Organizations: Department of Computer Science, Stanford University, Stanford, CA, USA · Samueli Electrical and Computer Engineering, UCLA, Los Angeles, CA, USA · Department of Computer Science, Emory University, Atlanta, GA, USA · Mayo Clinic, Rochester, MN, USA
Abstract
Many real-world retrieval and matching problems require more than topical relevance: a candidate must satisfy the specific constraints of one profile among many, not just be relevant to it. Clinical trials are a high-stakes instance of this challenge: they are central to evidence-based medicine, yet many struggle to meet enrollment targets, despite the availability of over half a million trials listed on ClinicalTrials.gov, which attracts approximately two million users monthly. Existing retrieval techniques, largely based on keyword and embedding-similarity matching, treat eligibility constraints as soft signals rather than binding requirements, resulting in low recall, low precision, and limited interpretability. We propose SatIR, a scalable, efficient, high-precision, high-recall, interpretable clinical trial retrieval method based on formal constraint satisfaction. Leveraging established medical ontologies, we use Large Language Models (LLMs) to convert informal reasoning -- regarding ambiguity, implicit clinical assumptions, and incomplete patient records -- into explicit, precise, controllable, and interpretable formal Satisfiability Modulo Theories (SMT) constraints. For scalable and efficient retrieval, we project the SMT matching problem onto relational algebra, enabling an efficient database implementation that retains high recall while sacrificing little precision. SatIR consistently improves eligibility-aware retrieval over similarity-based baselines on the SIGIR 2016 dataset and a benchmark derived from TREC 2022. Relative to TrialGPT-style retrieval, SatIR retrieves 32%-72% more relevant-and-eligible trials per patient on SIGIR 2016 and achieves 1.8-3.2x higher eligible-trial recall on the TREC benchmark. Retrieval is fast, requiring only 146 milliseconds per patient over 3,621 SIGIR trials.
Reasoning-Intensive Retrieval (RIR) targets retrieval settings where relevance is mediated by latent inferential links between a query and supporting evidence, rather than semantic similarity. Motivated by the emergent reasoning abilities of Large Language Models (LLMs), recent work integrates these capabilities into the IR field, spanning the entire pipeline from benchmarks to retrievers and rerankers. Despite this progress, the field lacks a systematic framework to organize current efforts and articulate a clear path forward. To provide a clear roadmap for this rapidly growing yet fragmented area, this survey (1) systematizes existing RIR benchmarks by knowledge domains and modalities, providing a detailed analysis of the current landscape; (2) introduces a structured taxonomy that categorizes methods based on where and how reasoning is integrated into the retrieval pipeline, alongside an analysis of their trade-offs and practical applications; and (3) summarizes challenges and future directions to guide research in this evolving field.
Ensuring factuality and interpretability in RAG remains an open and urgent problem. We introduce Contrastive Evidence Rationale Attention (CERA), the first retrieval framework to employ subjectivity-based hard negative selection and inject an evidential inductive bias into contrastive learning through an auxiliary attention alignment loss. CERA fine-tunes a dense retriever using two training objectives: triplet-based contrastive learning and interpretable attention alignment, which supervises CLS-to-token attention using a part-of-speech-weighted masking distribution over human-annotated factual rationales as evidence signals. Experiments on a large corpus of clinical trial reports demonstrate that the subjectivity-based hard negative selection substantially improves retrieval effectiveness compared to both Contriever and hard negative selection baselines. Furthermore, rationale alignment improves faithfulness while maintaining competitive retrieval performance, supporting the hypothesis that attention can serve as a more faithful explanation of model behavior when guided by human rationales. Moving beyond topical similarity, CERA enables the retriever to identify the specific tokens that constitute supporting evidence, promoting more interpretable evidence selection in RAG systems.
Retrieval benchmarks are increasingly saturating, but we argue that efficient search is far from a solved problem. We identify a class of queries we call oblique, which seek documents that instantiate a latent pattern, like finding all tweets that express an implicit stance, chat logs that demonstrate a particular failure mode, or transcripts that match an abstract scenario. We study three mechanisms through which obliqueness may arise and introduce OBLIQ-Bench, a suite of five oblique search problems over real long-tail corpora. OBLIQ-Bench exposes an overlooked asymmetry between retrieval and verification, where reasoning LLMs reliably recognize latent relevance whenever relevant documents are surfaced, but even sophisticated retrieval pipelines fail to surface most relevant documents in the first place. We hope that OBLIQ-Bench will drive research into retrieval architectures that efficiently capture latent patterns and implicit signals in large corpora.