# EMPOWER: Evolutionary Medical Prompt Optimization With Reinforcement Learning

arXiv: https://arxiv.org/abs/2508.17703 · HTML: https://mlsanity.com/paper/2508.17703/

## Key facts

- Cited by 6 papers in the map (data through 14 Oct 2026).
- Placed in RL for clinical treatment and surgery, one of 15 directions in Deep reinforcement learning methods.
- First posted on arXiv 25 Aug 2025.

## Placed in

- Deep reinforcement learning methods / [RL for clinical treatment and surgery](https://mlsanity.com/deeprl/rl-for-clinical-treatment-and-surgery/)

## Built on by (most cited first, 6 of 6)

- [What if Agents Could Imagine? Reinforcing Open-Vocabulary HOI Comprehension through Generation](https://mlsanity.com/paper/2602.11499/) (2026)
- [CoC-VLA: Delving into Adversarial Domain Transfer for Explainable Autonomous Driving via Chain-of-Causality Visual-Language-Action Model](https://mlsanity.com/paper/2511.19914/) (2025)
- [IndusAgent: Reinforcing Open-Vocabulary Industrial Anomaly Detection with Agentic Tools](https://mlsanity.com/paper/2605.20682/) (2026)
- [LLM-Guided Evolution for Medical Decision Pipelines](https://mlsanity.com/paper/2606.07342/) (2026)
- [Conflict-Aware Federated Fine-Tuning of Large Language Models with Mixture-of-Experts](https://mlsanity.com/paper/2606.15625/) (2026)
- [X-Ragent: Tool-Augmented Reinforcement Learning for Evidence-Grounded Chest X-Ray Reasoning](https://mlsanity.com/paper/2610.16811/) (2026)

## Abstract (arXiv)

Prompt engineering significantly influences the reliability and clinical utility of Large Language Models (LLMs) in medical applications. Current optimization approaches inadequately address domain-specific medical knowledge and safety requirements. This paper introduces EMPOWER, a novel evolutionary framework that enhances medical prompt quality through specialized representation learning, multi-dimensional evaluation, and structure-preserving algorithms. Our methodology incorporates: (1) a medical terminology attention mechanism, (2) a comprehensive assessment architecture evaluating clarity, specificity, clinical relevance, and factual accuracy, (3) a component-level evolutionary algorithm preserving clinical reasoning integrity, and (4) a semantic verification module ensuring adherence to medical knowledge. Evaluation across diagnostic, therapeutic, and educational tasks demonstrates significant improvements: 24.7% reduction in factually incorrect content, 19.6% enhancement in domain specificity, and 15.3% higher clinician preference in blinded evaluations. The framework addresses critical challenges in developing clinically appropriate prompts, facilitating more responsible integration of LLMs into healthcare settings.