{"title":"Leveraging long context in retrieval augmented language models for medical question answering","authors":"Gongbo Zhang, Zihan Xu, Qiao Jin, Fangyi Chen, Yilu Fang, Yi Liu, Justin F. Rousseau, Ziyang Xu, Zhiyong Lu, Chunhua Weng, Yifan Peng","doi":"10.1038/s41746-025-01651-w","DOIUrl":null,"url":null,"abstract":"<p>While holding great promise for improving and facilitating healthcare through applications of medical literature summarization, large language models (LLMs) struggle to produce up-to-date responses on evolving topics due to outdated knowledge or hallucination. Retrieval-augmented generation (RAG) is a pivotal innovation that improves the accuracy and relevance of LLM responses by integrating LLMs with a search engine and external sources of knowledge. However, the quality of RAG responses can be largely impacted by the rank and density of key information in the retrieval results, such as the “lost-in-the-middle” problem. In this work, we aim to improve the robustness and reliability of the RAG workflow in the medical domain. Specifically, we propose a map-reduce strategy, BriefContext, to combat the “lost-in-the-middle” issue without modifying the model weights. We demonstrated the advantage of the workflow with various LLM backbones and on multiple QA datasets. This method promises to improve the safety and reliability of LLMs deployed in healthcare domains by reducing the risk of misinformation, ensuring critical clinical content is retained in generated responses, and enabling more trustworthy use of LLMs in critical tasks such as medical question answering, clinical decision support, and patient-facing applications.</p>","PeriodicalId":19349,"journal":{"name":"NPJ Digital Medicine","volume":"55 1","pages":""},"PeriodicalIF":12.4000,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"NPJ Digital Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41746-025-01651-w","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
While holding great promise for improving and facilitating healthcare through applications of medical literature summarization, large language models (LLMs) struggle to produce up-to-date responses on evolving topics due to outdated knowledge or hallucination. Retrieval-augmented generation (RAG) is a pivotal innovation that improves the accuracy and relevance of LLM responses by integrating LLMs with a search engine and external sources of knowledge. However, the quality of RAG responses can be largely impacted by the rank and density of key information in the retrieval results, such as the “lost-in-the-middle” problem. In this work, we aim to improve the robustness and reliability of the RAG workflow in the medical domain. Specifically, we propose a map-reduce strategy, BriefContext, to combat the “lost-in-the-middle” issue without modifying the model weights. We demonstrated the advantage of the workflow with various LLM backbones and on multiple QA datasets. This method promises to improve the safety and reliability of LLMs deployed in healthcare domains by reducing the risk of misinformation, ensuring critical clinical content is retained in generated responses, and enabling more trustworthy use of LLMs in critical tasks such as medical question answering, clinical decision support, and patient-facing applications.
期刊介绍:
npj Digital Medicine is an online open-access journal that focuses on publishing peer-reviewed research in the field of digital medicine. The journal covers various aspects of digital medicine, including the application and implementation of digital and mobile technologies in clinical settings, virtual healthcare, and the use of artificial intelligence and informatics.
The primary goal of the journal is to support innovation and the advancement of healthcare through the integration of new digital and mobile technologies. When determining if a manuscript is suitable for publication, the journal considers four important criteria: novelty, clinical relevance, scientific rigor, and digital innovation.