mlsanityData to 14 Oct 2026

Rationale-Guided Retrieval Augmented Generation for Medical Question Answering

arXiv 2411.00300 ↗First posted 1 Nov 2024cs.CLcited by 41

On the map: Retrieval-augmented generation → Medical and biomedical RAG

Abstract (arXiv)

Large language models (LLM) hold significant potential for applications in biomedicine, but they struggle with hallucinations and outdated knowledge. While retrieval-augmented generation (RAG) is generally employed to address these issues, it also has its own set of challenges: (1) LLMs are vulnerable to irrelevant or incorrect context, (2) medical queries are often not well-targeted for helpful information, and (3) retrievers are prone to bias toward the specific source corpus they were trained on. In this study, we present RAG2 (RAtionale-Guided RAG), a new framework for enhancing the reliability of RAG in biomedical contexts. RAG2 incorporates three key innovations: a small filtering model trained on perplexity-based labels of rationales, which selectively augments informative snippets of documents while filtering out distractors; LLM-generated rationales as queries to improve the utility of retrieved snippets; a structure designed to retrieve snippets evenly from a comprehensive set of four biomedical corpora, effectively mitigating retriever bias. Our experiments demonstrate that RAG2 improves the state-of-the-art LLMs of varying sizes, with improvements of up to 6.1%, and it outperforms the previous best medical RAG model by up to 5.6% across three medical question-answering benchmarks. Our code is available at https://github.com/dmis-lab/RAG2.

Key facts. Cited by 41 papers in the map (data through 14 Oct 2026). Placed in Medical and biomedical RAG, one of 15 directions in Retrieval-augmented generation. Builds on 28 of its 48 references that are in the map. First posted on arXiv 1 Nov 2024.

Builds on

28 of 48 references.

Closest ancestors · 4

Same direction, newest first

  1. 2024Improving Retrieval-Augmented Generation in Medicine with Iterative Follow-up Questions1 Aug
  2. 2024Bailicai: A Domain-Optimized Retrieval-Augmented Generation Framework for Medical Applications24 Jul
  3. 2024Benchmarking Retrieval-Augmented Generation for Medicine20 Feb
  4. 2023Almanac: Retrieval-Augmented Language Models for Clinical Medicine1 Mar

Other references · 24

  1. 2023Llama 2: Open Foundation and Fine-Tuned Chat Modelscited by 13,028
  2. 2020Retrieval-Augmented Generation for Knowledge-Intensive NLP Taskscited by 9,297
  3. 2020Measuring Massive Multitask Language Understandingcited by 7,963
  4. 2023Efficient Memory Management for Large Language Model Serving with PagedAttentioncited by 5,944
  5. 2019BERTScore: Evaluating Text Generation with BERTcited by 5,512
  6. 2023Self-RAG: Learning to Retrieve, Generate, and Critique through Self-Reflectioncited by 1,839
  7. 2022Large Language Models Encode Clinical Knowledgecited by 1,830
  8. 2020What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Examscited by 1,356
  9. 2024Adaptive-RAG: Learning to Adapt Retrieval-Augmented Large Language Models through Question Complexitycited by 451
  10. 2024BioMistral: A Collection of Open-Source Pretrained Large Language Models for Medical Domainscited by 301
  11. 2023ARES: An Automated Evaluation Framework for Retrieval-Augmented Generation Systemscited by 265
  12. 2024RAFT: Adapting Language Model to Domain Specific RAGcited by 262
12 more
  1. 2022RealTime QA: What's the Answer Right Now?cited by 244
  2. 2024Capabilities of Gemini Models in Medicinecited by 237
  3. 2023MedCPT: Contrastive Pre-trained Transformers with Large-scale PubMed Search Logs for Zero-shot Biomedical Information Retrievalcited by 185
  4. 2024ClashEval: Quantifying the tug-of-war between an LLM's internal prior and external evidencecited by 113
  5. 2024Speculative RAG: Enhancing Retrieval Augmented Generation through Draftingcited by 77
  6. 2024RAT: Retrieval Augmented Thoughts Elicit Context-Aware Reasoning in Long-Horizon Generationcited by 75
  7. 2023Knowledge-Augmented Reasoning Distillation for Small Language Models in Knowledge-Intensive Taskscited by 64
  8. 2023Neural Retrievers are Biased Towards LLM-Generated Contentcited by 38
  9. 2021Evaluating Entity Disambiguation and the Role of Popularity in Retrieval-Based NLPcited by 31
  10. 2024Small Language Models Learn Enhanced Reasoning Skills from Medical Textbookscited by 30
  11. 2024Similarity is Not All You Need: Endowing Retrieval Augmented Generation with Multi Layered Thoughtscited by 16
  12. 2022Automatic Creation of Named Entity Recognition Datasets by Querying Phrase Representationscited by 1

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Cited by year (2026 to 14 Oct)

Citing papers per year: 2024: 2; 2025: 16; 2026: 23.

41 papers.

