Clinical diagnosis requires answers that are accurate, verifiable, and explicitly grounded in official guidelines. While large language models excel at natural language processing, their tendency to hallucinate undermines their utility in high-stakes medical contexts where precision is essential. Existing retrieval-augmented generation (RAG) systems treat all evidence equally, producing noisy context and generic answers misaligned with clinical practice. We present ClinicBot, an AI system that translates guideline recommendations into trustworthy clinical support through three key advances: (1) structured extraction of clinical guidelines into semantic units (recommendations, tables, definitions, narrative) with explicit provenance, (2) evidence prioritization that ranks content by clinical significance and guideline structure rather than textual similarity, and (3) a web-based interface that presents concise, actionable answers with verifiable evidence. We will demonstrate ClinicBot using diabetes questions from real patients and an additional diabetes risk assessment tool that is faithful to the American Diabetes Association (ADA) Standards of Care in Diabetes (2025). The demonstration will illustrate how semantic knowledge extraction and hierarchical evidence ranking can reliably operate in a multi-agent setting to process complex clinical guidelines at scale.
Figures & tables
Figure 1. Guideline-Structured RAG System Architecture. The system routes clinician queries to relevant guideline subsections, retrieves evidence in priority order (recommendations first, then structured criteria tables, then supporting text), generates guideline-aligned concise answers with explicit citations, validates that all claims are grounded in retrieved evidence, and presents results via a two-part interface: Concise Answer and Supporting Evidence . The structured guideline knowledge base preserves source attribution and enables full traceability.
Figure 2. ClinicBot’s interfaces demonstrate guideline-grounded clinical support. Left : Medical question answering interface, where clinicians submit patient queries and receive two-part responses: a concise answer (highlighted in green) followed by expandable supporting evidence with citations and clinical rationale. Right : Diabetes risk assessment interface, where clinicians input patient information and ClinicBot computes risk scores with clinical interpretation and actionable recommendations.
Clinical practice guidelines (CPGs) encode diagnostic criteria, but LLM systems typically retrieve guideline text or absorb it through training rather than execute its rules. We introduce GuideSkill, an external reasoning layer that compiles disease-specific criteria into executable functions returning ordinal diagnostic-support scores. GuideSkill-Zero is initialized from guidelines, while GuideSkill-Evo uses case--diagnosis pairs to refine covered skills and add missing diagnoses. At inference, an LLM proposes a differential diagnosis, grounds the features required by each matched skill, and fuses its ranking with the executed skill scores. Across four benchmarks and four backbones, GuideSkill-Zero improves macro-average accuracy over guideline RAG by 13.45% on average. GuideSkill-Evo achieves the highest macro-average for every backbone, improves over direct inference by 18.49% relatively, and increases gold-label skill coverage from 56.5% to 99.5%. On Qwen3.5-9B, it also exceeds the strongest parameter-update baseline by 11.16% without updating the backbone. Expert evaluation further indicates that GuideSkill produces clinically sound and broadly acceptable skills, suggesting that its initialized and evolved rules are reliable and practically meaningful. These results support executable skills as a model-agnostic mechanism for combining guideline-derived procedures with case-derived diagnostic patterns.
Lang Cao, Yuhao Shen, Tianyang Luo +3
University of Illinois Urbana-Champaign · ♦The Chinese University of Hong Kong, Shenzhen · ⋂Albert Einstein College of Medicine
Clinical decision-making requires synthesizing heterogeneous evidence, including patient histories, clinical guidelines, and trajectories of comparable cases. While large language models (LLMs) offer strong reasoning capabilities, they remain prone to hallucinations and struggle to integrate long, structured medical documents. We present MED-COPILOT, an interactive clinical decision-support system designed for clinicians and medical trainees, which combines guideline-grounded GraphRAG retrieval with hybrid semantic-keyword similar-patient retrieval to support transparent and evidence-aware clinical reasoning. The system builds a structured knowledge graph from WHO and NICE guidelines, applies community-level summarization for efficient retrieval, and maintains a 36,000-case similar-patient database derived from SOAP-normalized MIMIC-IV notes and Synthea-generated records. We evaluate our framework on clinical note completion and medical question answering, and demonstrate that it consistently outperforms parametric LLM baselines and standard RAG, improving both generation fidelity and clinical reasoning accuracy. The full system is available at https://huggingface.co/spaces/Cryo3978/Med_GraphRAG , enabling users to inspect retrieved evidence, visualize token-level similarity contributions, and conduct guided follow-up analysis. Our results demonstrate a practical and interpretable approach to integrating structured guideline knowledge with patient-level analogical evidence for clinical LLMs.
Large language models (LLMs) offer promising clinical decision support but remain vulnerable to hallucinated facts, unsupported recommendations, and citation errors. We present DIASENTINEL, a fully on-premise multi-agent system for one-year type 2 diabetes mellitus (T2DM) risk screening and guideline-grounded report generation from electronic health records (EHRs). The system integrates calibrated risk prediction, deterministic clinical signal extraction, Reciprocal Rank Fusion over American Diabetes Association (ADA) guidelines, and a hybrid verification layer combining rule-based checks with LLM entailment. The demonstration provides a real-time batch-screening dashboard and an interactive patient report interface with cited recommendations, verification results, and raw EHR comparison. DIASENTINEL demonstrates a practical framework for reliable, auditable, and privacy-preserving LLM-based clinical decision support.
Yung Wei Shueh, Zhi-Jie Chen, Chia-Hsuan Hsu +9
Far Eastern Memorial Hospital, Taiwan · University of Michigan, USA · Rutgers University, USA +1