Reinforcement Learning Improves LLM Accuracy and Reasoning in Disease Classification from Radiology Reports

With respect to improving the reasoning accuracy of LLMs, the representative reinforcement learning (RL) method - Group Relative Policy Optimization (GRPO) - has achieved critical success, yet it still suffers from the issue of insignificant reward signals. This paper introduces ReST-RL, a unified Reinforced Self-Training (ReST) policy-value framework that reconnects policy optimization and value-guided search to improve LLM reasoning ability. Firstly, ReST-GRPO adopts an optimized ReST-style algorithm to reshape the policy-induced trajectory distribution by increasing the reward variance of GRPO sampling and exposing the policy to more informative partial states, thereby improving training efficiency and effectiveness. Then, we further introduce a decoding optimization method, VM-MCTS, which trains a Value Model (VM) from self-collected Monte-Carlo Tree Search (MCTS) targets and deploys it through an adapted MCTS algorithm to provide precise process signals and verification scores, further enhancing reasoning accuracy. These two stages are internally dependent - ReST-GRPO yields higher-quality trajectories for value learning with VM-MCTS, which in turn enables more effective inference-time search. We validate our framework on multiple coding benchmarks (e.g., APPS, BigCodeBench, and HumanEval), where it significantly outperforms other reinforcement training baselines (naive GRPO, DAPO, and ReST-DPO), as well as decoding and verification baselines (e.g., PRM-BoN and ORM-MCTS), indicating its power to strengthen LLM reasoning capability. Moreover, we further evaluate ReST-RL on out-of-domain math and science reasoning tasks, where it achieves improved performance without target-domain tuning and favorable end-to-end efficiency trade-offs, providing preliminary transfer evidence beyond our primary coding domain.

Large language models show strong reasoning ability, but their internal reasoning process can remain unstable in complex multi-step settings, where early hidden-state errors may propagate to incorrect predictions. We propose ReLAR, a reinforcement-guided latent refinement framework that iteratively updates hidden representations before decoding. ReLAR maintains a compact latent reasoning state and uses learned depth and action controllers to adaptively determine both the number and direction of refinement steps. The controllers are trained with a policy gradient objective based on step-wise likelihood improvement, enabling efficient input-dependent reasoning without explicit chain-of-thought generation. Experiments on medical, mathematical, multi-hop reasoning, and open-ended generation benchmarks show that ReLAR improves accuracy, generation quality, and reasoning stability with substantially lower inference overhead than explicit reasoning baselines.

Automatic report labeling facilitates the identification of clinical findings from unstructured text and enables large-scale annotation for medical imaging research. Existing rule-based labelers struggle with the diverse descriptions in clinical reports, while fine-tuning pre-trained language models (PLMs) requires large amounts of labeled data that are often unavailable in clinical settings. In this paper, we propose PromptRad, a knowledge-enhanced multi-label \textbf{prompt}-tuning approach for \textbf{rad}iology report labeling under low-resource settings. PromptRad reformulates multi-label classification as masked language modeling and incorporates synonyms from the UMLS Metathesaurus into a multi-word verbalizer to enrich category representations. By fine-tuning the PLM without additional classification layers, PromptRad requires substantially less labeled data than conventional fine-tuning. Experiments on liver CT (computed tomography) reports show that PromptRad outperforms dictionary-based and fine-tuning baselines with only 32 labeled training examples, and achieves competitive performance with GPT-4 despite using a much smaller model. Further analysis demonstrates that PromptRad captures complex negation patterns more effectively than existing methods, making it a promising solution for report labeling in data-scarce clinical scenarios. Our code is available at https://github.com/ila-lab/PromptRad.