Biomedical IR

Patient-specific clinical question answering requires locating the right evidence within long, heterogeneous longitudinal clinical records in which relevant facts may be scattered across encounters, repeated in copied-forward notes, or expressed using different clinical terminology. We evaluated whether biomedical reranking can improve evidence selection and downstream answer quality in a locally deployed retrieval-augmented generation pipeline for longitudinal clinical notes. The pipeline combines PubMedBERT dense retrieval, BM25 lexical retrieval, weighted reciprocal-rank fusion, and MedCPT cross-encoder reranking. Across 1,000 open- and closed-ended question-answer pairs from a cohort of 200 bariatric surgery patients, reranking increased exact source-chunk retrieval within the top 10 items, Hit@10 from 46.6% to 60.6% and mean reciprocal rank from 0.2371 to 0.3252. With Qwen3-8B generation, local judge-assessed answer correctness increased from 44.8% to 48.6%. These results show that biomedical reranking can improve the placement of relevant clinical evidence within a limited context window, although gains in retrieval do not translate proportionally into gains in answer correctness.

This paper presents an overview of the fourteenth edition of the BioASQ challenge, organized in the context of the Conference and Labs of the Evaluation Forum (CLEF) 2026. BioASQ is an international challenge series that supports progress in biomedical language processing tasks ranging from semantic indexing and information extraction to question answering and summarization. In 2026, BioASQ included six shared tasks: a) Task 14b on biomedical semantic question answering. b) Task Synergy14 on question answering for developing biomedical top- ics. c) Task MultiClinSum-2 on multilingual clinical summarization. d) Task BioNNE-R on extracting relations between nested named entities in Russian and English. e) Task ELCardioCC on clinical coding in cardiology. f) Task GutBrainIE on gut-brain interplay information extrac- tion. Across these six tasks, 87 distinct teams participated, submitting more than 1000 runs overall. As in previous editions, several submissions reached competitive performance, reflecting the continued progress of state-of-the-art methods across biomedical language processing tasks.

Large language model (LLM)-based clinical assistants are increasingly being integrated into electronic health record (EHR) systems, transforming how clinicians retrieve and synthesize information from patient records. Their safety and utility depend on rigorous evaluation, yet existing benchmarks are manually curated, costly to update, and rapidly become obsolete with evolving technological advancements. We present a scalable framework that automatically generates question--answer pairs from longitudinal EHR notes. Nineteen clinicians validate the benchmark generator, producing the Benchmark for Retrieving Information in EHRs (BRIE), a continuously maintainable evaluation dataset. Across nine LLMs and five inference strategies, state-of-the-art systems frequently omit clinically important information, particularly for questions requiring synthesis across multiple documents and encounters. Because the generator itself is validated, BRIE supports evaluations that static benchmarks cannot, including the generation of multiple answers that reflect variation in clinician reasoning for robust performance assessment and continuously refreshing benchmark content to guard against leakage. Our results demonstrate that scalable benchmark generation enables rigorous, up-to-date evaluation of clinical LLMs as they are deployed in rapidly evolving healthcare settings.

We introduce OntologyBench, a tiered biomedical retrieval benchmark comprising 471,854 training and 125,744 evaluation query-document relevance pairs across concept grounding, relational retrieval, and compositional phenotype-based retrieval. Although these tasks can be tractable using ontology-aware reference methods, across task tiers, embedding performance is generally lower on relational and compositional tasks than on concept-grounding tasks. Fine-tuning on ontology-derived supervision improves performance on several relational and compositional tasks, whereas the evaluated reranking and LLM-based candidate-scoring methods provide little or no end-to-end improvement. Errors frequently reflect diseases matching only subsets of the phenotype evidence. These findings indicate that the evaluated embedding and reranking configurations do not reliably recover the compatibility encoded by the selected ontology relations and phenotype combinations and motivate retrieval systems that better integrate learned representations with structured biomedical knowledge.

The exponential growth of scientific publications calls for automatic Information Extraction (IE) systems to support knowledge discovery. In this context, the GutBrainIE benchmark evaluates Named Entity Recognition (NER), Named Entity Recognition and Disambiguation (NERD), and Relation Extraction (RE) systems in the gut-brain axis domain. We propose Two-stage Workflow for Information eXtraction (TWIX), an end-to-end IE pipeline featuring three interconnected modules, each leveraging a two-stage framework to solve all four GutBrainIE subtasks. Evaluation on the development and test sets shows that our method substantially outperforms the baseline by a wide margin, while also ranking first among all participant submissions across all subtasks. These results indicate that the proposed two-stage pipeline effectively improves both precision and recall in practical settings.

