine](https://mlsanity.com/paper/2308.06834/) (2023)
- [End-to-End Knowledge-Routed Relational Dialogue System for Automatic Diagnosis](https://mlsanity.com/paper/1901.10623/) (2019)
- [Uncertainty of Thoughts: Uncertainty-Aware Planning Enhances Information Seeking in Large Language Models](https://mlsanity.com/paper/2402.03271/) (2024)
- [Augmenting Interpretable Models with LLMs during Training](https://mlsanity.com/paper/2209.11799/) (2022)
- [Apollo: A Lightweight Multilingual Medical LLM towards Democratizing Medical AI to 6B People](https://mlsanity.com/paper/2403.03640/) (2024)
- [Phoenix: Democratizing ChatGPT across Languages](https://mlsanity.com/paper/2304.10453/) (2023)
- [Exploring Autonomous Agents through the Lens of Large Language Models: A Review](https://mlsanity.com/paper/2404.04442/) (2024)
- [Diaformer: Automatic Diagnosis via Symptoms Sequence Generation](https://mlsanity.com/paper/2112.10433/) (2021)
- [Efficient Symptom Inquiring and Diagnosis via Adaptive Alignment of Reinforcement Learning and Classification](https://mlsanity.com/paper/2112.00733/) (2021)
- [Imperfect also Deserves Reward: Multi-Level and Sequential Reward Modeling for Better Dialog Management](https://mlsanity.com/paper/2104.04748/) (2021)

## Built on by (most cited first, 30 of 43)

- [HuatuoGPT-o1, Towards Medical Complex Reasoning with LLMs](https://mlsanity.com/paper/2412.18925/) (2024)
- [From LLM Reasoning to Autonomous AI Agents: A Comprehensive Review](https://mlsanity.com/paper/2504.19678/) (2025)
- [MedReason: Eliciting Factual Medical Reasoning Steps in LLMs via Knowledge Graphs](https://mlsanity.com/paper/2504.00993/) (2025)
- [A Survey of LLM-Driven AI Agent Communication: Protocols, Security Risks, and Defense Countermeasures](https://mlsanity.com/paper/2506.19676/) (2025)
- [Beyond Distillation: Pushing the Limits of Medical LLM Reasoning with Minimalist Rule-Based RL](https://mlsanity.com/paper/2505.17952/) (2025)
- [MEDDxAgent: A Unified Modular Agent Framework for Explainable Automatic Differential Diagnosis](https://mlsanity.com/paper/2502.19175/) (2025)
- [Medchain: Bridging the Gap Between LLM Agents and Clinical Practice with Interactive Sequence](https://mlsanity.com/paper/2412.01605/) (2024)
- [Citrus: Leveraging Expert Cognitive Pathways in a Medical Language Model for Advanced Medical Decision Support](https://mlsanity.com/paper/2502.18274/) (2025)
- [Evolving Medical Imaging Agents via Experience-driven Self-skill Discovery](https://mlsanity.com/paper/2603.05860/) (2026)
- [Towards Next-Generation Medical Agent: How o1 is Reshaping Decision-Making in Medical Scenarios](https://mlsanity.com/paper/2411.14461/) (2024)
- [End-to-End Agentic RAG System Training for Traceable Diagnostic Reasoning](https://mlsanity.com/paper/2508.15746/) (2025)
- [CLINIC: Evaluating Multilingual Trustworthiness in Language Models for Healthcare](https://mlsanity.com/paper/2512.11437/) (2025)
- [SIRI-Bench: Challenging VLMs' Spatial Intelligence through Complex Reasoning Tasks](https://mlsanity.com/paper/2506.14512/) (2025)
- [CXRAgent: Director-Orchestrated Multi-Stage Reasoning for Chest X-Ray Interpretation](https://mlsanity.com/paper/2510.21324/) (2025)
- [MedKGI: Iterative Differential Diagnosis with Medical Knowledge Graphs and Information-Guided Inquiring](https://mlsanity.com/paper/2512.24181/) (2025)
- [Reasoning LLMs in the Medical Domain: A Literature Survey](https://mlsanity.com/paper/2508.19097/) (2025)
- [Self-Regularization with Sparse Autoencoders for Controllable LLM-based Classification](https://mlsanity.com/paper/2502.14133/) (2025)
- [Inflated Excellence or True Performance? Rethinking Medical Diagnostic Benchmarks with Dynamic Evaluation](https://mlsanity.com/paper/2510.09275/) (2025)
- [Guideline-Grounded Evidence Accumulation for High-Stakes Agent Verification](https://mlsanity.com/paper/2603.02798/) (2026)
- [Data to Defense: The Role of Curation in Customizing LLMs Against Jailbreaking Attacks](https://mlsanity.com/paper/2410.02220/) (2024)
- [MEDEQUALQA: Evaluating Biases in LLMs with Counterfactual Reasoning](https://mlsanity.com/paper/2510.12818/) (2025)
- [MedAction: Towards Active Multi-turn Clinical Diagnostic LLMs](https://mlsanity.com/paper/2605.07305/) (2026)
- [Fact or Guesswork? Evaluating Large Language Models' Medical Knowledge with Structured One-Hop Judgments](https://mlsanity.com/paper/2502.14275/) (2025)
- [DDO: Dual-Decision Optimization for LLM-Based Medical Consultation via Multi-Agent Collaboration](https://mlsanity.com/paper/2505.18630/) (2025)
- [MedRepBench: A Comprehensive Benchmark for Medical Report Interpretation](https://mlsanity.com/paper/2508.16674/) (2025)
- [CLARITY: Clinical Assistant for Routing, Inference, and Triage](https://mlsanity.com/paper/2510.02463/) (2025)
- [Knowledge-Augmented Long-CoT Generation for Complex Biomolecular Reasoning](https://mlsanity.com/paper/2511.08024/) (2025)
- [EMSDialog: Synthetic Multi-person Emergency Medical Service Dialogue Generation from Electronic Patient Care Reports via Multi-LLM Agents](https://mlsanity.com/paper/2604.07549/) (2026)
- [RAD: Towards Trustworthy Retrieval-Augmented Multi-modal Clinical Diagnosis](https://mlsanity.com/paper/2509.19980/) (2025)
- [Beyond MedQA: Towards Real-world Clinical Decision Making in the Era of LLMs](https://mlsanity.com/paper/2510.20001/) (2025)

## Abstract (arXiv)

The field of medical diagnosis has undergone a significant transformation with the advent of large language models (LLMs), yet the challenges of interpretability within these models remain largely unaddressed. This study introduces Chain-of-Diagnosis (CoD) to enhance the interpretability of LLM-based medical diagnostics. CoD transforms the diagnostic process into a diagnostic chain that mirrors a physician's thought process, providing a transparent reasoning pathway. Additionally, CoD outputs the disease confidence distribution to ensure transparency in decision-making. This interpretability makes model diagnostics controllable and aids in identifying critical symptoms for inquiry through the entropy reduction of confidences. With CoD, we developed DiagnosisGPT, capable of diagnosing 9604 diseases. Experimental results demonstrate that DiagnosisGPT outperforms other LLMs on diagnostic benchmarks. Moreover, DiagnosisGPT provides interpretability while ensuring controllability in diagnostic rigor.