arXiv:2511.10067cs.AIcs.CL2025-11被引 5

通过多维度自我优化,让大模型更懂医疗场景中的上下文细节。

Enhancing the Medical Context-Awareness Ability of LLMs via Multifaceted Self-Refinement Learning

  • 设计条件查询生成器模拟真实患者、医生等多角色情境。
  • 模型自评并优化回答,在决策、沟通、安全三方面提升表现。
  • 小模型经训练后超越大模型,达开源医疗LLM新标杆。

大型语言模型在医疗领域展现出巨大潜力,但在实际应用中仍因缺乏上下文感知能力而表现不佳,难以识别用户身份、病史、风险因素等关键信息,导致回复不安全或不恰当。为此,我们提出多维自我精炼(MuSeR)方法,通过自评估与自我修正,从决策、沟通和安全三个维度增强模型的上下文感知能力。首先,设计属性条件查询生成器,通过改变角色、地区、意图和信息模糊度等属性,模拟多样化真实医疗场景;随后,由模型生成回答,自评其在三方面的表现,并进行迭代优化;最后,使用优化后的数据对模型进行监督微调。在最新HealthBench数据集上的实验表明,该方法显著提升模型性能,尤其在上下文感知维度进步明显。进一步结合知识蒸馏,小型模型(如Qwen3-32B)性能超越其教师模型,在HealthBench上达到63.8%的分数,其困难子集达43.1%,刷新开源大模型新纪录。代码与数据集将公开于https://muser-llm.github.io。

原文摘要 · Abstract (English)

Large language models (LLMs) have shown great promise in the medical domain, achieving strong performance on several benchmarks. However, they continue to underperform in real-world medical scenarios, which often demand stronger context-awareness, i.e., the ability to recognize missing or critical details (e.g., user identity, medical history, risk factors) and provide safe, helpful, and contextually appropriate responses. To address this issue, we propose Multifaceted Self-Refinement (MuSeR), a data-driven approach that enhances LLMs' context-awareness along three key facets (decision-making, communication, and safety) through self-evaluation and refinement. Specifically, we first design a attribute-conditioned query generator that simulates diverse real-world user contexts by varying attributes such as role, geographic region, intent, and degree of information ambiguity. An LLM then responds to these queries, self-evaluates its answers along three key facets, and refines its responses to better align with the requirements of each facet. Finally, the queries and refined responses are used for supervised fine-tuning to reinforce the model's context-awareness ability. Evaluation results on the latest HealthBench dataset demonstrate that our method significantly improves LLM performance across multiple aspects, with particularly notable gains in the context-awareness axis. Furthermore, by incorporating knowledge distillation with the proposed method, the performance of a smaller backbone LLM (e.g., Qwen3-32B) surpasses its teacher model, achieving a new SOTA across all open-source LLMs on HealthBench (63.8%) and its hard subset (43.1%). Code and dataset will be released at https://muser-llm.github.io.

医疗AI上下文感知自我优化大模型

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