# A Systematic Study of Retrieval Pipeline Design for Retrieval-Augmented Medical Question Answering

arXiv: https://arxiv.org/abs/2604.07274 · HTML: https://mlsanity.com/paper/2604.07274/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical and biomedical RAG, one of 15 directions in Retrieval-augmented generation.
- Builds on 28 of its 31 references that are in the map.
- First posted on arXiv 8 Apr 2026.

## Placed in

- Retrieval-augmented generation / [Medical and biomedical RAG](https://mlsanity.com/rag/medical-and-biomedical-rag/)

## Builds on (most cited first, 28 of 28)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Large Language Models are Zero-Shot Reasoners](https://mlsanity.com/paper/2205.11916/) (2022)
- [On the Opportunities and Risks of Foundation Models](https://mlsanity.com/paper/2108.07258/) (2021)
- [Retrieval-Augmented Generation for Large Language Models: A Survey](https://mlsanity.com/paper/2312.10997/) (2023)
- [REALM: Retrieval-Augmented Language Model Pre-Training](https://mlsanity.com/paper/2002.08909/) (2020)
- [Survey of Hallucination in Natural Language Generation](https://mlsanity.com/paper/2202.03629/) (2022)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [Improving language models by retrieving from trillions of tokens](https://mlsanity.com/paper/2112.04426/) (2021)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [BEIR: A Heterogenous Benchmark for Zero-shot Evaluation of Information Retrieval Models](https://mlsanity.com/paper/2104.08663/) (2021)
- [Leveraging Passage Retrieval with Generative Models for Open Domain Question Answering](https://mlsanity.com/paper/2007.01282/) (2020)
- [ColBERT: Efficient and Effective Passage Search via Contextualized Late Interaction over BERT](https://mlsanity.com/paper/2004.12832/) (2020)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [A Multitask, Multilingual, Multimodal Evaluation of ChatGPT on Reasoning, Hallucination, and Interactivity](https://mlsanity.com/paper/2302.04023/) (2023)
- [In-Context Retrieval-Augmented Language Models](https://mlsanity.com/paper/2302.00083/) (2023)
- [Passage Re-ranking with BERT](https://mlsanity.com/paper/1901.04085/) (2019)
- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [MedMCQA : A Large-scale Multi-Subject Multi-Choice Dataset for Medical domain Question Answering](https://mlsanity.com/paper/2203.14371/) (2022)
- [ClinicalBERT: Modeling Clinical Notes and Predicting Hospital Readmission](https://mlsanity.com/paper/1904.05342/) (2019)
- [SPLADE: Sparse Lexical and Expansion Model for First Stage Ranking](https://mlsanity.com/paper/2107.05720/) (2021)
- [Pretrained Transformers for Text Ranking: BERT and Beyond](https://mlsanity.com/paper/2010.06467/) (2020)
- [Can large language models reason about medical questions?](https://mlsanity.com/paper/2207.08143/) (2022)

## Abstract (arXiv)

Large language models (LLMs) have demonstrated strong capabilities in medical question answering; however, purely parametric models often suffer from knowledge gaps and limited factual grounding. Retrieval-augmented generation (RAG) addresses this limitation by integrating external knowledge retrieval into the reasoning process. Despite increasing interest in RAG-based medical systems, the impact of individual retrieval components on performance remains insufficiently understood. This study presents a systematic evaluation of retrieval-augmented medical question answering using the MedQA USMLE benchmark and a structured textbook-based knowledge corpus. We analyze the interaction between language models, embedding models, retrieval strategies, query reformulation, and cross-encoder reranking within a unified experimental framework comprising forty configurations. Results show that retrieval augmentation significantly improves zero-shot medical question answering performance. The best-performing configuration was dense retrieval with query reformulation and reranking achieved 60.49% accuracy. Domain-specialized language models were also found to better utilize retrieved medical evidence than general-purpose models. The analysis further reveals a clear tradeoff between retrieval effectiveness and computational cost, with simpler dense retrieval configurations providing strong performance while maintaining higher throughput. All experiments were conducted on a single consumer-grade GPU, demonstrating that systematic evaluation of retrieval-augmented medical QA systems can be performed under modest computational resources.