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  1. 2025Training a Utility-based Retriever Through Shared Context Attribution for Retrieval-Augmented Language Modelscited by 13
  2. 2024Understanding the Impact of Confidence in Retrieval Augmented Generation: A Case Study in the Medical Domaincited by 9
  3. 2025SearchRAG: Can Search Engines Be Helpful for LLM-based Medical Question Answering?cited by 9
  4. 2025Principled Context Engineering for RAG: Statistical Guarantees via Conformal Predictioncited by 6
  5. 2025Ranking Free RAG: Replacing Re-ranking with Selection in RAG for Sensitive Domainscited by 5
  6. 2025MedCoT-RAG: Causal Chain-of-Thought RAG for Medical Question Answeringcited by 5
  7. 2024Knowledge-Augmented Multimodal Clinical Rationale Generation for Disease Diagnosis with Small Language Modelscited by 4
  8. 2025CLI-RAG: A Retrieval-Augmented Framework for Clinically Structured and Context Aware Text Generation with LLMscited by 4
  9. 2025Architecting Clinical Collaboration: Multi-Agent Reasoning Systems for Multimodal Medical VQAcited by 2
  10. 2025RAR2: Retrieval-Augmented Medical Reasoning via Thought-Driven Retrievalcited by 2
  11. 2025POLYRAG: Integrating Polyviews into Retrieval-Augmented Generation for Medical Applicationscited by 1
  12. 2025Continually Self-Improving Language Models for Bariatric Surgery Question--Answeringcited by 1
29 more
  1. 2025Evaluating LLMs in Medicine: A Call for Rigor, Transparencycited by 1
  2. 2026MED-COPILOT: A Medical Assistant Powered by GraphRAG and Similar Patient Case Retrievalcited by 1
  3. 2026When Chain-of-Thought Backfires: Evaluating Prompt Sensitivity in Medical Language Modelscited by 1
  4. 2026Process Reward Agents for Steering Knowledge-Intensive Reasoningcited by 1
  5. 2026REPAIR: Resolving Long-Tail Confusion in Scientific Retrievers via Fact-Verified Iterative Refinementcited by 1
  6. 2025ICA-RAG: Information Completeness Guided Adaptive Retrieval-Augmented Generation for Disease Diagnosiscited by 0
  7. 2025Accelerating Causal Network Discovery of Alzheimer Disease Biomarkers via Scientific Literature-based Retrieval Augmented Generationcited by 0
  8. 2025GraphMed-LT: Patient-Specific Graph Memory with Latent Clinical Thought Refinement for Multi-Turn Medical Conversationscited by 0
  9. 2025From Retrieval to Generation: Unifying External and Parametric Knowledge for Medical Question Answeringcited by 0
  10. 2025Investigating LLM Capabilities on Long Context Comprehension for Medical Question Answeringcited by 0
  11. 2026From Evidence-Based Medicine to Knowledge Graph: Retrieval-Augmented Generation for Sports Rehabilitation and a Domain Benchmarkcited by 0
  12. 2026ExDR: Explanation-driven Dynamic Retrieval Enhancement for Multimodal Fake News Detectioncited by 0
  13. 2026MedCoRAG: Interpretable Hepatology Diagnosis via Hybrid Evidence Retrieval and Multispecialty Consensuscited by 0
  14. 2026Ruling Out to Rule In: Contrastive Hypothesis Retrieval for Medical Question Answeringcited by 0
  15. 2026Effects of Cross-lingual Evidence in Multilingual Medical Question Answeringcited by 0
  16. 2026Iterative Multimodal Retrieval-Augmented Generation for Medical Question Answeringcited by 0
  17. 2026Overview of the MedHopQA track at BioCreative IX: track description, participation and evaluation of systems for multi-hop medical question answeringcited by 0
  18. 2026EHR-RAGp: Retrieval-Augmented Prototype-Guided Foundation Model for Electronic Health Recordscited by 0
  19. 2026Improving Answer Extraction in Context-based Question Answering Systems Using LLMscited by 0
  20. 2026Hybrid-IR: Dual-Path Hybrid Retrieval with Iterative Reasoning for Complex Medical Question Answeringcited by 0
  21. 2026MedJudgeRAG: Option-Wise Evidence Judgment with Dynamic Knowledge Graphs for Medical MCQAcited by 0
  22. 2026Adaptive Memory and Reflection Multi-Agent System for Medical Question Answeringcited by 0
  23. 2026Case2Flow: Bridging Patient Cases and Guideline Flowcharts through Multimodal Retrievalcited by 0
  24. 2026Constructing and Evaluating Clinical Reasoning Trajectories for Medical Agentcited by 0
  25. 2026DrugReason: Dynamic Multi-View Reasoning over Knowledge Graph and Language Evidence for Drug Repurposingcited by 0
  26. 2026Capability-Routed Visual Retrieval and Evidence Threading for Long-Context Document Question Answeringcited by 0
  27. 2026CLEAR: Cross-Source Evidence Adjudication for Large Language Models in Medicinecited by 0
  28. 2026EviGen: Predictive Evidence Scaffolding for Verifiable Clinical Rationale Generationcited by 0
  29. 2026Constraint-Driven Context Engineering: Designing Domain Interfaces for AI Systemscited by 0

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  1. 2026Benchmarking Retrieval Strategies for Biomedical Retrieval-Augmented Generation: A Controlled Empirical Study
  2. 2026When Retrieval Doesn't Help: A Large-Scale Study of Biomedical RAG
  3. 2026A Systematic Study of Retrieval Pipeline Design for Retrieval-Augmented Medical Question Answering
  4. 2025ModernBERT + ColBERT: Enhancing biomedical RAG through an advanced re-ranking retriever
  5. 2024Comprehensive and Practical Evaluation of Retrieval-Augmented Generation Systems for Medical Question Answering
  6. 2023MKRAG: Medical Knowledge Retrieval Augmented Generation for Medical Question Answering
  7. 2025Retrieval-Augmented Generation in Medicine: A Scoping Review of Technical Implementations, Clinical Applications, and Ethical Considerations
  8. 2025RAG-BioQA: A Retrieval-Augmented Generation Framework for Long-Form Biomedical Question Answering