让医疗大模型主动提问，减少误诊风险

Interactive medical questioning is essential in clinical consultations, where physicians must actively gather necessary patient information. Yet existing medical Large Language Models (LLMs) predominantly follow a reactive paradigm, risking diagnostic errors by answering before seeking sufficient details. To bridge this gap, we propose ProMed, a reinforcement learning framework that transitions LLMs toward a proactive paradigm, enabling them to ask clinically valuable questions before decision-making. Central to ProMed is the Shapley Information Gain (SIG) reward, which quantifies a question's clinical utility as the amount of newly acquired information, while considering its contextual importance via Shapley values. We integrate SIG into a two-stage training pipeline: (1) SIG-Guided Model Initialization uses Monte Carlo Tree Search to construct high-reward interaction trajectories for supervision, and (2) SIG-Augmented Policy Optimization, with a novel SIG-guided Reward Distribution Mechanism that prioritizes informative questions for fine-grained optimization. Experiments on partial-information medical benchmarks show that ProMed significantly outperforms state-of-the-art methods by 6.29% on average and delivers a 54.45% gain over the reactive paradigm, and generalizes robustly to out-of-domain cases. Our codes are available at https://github.com/hxxding/ProMed.