# Refine Medical Diagnosis Using Generation Augmented Retrieval and Clinical Practice Guidelines

arXiv: https://arxiv.org/abs/2506.21615 · HTML: https://mlsanity.com/paper/2506.21615/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 14 of its 55 references that are in the map.
- First posted on arXiv 22 Jun 2025.

## Builds on (most cited first, 14 of 14)

- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [DeepSeek-R1: Incentivizing Reasoning Capability in LLMs via Reinforcement Learning](https://mlsanity.com/paper/2501.12948/) (2025)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [A Survey on Hallucination in Large Language Models: Principles, Taxonomy, Challenges, and Open Questions](https://mlsanity.com/paper/2311.05232/) (2023)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [Smarter, Better, Faster, Longer: A Modern Bidirectional Encoder for Fast, Memory Efficient, and Long Context Finetuning and Inference](https://mlsanity.com/paper/2412.13663/) (2024)
- [ClinicalBERT: Modeling Clinical Notes and Predicting Hospital Readmission](https://mlsanity.com/paper/1904.05342/) (2019)
- [MEDITRON-70B: Scaling Medical Pretraining for Large Language Models](https://mlsanity.com/paper/2311.16079/) (2023)
- [Knowledge Editing for Large Language Models: A Survey](https://mlsanity.com/paper/2310.16218/) (2023)
- [LLMs Accelerate Annotation for Medical Information Extraction](https://mlsanity.com/paper/2312.02296/) (2023)
- [Large Language Models for Disease Diagnosis: A Scoping Review](https://mlsanity.com/paper/2409.00097/) (2024)
- [EMERGE: Enhancing Multimodal Electronic Health Records Predictive Modeling with Retrieval-Augmented Generation](https://mlsanity.com/paper/2406.00036/) (2024)
- [Causality extraction from medical text using Large Language Models (LLMs)](https://mlsanity.com/paper/2407.10020/) (2024)
- [RGAR: Recurrence Generation-augmented Retrieval for Factual-aware Medical Question Answering](https://mlsanity.com/paper/2502.13361/) (2025)

## Built on by (most cited first, 1 of 1)

- [From Evidence-Based Medicine to Knowledge Graph: Retrieval-Augmented Generation for Sports Rehabilitation and a Domain Benchmark](https://mlsanity.com/paper/2601.00216/) (2026)

## Abstract (arXiv)

Current medical language models, adapted from large language models (LLMs), typically predict ICD code-based diagnosis from electronic health records (EHRs) because these labels are readily available. However, ICD codes do not capture the nuanced, context-rich reasoning clinicians use for diagnosis. Clinicians synthesize diverse patient data and reference clinical practice guidelines (CPGs) to make evidence-based decisions. This misalignment limits the clinical utility of existing models. We introduce GARMLE-G, a Generation-Augmented Retrieval framework that grounds medical language model outputs in authoritative CPGs. Unlike conventional Retrieval-Augmented Generation based approaches, GARMLE-G enables hallucination-free outputs by directly retrieving authoritative guideline content without relying on model-generated text. It (1) integrates LLM predictions with EHR data to create semantically rich queries, (2) retrieves relevant CPG knowledge snippets via embedding similarity, and (3) fuses guideline content with model output to generate clinically aligned recommendations. A prototype system for hypertension diagnosis was developed and evaluated on multiple metrics, demonstrating superior retrieval precision, semantic relevance, and clinical guideline adherence compared to RAG-based baselines, while maintaining a lightweight architecture suitable for localized healthcare deployment. This work provides a scalable, low-cost, and hallucination-free method for grounding medical language models in evidence-based clinical practice, with strong potential for broader clinical deployment.