# AdaThink-Med: Optimizing Inference-Time Compute for Medical Reasoning via Uncertainty Quantification

arXiv: https://arxiv.org/abs/2509.24560 · HTML: https://mlsanity.com/paper/2509.24560/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 37 of its 53 references that are in the map.
- First posted on arXiv 29 Sep 2025.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)

## Builds on (most cited first, 30 of 37)

- [Qwen3 Technical Report](https://mlsanity.com/paper/2505.09388/) (2025)
- [DeepSeek-R1: Incentivizing Reasoning Capability in LLMs via Reinforcement Learning](https://mlsanity.com/paper/2501.12948/) (2025)
- [GPQA: A Graduate-Level Google-Proof Q&A Benchmark](https://mlsanity.com/paper/2311.12022/) (2023)
- [DAPO: An Open-Source LLM Reinforcement Learning System at Scale](https://mlsanity.com/paper/2503.14476/) (2025)
- [HybridFlow: A Flexible and Efficient RLHF Framework](https://mlsanity.com/paper/2409.19256/) (2024)
- [Challenging BIG-Bench Tasks and Whether Chain-of-Thought Can Solve Them](https://mlsanity.com/paper/2210.09261/) (2022)
- [Least-to-Most Prompting Enables Complex Reasoning in Large Language Models](https://mlsanity.com/paper/2205.10625/) (2022)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [Kimi k1.5: Scaling Reinforcement Learning with LLMs](https://mlsanity.com/paper/2501.12599/) (2025)
- [DeepSeek-Coder: When the Large Language Model Meets Programming -- The Rise of Code Intelligence](https://mlsanity.com/paper/2401.14196/) (2024)
- [DeepSeek-V3 Technical Report](https://mlsanity.com/paper/2412.19437/) (2024)
- [Do NOT Think That Much for 2+3=? On the Overthinking of o1-Like LLMs](https://mlsanity.com/paper/2412.21187/) (2024)
- [Beyond the 80/20 Rule: High-Entropy Minority Tokens Drive Effective Reinforcement Learning for LLM Reasoning](https://mlsanity.com/paper/2506.01939/) (2025)
- [Stop Overthinking: A Survey on Efficient Reasoning for Large Language Models](https://mlsanity.com/paper/2503.16419/) (2025)
- [L1: Controlling How Long A Reasoning Model Thinks With Reinforcement Learning](https://mlsanity.com/paper/2503.04697/) (2025)
- [Demystifying Long Chain-of-Thought Reasoning in LLMs](https://mlsanity.com/paper/2502.03373/) (2025)
- [O1-Pruner: Length-Harmonizing Fine-Tuning for O1-Like Reasoning Pruning](https://mlsanity.com/paper/2501.12570/) (2025)
- [HuatuoGPT-o1, Towards Medical Complex Reasoning with LLMs](https://mlsanity.com/paper/2412.18925/) (2024)
- [A Survey on Data Selection for Language Models](https://mlsanity.com/paper/2402.16827/) (2024)
- [MedXpertQA: Benchmarking Expert-Level Medical Reasoning and Understanding](https://mlsanity.com/paper/2501.18362/) (2025)
- [Reasoning Models Can Be Effective Without Thinking](https://mlsanity.com/paper/2504.09858/) (2025)
- [DAST: Difficulty-Adaptive Slow-Thinking for Large Reasoning Models](https://mlsanity.com/paper/2503.04472/) (2025)
- [Between Underthinking and Overthinking: An Empirical Study of Reasoning Length and correctness in LLMs](https://mlsanity.com/paper/2505.00127/) (2025)
- [Thinkless: LLM Learns When to Think](https://mlsanity.com/paper/2505.13379/) (2025)
- [SEED-GRPO: Semantic Entropy Enhanced GRPO for Uncertainty-Aware Policy Optimization](https://mlsanity.com/paper/2505.12346/) (2025)
- [Learn to Reason Efficiently with Adaptive Length-based Reward Shaping](https://mlsanity.com/paper/2505.15612/) (2025)
- [ShorterBetter: Guiding Reasoning Models to Find Optimal Inference Length for Efficient Reasoning](https://mlsanity.com/paper/2504.21370/) (2025)
- [Think Only When You Need with Large Hybrid-Reasoning Models](https://mlsanity.com/paper/2505.14631/) (2025)
- [Language Models are Hidden Reasoners: Unlocking Latent Reasoning Capabilities via Self-Rewarding](https://mlsanity.com/paper/2411.04282/) (2024)
- [Med42 -- Evaluating Fine-Tuning Strategies for Medical LLMs: Full-Parameter vs. Parameter-Efficient Approaches](https://mlsanity.com/paper/2404.14779/) (2024)

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

- [Medical Reasoning with Large Language Models: A Survey and MR-Bench](https://mlsanity.com/paper/2604.08559/) (2026)
- [TAM-Chain: Multi-Scale Thyroid Cytology Classification via Absorbing Markov Chains and Shannon Entropy Uncertainty Quantification for False-Negative Suppression and Domain-Shift Adaptation](https://mlsanity.com/paper/2609.28590/) (2026)

## Abstract (arXiv)

Extended Chain-of-Thought (CoT) reasoning has significantly bolstered the capabilities of medical large language models (LLMs). However, current models exhibit static computational expenditure, applying lengthy reasoning processes indiscriminately to both simple queries and complex diagnostic cases. This inefficiency is particularly prohibitive in real-world healthcare, where clinical scenarios range from time-sensitive emergencies requiring rapid response to intricate pathologies demanding deep analysis. To address this, we propose AdaThink-MedfootnoteCode available at https://github.com/shaohao011/AdaThinkMed, an end-to-end framework for adaptive reasoning via uncertainty-guided length calibration. Although the underlying mechanism is generalizable, we demonstrate its critical value in the medical domain, where balancing inference latency with diagnostic precision is paramount. AdaThink-Med leverages entropy-based uncertainty estimation within reinforcement fine-tuning to dynamically shape reward signals: it penalizes verbosity for high-confidence correct answers (e.g., straightforward knowledge retrieval) while incentivizing extended exploration for uncertain or ambiguous scenarios. Across six medical benchmarks, AdaThink-Med reduces inference token consumption by 4.7× to 6.4× on Qwen and Llama architectures, respectively, with minimal performance trade-offs. Notably, our reward design naturally produces distinct ``non-thinking'' and ``thinking'' modes within a single model, enabling efficient allocation of computational resources without any external router or classifier.