arXiv:2605.14126cs.LGcs.AI2026-05

用强化学习提升医疗数据智能体的多步推理能力,准确率从50%提至77%。

Reinforcement Learning for Tool-Calling Agents in Fast Healthcare Interoperability Resources (FHIR)

论文配图:Reinforcement Learning for Tool-Calling Agents in Fast Healthcare Interoperability Resources (FHIR)
图 1 · 摘自论文原文
  • 将FHIR医疗数据图的推理任务建模为序列决策问题,通过强化学习优化智能体行为。
  • 在真实医院数据上,使用Qwen3-8B模型使答案正确率从50%提升至77%。
  • 适合医疗AI、临床决策系统开发者,尤其关注数据完整性与多步推理的场景。

Fast Healthcare Interoperability Resources (FHIR) 是医疗数据互操作性的主流标准,其电子健康记录构成可查询的结构化图。回答临床相关问题需智能体在多种资源类型间进行多步推理、过滤与聚合。先前研究表明,即使采用工具增强的LLM智能体(如检索、代码执行、多轮规划),仍常选错资源或违反遍历约束。本文在FHIR-AgentBench基准上研究该问题,将FHIR上的推理建模为可查询结构化图上的序列决策过程。我们实现了一个多轮CodeAct智能体,并通过自定义环境与工具进行强化学习后训练。由LLM Judge提供的执行感知奖励信号驱动优化。相比提示工程与封闭模型基线,强化学习后训练显著提升性能并强制遵守数据完整性约束。实验表明,使用更小更便宜的Qwen3-8B模型,在FHIR-AgentBench上答案正确率从50%(o4-mini)提升至77%。本文提出一个端到端后训练流程(环境构建、指令架设、模型训练与定制评估),可稳定提升对结构化临床图的多轮推理能力。

原文摘要 · Abstract (English)

Fast Healthcare Interoperability Resources (FHIR) is the dominant standard for interoperable exchange of healthcare data. In FHIR, electronic health records form a directed graph of resources. Answering clinically meaningful questions over FHIR requires agents to perform multi-step reasoning, filtering, and aggregation across multiple resource types. Prior work shows that even tool-augmented LLM agents (retrieval, code execution, multi-turn planning) often select the wrong resources or violate traversal constraints. We study this problem in the context of FHIR-AgentBench, a benchmark for realistic question answering over real-world hospital data, and frame reasoning on FHIR as a sequential decision-making problem over a queryable structured graph. We implement a multi-turn CodeAct agent and post-train it with reinforcement learning using a custom harness and tools. A LLM Judge provides execution-grounded rewards. Compared to prompt-based, closed-model baselines, RL post-training improves performance while enforcing data-integrity constraints. Empirically, our approach improves answer correctness from 50% (o4-mini) to 77% on FHIR-AgentBench using a smaller and cheaper Qwen3-8B model. We present an end-to-end post-training pipeline (environment building, harness construction, model training and custom evaluation) that reliably improves multi-turn reasoning over structured clinical graphs.

医疗AI强化学习多步推理FHIR

Thank you to arXiv for use of its open access interoperability. PaperDance 不是 arXiv 官方产品;中文卡片由大模型生成,请以原文为准。