# RASC+: Retrieval-Constrained LLM Adjudication for Clinical Value Set Authoring

arXiv: https://arxiv.org/abs/2606.23992 · HTML: https://mlsanity.com/paper/2606.23992/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 5 of its 6 references that are in the map.
- First posted on arXiv 22 Jun 2026.

## Builds on (most cited first, 5 of 5)

- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Qwen3 Embedding: Advancing Text Embedding and Reranking Through Foundation Models](https://mlsanity.com/paper/2506.05176/) (2025)
- [Self-Alignment Pretraining for Biomedical Entity Representations](https://mlsanity.com/paper/2010.11784/) (2020)
- [MedCPT: Contrastive Pre-trained Transformers with Large-scale PubMed Search Logs for Zero-shot Biomedical Information Retrieval](https://mlsanity.com/paper/2307.00589/) (2023)
- [Retrieve, Then Classify: Corpus-Grounded Automation of Clinical Value Set Authoring](https://mlsanity.com/paper/2604.14616/) (2026)

## Abstract (arXiv)

Clinical value sets define the standardized terminology codes used in quality measurement, phenotyping, cohort construction, and clinical decision support. The recently introduced Retrieval-Augmented Set Completion (RASC) benchmark showed that direct zero-shot large language model (LLM) generation is poorly suited to this task: clinical code systems are large, version-controlled, and not reliably memorized by language models. We study a stage-wise alternative in which candidate-pool construction is optimized for recall and a constrained LLM adjudicator is optimized for candidate selection. On the full 3,744-value-set RASC test split, Qwen3-based retrieval with vocabulary-aware expansion and code-display rescue retrieval increases candidate-pool recall from the original RASC retrieval baseline of 0.553 to 0.730; on the held-out-publisher stratum, pool recall is 0.655. The higher-recall pool alone is not sufficient: applying the original SAPBert cross-encoder to this expanded pool gives full-test macro F1 of 0.287 and held-out-publisher macro F1 of 0.233. Replacing the stage-2 selector with blinded GPT-5 adjudication over the same pool increases full-test macro F1 to 0.549 and held-out-publisher macro F1 to 0.533. These results show that retrieval-constrained LLM adjudication can substantially improve value set completion while preserving the safety constraint that all returned codes must come from an auditable candidate pool.