arXiv:2511.10900cs.CLcs.AI2025-11AAAI被引 4

针对急救医疗问答,引入专家级提示与检索增强生成,显著提升模型准确性。

Expert-Guided Prompting and Retrieval-Augmented Generation for Emergency Medical Service Question Answering

  • 基于临床领域和资质等级设计分层提示,引导模型推理。
  • 结合专业知识库检索,使回答准确率最高提升4.59%。
  • 适用于急救医疗培训与认证模拟,适合医学AI研发者参考。

大型语言模型在医疗问答中表现潜力,但常忽视专业人员依赖的领域专长(如创伤、气道)和资质等级(如EMT、Paramedic)。现有方法多采用通用提示或检索策略,未充分利用结构化背景信息,限制了高风险场景下的性能。本文提出EMSQA数据集,包含24.3K道多选题,覆盖10个临床领域和4个资质等级,并构建了40K文档、200万词符的领域对齐知识库。在此基础上,提出(i)Expert-CoT:基于临床领域与资质等级的链式思维提示策略;(ii)ExpertRAG:基于领域对齐文档与真实患者数据的检索增强生成管道。在4个LLM上的实验表明,Expert-CoT相比基础CoT提升最高2.05%;结合ExpertRAG后,相较标准RAG基线最高提升4.59%。值得注意的是,32B参数的专家增强型LLM成功通过所有计算机自适应急救认证模拟考试。

原文摘要 · Abstract (English)

Large language models (LLMs) have shown promise in medical question answering, yet they often overlook the domain-specific expertise that professionals depend on, such as the clinical subject areas (e.g., trauma, airway) and the certification level (e.g., EMT, Paramedic). Existing approaches typically apply general-purpose prompting or retrieval strategies without leveraging this structured context, limiting performance in high-stakes settings. We address this gap with EMSQA, an 24.3K-question multiple-choice dataset spanning 10 clinical subject areas and 4 certification levels, accompanied by curated, subject area-aligned knowledge bases (40K documents and 2M tokens). Building on EMSQA, we introduce (i) Expert-CoT, a prompting strategy that conditions chain-of-thought (CoT) reasoning on specific clinical subject area and certification level, and (ii) ExpertRAG, a retrieval-augmented generation pipeline that grounds responses in subject area-aligned documents and real-world patient data. Experiments on 4 LLMs show that Expert-CoT improves up to 2.05% over vanilla CoT prompting. Additionally, combining Expert-CoT with ExpertRAG yields up to a 4.59% accuracy gain over standard RAG baselines. Notably, the 32B expertise-augmented LLMs pass all the computer-adaptive EMS certification simulation exams.

医疗问答提示工程RAG急救

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