# Case2Flow: Bridging Patient Cases and Guideline Flowcharts through Multimodal Retrieval

arXiv: https://arxiv.org/abs/2608.26414 · HTML: https://mlsanity.com/paper/2608.26414/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 9 of its 21 references that are in the map.
- First posted on arXiv 26 Aug 2026.

## Builds on (most cited first, 9 of 9)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [M3-Embedding: Multi-Linguality, Multi-Functionality, Multi-Granularity Text Embeddings Through Self-Knowledge Distillation](https://mlsanity.com/paper/2402.03216/) (2024)
- [VisRAG: Vision-based Retrieval-augmented Generation on Multi-modality Documents](https://mlsanity.com/paper/2410.10594/) (2024)
- [MedAgent-Pro: Towards Evidence-based Multi-modal Medical Diagnosis via Reasoning Agentic Workflow](https://mlsanity.com/paper/2503.18968/) (2025)
- [VDocRAG: Retrieval-Augmented Generation over Visually-Rich Documents](https://mlsanity.com/paper/2504.09795/) (2025)
- [Rationale-Guided Retrieval Augmented Generation for Medical Question Answering](https://mlsanity.com/paper/2411.00300/) (2024)
- [FT-MDT: Extracting Decision Trees from Medical Texts via a Novel Low-rank Adaptation Method](https://mlsanity.com/paper/2510.04655/) (2025)
- [Training and Evaluation of Guideline-Based Medical Reasoning in LLMs](https://mlsanity.com/paper/2512.03838/) (2025)

## Abstract (arXiv)

Medical guidelines encode rich, evidence-based decision logic, yet the specific decision artifact a clinician needs is hard to locate within a guideline, let alone across guidelines covering plausible diseases and treatments. While guideline passages have supported end-to-end question answering, flowcharts remain largely underused in decision support despite their ability to encode actionable clinical pathways. We therefore introduce Case2Flow, a task designed to retrieve the most relevant guideline flowchart for a given patient case from a collection of guideline documents. To support it, we construct FlowAtlas, a curated corpus of 202 flowcharts extracted from 2,080 medical guidelines, together with a pipeline that synthesises 1,911 aligned case-flowchart pairs. Our evaluation of multimodal retrieval methods reveals systematic failure modes, including overreliance on keywords and spurious token-patch matches induced by uninformative background regions in flowcharts. Motivated by this, we propose CRISP, a training-free scoring method that sharpens late-interaction retrieval by suppressing uninformative patches, discounting ambiguous token matches, and incorporating bidirectional query-image alignment. CRISP improves Recall@1 by up to 18.71 percentage points, while a blinded physician assessment on published case narratives provides preliminary feasibility evidence beyond synthetic queries.