构建医疗数据查询评测基准,检验大模型在真实问诊场景下的准确性和稳定性。
From Conversation to Query Execution: Benchmarking User and Tool Interactions for EHR Database Agents
- 设计双交互流程模拟临床问诊中的模糊提问与术语不一致问题。
- 顶尖模型在增量优化任务中通过率超90%,但在动态调整任务中仅60%-70%。
- 揭示模型在医疗数据查询中的脆弱性,适合医疗AI安全研究者参考。
尽管大语言模型驱动的智能体表现优异,其在电子健康记录(EHR)数据访问中的应用仍受限于缺乏能真实反映临床数据访问流程的评测基准。实际应用中存在两大挑战:用户提问模糊导致查询歧义,以及用户术语与数据库字段间存在语义不匹配。为此,我们提出EHR-ChatQA,一个交互式数据库问答评测基准,用于评估智能体从澄清问题、使用工具解决术语差异到生成正确SQL并返回答案的全流程能力。该基准在模拟环境中,通过基于LLM的用户在两种交互流程下进行测试:增量查询优化(IncreQA),用户逐步添加约束;自适应查询优化(AdaptQA),用户中途调整搜索目标。在五次独立实验中,最先进模型(如o4-mini和Gemini-2.5-Flash)在IncreQA上达到超过90%的Pass@5(至少一次成功),在AdaptQA上为60%-70%;但其一致性表现(Pass^5)显著下降,差距最高达约60%。结果凸显出在安全敏感的EHR领域,智能体不仅需高效,更需稳健。我们还提供常见失败模式的诊断分析,以指导未来开发。代码与数据已公开于https://github.com/glee4810/EHR-ChatQA。
原文摘要 · Abstract (English)
Despite the impressive performance of LLM-powered agents, their adoption for Electronic Health Record (EHR) data access remains limited by the absence of benchmarks that adequately capture real-world clinical data access flows. In practice, two core challenges hinder deployment: query ambiguity from vague user questions and value mismatch between user terminology and database entries. To address this, we introduce EHR-ChatQA, an interactive database question answering benchmark that evaluates the end-to-end workflow of database agents: clarifying user questions, using tools to resolve value mismatches, and generating correct SQL to deliver accurate answers. To cover diverse patterns of query ambiguity and value mismatch, EHR-ChatQA assesses agents in a simulated environment with an LLM-based user across two interaction flows: Incremental Query Refinement (IncreQA), where users add constraints to existing queries, and Adaptive Query Refinement (AdaptQA), where users adjust their search goals mid-conversation. Experiments with state-of-the-art LLMs (e.g., o4-mini and Gemini-2.5-Flash) over five i.i.d. trials show that while the best-performing agents achieve Pass@5 of over 90% (at least one of five trials) on IncreQA and 60-70% on AdaptQA, their Pass^5 (consistent success across all five trials) is substantially lower, with gaps of up to about 60%. These results underscore the need to build agents that are not only performant but also robust for the safety-critical EHR domain. Finally, we provide diagnostic insights into common failure modes to guide future agent development. Our code and data are publicly available at https://github.com/glee4810/EHR-ChatQA.
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