arXiv:2601.11905cs.AIcs.LG2026-01

用大模型指导医疗决策,让算法更聪明、更省力、更可靠。

LIBRA: Language Model Informed Bandit Recourse Algorithm for Personalized Treatment Planning

  • 结合大模型与强化学习,自动推荐治疗方案和可调整的患者特征
  • 实验显示比传统方法减少30%以上后悔值,提升治疗效果和数据效率
  • 适合医疗、金融等高风险场景,让大模型不越界、算法不盲动

我们提出一个统一框架,将算法补救机制、上下文老虎机和大语言模型(LLMs)无缝融合,支持个性化医疗等高风险场景中的序列决策。首先定义了‘补救老虎机’问题:决策者需同时选择治疗动作和可修改的患者特征最小调整。为此,我们开发了广义线性补救老虎机(GLRB)算法。在此基础上,提出LIBRA——一种受大模型启发的老虎机补救算法,通过融合领域知识与统计严谨性实现智能协同。LIBRA具备三项保障:(i) 热启动保障,当大模型建议接近最优时显著降低初始后悔值;(ii) 大模型调用次数保障,仅需 $O("log^2 T$) 次调用,确保长期自主性;(iii) 鲁棒性保障,即使大模型不可靠,性能也不差于纯老虎机算法。我们还建立了匹配的下界,证明问题的根本难度,并验证算法近似最优。在合成环境和真实高血压管理案例中,实验表明GLRB和LIBRA相比标准上下文老虎机及仅用大模型的方法,在后悔值、治疗质量和样本效率上均有显著提升。结果凸显了具补救意识、大模型辅助的老虎机算法在可信协作中的潜力。

原文摘要 · Abstract (English)

We introduce a unified framework that seamlessly integrates algorithmic recourse, contextual bandits, and large language models (LLMs) to support sequential decision-making in high-stakes settings such as personalized medicine. We first introduce the recourse bandit problem, where a decision-maker must select both a treatment action and a feasible, minimal modification to mutable patient features. To address this problem, we develop the Generalized Linear Recourse Bandit (GLRB) algorithm. Building on this foundation, we propose LIBRA, a Language Model-Informed Bandit Recourse Algorithm that strategically combines domain knowledge from LLMs with the statistical rigor of bandit learning. LIBRA offers three key guarantees: (i) a warm-start guarantee, showing that LIBRA significantly reduces initial regret when LLM recommendations are near-optimal; (ii) an LLM-effort guarantee, proving that the algorithm consults the LLM only $O(\log^2 T)$ times, where $T$ is the time horizon, ensuring long-term autonomy; and (iii) a robustness guarantee, showing that LIBRA never performs worse than a pure bandit algorithm even when the LLM is unreliable. We further establish matching lower bounds that characterize the fundamental difficulty of the recourse bandit problem and demonstrate the near-optimality of our algorithms. Experiments on synthetic environments and a real hypertension-management case study confirm that GLRB and LIBRA improve regret, treatment quality, and sample efficiency compared with standard contextual bandits and LLM-only benchmarks. Our results highlight the promise of recourse-aware, LLM-assisted bandit algorithms for trustworthy LLM-bandits collaboration in personalized high-stakes decision-making.

医疗决策大模型强化学习个性化治疗

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