# Large Language Models for Structured Clinical Data Analysis: Dual-Agent Grounding and Validation

arXiv: https://arxiv.org/abs/2609.34039 · HTML: https://mlsanity.com/paper/2609.34039/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 8 of its 24 references that are in the map.
- First posted on arXiv 28 Sep 2026.

## Builds on (most cited first, 8 of 8)

- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Toolformer: Language Models Can Teach Themselves to Use Tools](https://mlsanity.com/paper/2302.04761/) (2023)
- [Aleatoric and Epistemic Uncertainty in Machine Learning: An Introduction to Concepts and Methods](https://mlsanity.com/paper/1910.09457/) (2019)
- [HuatuoGPT, towards Taming Language Model to Be a Doctor](https://mlsanity.com/paper/2305.15075/) (2023)
- [Towards Building Multilingual Language Model for Medicine](https://mlsanity.com/paper/2402.13963/) (2024)
- [BianQue: Balancing the Questioning and Suggestion Ability of Health LLMs with Multi-turn Health Conversations Polished by ChatGPT](https://mlsanity.com/paper/2310.15896/) (2023)
- [Question Answering for Complex Electronic Health Records Database using Unified Encoder-Decoder Architecture](https://mlsanity.com/paper/2111.14703/) (2021)
- [Towards Understanding the Generalization of Medical Text-to-SQL Models and Datasets](https://mlsanity.com/paper/2303.12898/) (2023)

## Abstract (arXiv)

Objective: To develop and characterize CLEAR-Med, a dual-agent framework for natural-language analysis of structured clinical data that separates SQL-based invocation from independent validation. Methods: CLEAR-Med uses one agent to translate a question into executable Structured Query Language (SQL), retain the executed query and database result, and produce a draft. Deterministic checks and a separately invoked cross-provider Validation Agent then accept the draft, request one bounded repair, or abstain. We formalized the system as a bounded selective pipeline and evaluated CLEAR-Med's configuration and scalability, and the Invocation Agent's accuracy and consistency on a 25-query development benchmark, using a harmonized 21-site neonatal hypoxic-ischemic encephalopathy table containing 532 de-identified infant records and approximately 1,300 variables. Results: CLEAR-Med completed all six nominal scalability configurations, including 500x1300. Across 25 development-benchmark queries repeated five times, the Invocation Agent answered 83 of 125 responses correctly (66.4%; query-cluster bootstrap 95% CI, 48.0-83.2%), compared with 15 of 125 (12.0%; 95% CI, 3.2-22.4%) for the ungrounded ChatGPT baseline, a paired improvement of 54.4 percentage points (95% CI, 36.8-72.0%). Conclusion: CLEAR-Med provides a general architecture for traceable analysis of structured clinical data: numerical claims remain linked to executed SQL, and unresolved cases can fail closed. The reported experiments characterize CLEAR-Med's configuration and scalability and the Invocation Agent's accuracy, while the formal analysis establishes the encoded-property guarantee of the complete control flow; a prospective full-pipeline evaluation of the validation and abstention stages is the next stage of this work.