Leveraging long context in retrieval augmented language models for medical question answering.

TitleLeveraging long context in retrieval augmented language models for medical question answering.
Publication TypeJournal Article
Year of Publication2025
AuthorsZhang G, Xu Z, Jin Q, Chen F, Fang Y, Liu Y, Rousseau JF, Xu Z, Lu Z, Weng C, Peng Y
JournalNPJ Digit Med
Volume8
Issue1
Pagination239
Date Published2025 May 02
ISSN2398-6352
Abstract

While holding great promise for improving and facilitating healthcare through applications of medical literature summarization, large language models (LLMs) struggle to produce up-to-date responses on evolving topics due to outdated knowledge or hallucination. Retrieval-augmented generation (RAG) is a pivotal innovation that improves the accuracy and relevance of LLM responses by integrating LLMs with a search engine and external sources of knowledge. However, the quality of RAG responses can be largely impacted by the rank and density of key information in the retrieval results, such as the "lost-in-the-middle" problem. In this work, we aim to improve the robustness and reliability of the RAG workflow in the medical domain. Specifically, we propose a map-reduce strategy, BriefContext, to combat the "lost-in-the-middle" issue without modifying the model weights. We demonstrated the advantage of the workflow with various LLM backbones and on multiple QA datasets. This method promises to improve the safety and reliability of LLMs deployed in healthcare domains by reducing the risk of misinformation, ensuring critical clinical content is retained in generated responses, and enabling more trustworthy use of LLMs in critical tasks such as medical question answering, clinical decision support, and patient-facing applications.

DOI10.1038/s41746-025-01651-w
Alternate JournalNPJ Digit Med
PubMed ID40316710
PubMed Central IDPMC12048518
Grant ListR01 LM014573 / LM / NLM NIH HHS / United States
R01 LM009886 / LM / NLM NIH HHS / United States
NIH Intramural Research Program / / U.S. National Library of Medicine /
R01LM014344 / / U.S. National Library of Medicine /
R01 LM014344 / LM / NLM NIH HHS / United States
UL1TR002384 / / U.S. National Center for Advancing Clinical and Translational Science /
UL1 TR002384 / TR / NCATS NIH HHS / United States
UL1TR001873 / / U.S. National Center for Advancing Clinical and Translational Science /
UL1 TR001873 / TR / NCATS NIH HHS / United States
R01LM009886 / / U.S. National Library of Medicine /