Strong Reasoning Isn't Enough: Evaluating Evidence Elicitation in Interactive Diagnosis
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Abstract (arXiv)
Interactive medical consultation requires an agent to proactively elicit missing clinical evidence under uncertainty. Yet existing evaluations largely remain static or outcome-centric, neglecting the evidence-gathering process. In this work, we propose an interactive evaluation framework that explicitly models the consultation process using a simulated patient and a revsimulated reporter grounded in atomic evidences. Based on this representation, we introduce Information Coverage Rate (ICR) to quantify how completely an agent uncovers necessary evidence during interaction. To support systematic study, we build EviMed, an evidence-based benchmark spanning diverse conditions from common complaints to rare diseases, and evaluate 10 models with varying reasoning abilities. We find that strong diagnostic reasoning does not guarantee effective information collection, and this insufficiency acts as a primary bottleneck limiting performance in interactive settings. To address this, we propose REFINE, a strategy that leverages diagnostic verification to guide the agent in proactively resolving uncertainties. Extensive experiments demonstrate that REFINE consistently outperforms baselines across diverse datasets and facilitates effective model collaboration, enabling smaller agents to achieve superior performance under strong reasoning supervision. Our code can be found at https://github.com/NanshineLoong/EID-Benchmark .
Key facts. Cited by 2 papers in the map (data through 7 Oct 2026). Builds on 27 of its 47 references that are in the map. First posted on arXiv 27 Jan 2026.
Builds on
27 of 47 references.
References · 27
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15 more
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- 2025LLMs Get Lost In Multi-Turn Conversationcited by 400
- 2023MedAgents: Large Language Models as Collaborators for Zero-shot Medical Reasoningcited by 311
- 2023MINT: Evaluating LLMs in Multi-turn Interaction with Tools and Language Feedbackcited by 293
- 2024AgentClinic: a multimodal agent benchmark to evaluate AI in simulated clinical environmentscited by 215
- 2024MediQ: Question-Asking LLMs and a Benchmark for Reliable Interactive Clinical Reasoningcited by 145
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- 2024ClinicalLab: Aligning Agents for Multi-Departmental Clinical Diagnostics in the Real Worldcited by 28
- 2024LLMs Can Simulate Standardized Patients via Agent Coevolutioncited by 22
- 2025Ask Patients with Patience: Enabling LLMs for Human-Centric Medical Dialogue with Grounded Reasoningcited by 19
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Citing papers per year: 2026: 2.
2 papers.
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- 2026Active Evidence-Seeking and Diagnostic Reasoning in Large Language Models for Clinical Decision Support
- 2026MeDxAgent: Multi-Agent Consultation for Interactive Medical Diagnosis
- 2026EviDx: Evidence-Aware Active Diagnosis with Scaffolded LLM Agents
- 2026Reinforcement Learning for Evidence-Seeking Diagnostic Reasoning with Large Language Models
- 2026ConsultMind:Towards Automated Diagnostic Consultation via Uncertainty-Aware Reasoning
- 2026Improving Clinical Diagnosis with Counterfactual Multi-Agent Reasoning
- 2024Enhancing Diagnostic Accuracy through Multi-Agent Conversations: Using Large Language Models to Mitigate Cognitive Bias
- 2026Within the MDT Room: Situated in Multidisciplinary Team-Grounded Agent Debate for Clinical Diagnosis