# Pareto-Optimized Open-Source LLMs for Healthcare via Context Retrieval

arXiv: https://arxiv.org/abs/2409.15127 · HTML: https://mlsanity.com/paper/2409.15127/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 18 of its 26 references that are in the map.
- First posted on arXiv 23 Sep 2024.

## Builds on (most cited first, 18 of 18)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [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)
- [Tree of Thoughts: Deliberate Problem Solving with Large Language Models](https://mlsanity.com/paper/2305.10601/) (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)
- [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)
- [Can Generalist Foundation Models Outcompete Special-Purpose Tuning? Case Study in Medicine](https://mlsanity.com/paper/2311.16452/) (2023)
- [Can large language models reason about medical questions?](https://mlsanity.com/paper/2207.08143/) (2022)
- [MedCPT: Contrastive Pre-trained Transformers with Large-scale PubMed Search Logs for Zero-shot Biomedical Information Retrieval](https://mlsanity.com/paper/2307.00589/) (2023)
- [AnglE-optimized Text Embeddings](https://mlsanity.com/paper/2309.12871/) (2023)
- [Diagnostic Reasoning Prompts Reveal the Potential for Large Language Model Interpretability in Medicine](https://mlsanity.com/paper/2308.06834/) (2023)
- [Gemini Goes to Med School: Exploring the Capabilities of Multimodal Large Language Models on Medical Challenge Problems & Hallucinations](https://mlsanity.com/paper/2402.07023/) (2024)
- [OpenMedLM: Prompt engineering can out-perform fine-tuning in medical question-answering with open-source large language models](https://mlsanity.com/paper/2402.19371/) (2024)
- [Aloe: A Family of Fine-tuned Open Healthcare LLMs](https://mlsanity.com/paper/2405.01886/) (2024)

## Built on by (most cited first, 2 of 2)

- [RAGDoll: Efficient Offloading-based Online RAG System on a Single GPU](https://mlsanity.com/paper/2504.15302/) (2025)
- [LLMs on a Budget? Say HOLA](https://mlsanity.com/paper/2506.18952/) (2025)

## Abstract (arXiv)

This study leverages optimized context retrieval to enhance open-source Large Language Models (LLMs) for cost-effective, high performance healthcare AI. We demonstrate that this approach achieves state-of-the-art accuracy on medical question answering at a fraction of the cost of proprietary models, significantly improving the cost-accuracy Pareto frontier on the MedQA benchmark. Key contributions include: (1) OpenMedQA, a novel benchmark revealing a performance gap in open-ended medical QA compared to multiple-choice formats; (2) a practical, reproducible pipeline for context retrieval optimization; and (3) open-source resources (Prompt Engine, CoT/ToT/Thinking databases) to empower healthcare AI development. By advancing retrieval techniques and QA evaluation, we enable more affordable and reliable LLM solutions for healthcare.