BioMedRAG introduced retrieval-augmented generation with a learned chunk scorer for biomedical information extraction. However, it relies on fixed-size chunking which can fragment semantic evidence. We propose a configurable semantic chunking framework that addresses this limitation by combining entity-preserving windows, trigger-centered chunking, proposition-first extraction, tiered trigger prioritization, and hierarchical relation resolution. The framework integrates with BioMedRAG by replacing only the chunk construction stage while preserving the embedding model, learned chunk scorer, generator, and evaluation protocol. We evaluate the framework on biomedical relation extraction benchmarks (GM-CIHT, DDI, ChemProt) and adverse event classification (ADE). On GM-CIHT, the full hybrid configuration achieves 82.6% F1, improving over the fixed-size baseline (74.2% F1) by 8.4 points under our experimental setup. Cross-dataset analysis shows that semantic chunking improves extraction datasets with explicit relation cues, such as GM-CIHT and DDI, while fixed chunking remains competitive or stronger for dense biochemical extraction and binary classification settings such as ChemProt and ADE. By externalizing chunking logic into configuration files, the framework provides an interpretable and adaptable alternative to rigid fixed-size chunking for biomedical RAG pipelines.

Biomedical artificial intelligence is moving from literature retrieval toward evidence synthesis for knowledge graphs, clinical decision support, and computational models. Yet most information-extraction systems still represent findings as simple relations, discarding the quantitative and contextual detail needed for interpretation and reuse. A claim that one entity affects another is insufficient when the magnitude, unit, population, comparator, experimental conditions, uncertainty, and provenance are missing. We define quantitative evidence mining as a framework for transforming biomedical findings into structured, context-rich, and auditable evidence units. We define the core elements of an evidence unit: the claim; measured entity and property; value, unit, or scale; comparator; population; biological or clinical conditions; temporal context; uncertainty; provenance; validation results; and expert-review status. We propose an eight-stage reference architecture spanning corpus selection, entity recognition, quantity extraction, context linking, normalization, evidence-unit assembly, multidimensional plausibility assessment, and export and governance. A central principle is that plausibility should not be collapsed into a single truth label; statistical, biological, methodological, contextual, and provenance-based support should remain explicit. The framework links information extraction to evidence synthesis and computational reuse, with applications in clinical-trial analysis, biomarker research, pharmacovigilance, knowledge-graph construction, and mechanistic modelling. It is a research agenda rather than a validated end-to-end system. Progress will require annotated multimodal benchmarks, rigorous component- and workflow-level evaluation, prospective testing, transparent provenance, and sustained expert oversight.

Large language model (LLM) chatbots are increasingly used to answer clinical questions with citations to relevant studies, yet the quality of retrieved evidence and factors influencing study selection remain unclear. We evaluated three general-purpose LLM chatbots (Claude Sonnet 5, Gemini 3.1 Pro, and ChatGPT GPT-5.5) using 20 clinical questions adapted from 2026 Cochrane reviews. We simulated patient, clinician, and evidence-synthesis researcher roles and obtained four independent responses for each chatbot-role-question combination, yielding 720 responses (3 chatbots $\times$ 3 user roles $\times$ 4 repetitions $\times$ 20 review questions). Chatbots were asked to support their answers with primary clinical citations, which were benchmarked against the included and excluded study sets of the corresponding Cochrane reviews. On average, a single response retrieved 39.2% $\pm$ 29.8% of the corresponding Cochrane included-study set and 5.0% $\pm$ 9.4% of the excluded-study set. Recall of included studies varied significantly by model and user role. ChatGPT achieved higher recall than Claude or Gemini (63.1% $\pm$ 29.5% vs. 37.0% $\pm$ 23.8% vs. 17.3% $\pm$ 13.1%; blocked permutation test, $p=2.0\times10^{-5}$), and the researcher role yielded higher recall than the clinician or patient roles (42.8% $\pm$ 30.8% vs. 38.6% $\pm$ 28.9% vs. 36.1% $\pm$ 29.3%; $p=2.0\times10^{-5}$). Controlling for publication year, citations per year, and open-access status, sample size was the only significant predictor of retrieval: each doubling of sample size was associated with 50% higher odds of retrieval (odds ratio 1.50, 95% CI 1.24-1.81). These findings show that LLM chatbots can retrieve studies identified by expert reviewers, but retrieval varies substantially across models and user roles and favors larger clinical trials.

This work presents DS@GT ARC BioASQ team's work for a biomedical question answering pipeline, integrating multi-source query expansion, neural reranking, retrieval refinement, and OpenBioLLM-assisted answer generation. The system combines PubMed retrieval with fine-tuned MiniLM-based semantic reranking, Reciprocal Rank Fusion (RRF), and feature-based relevance scoring to improve document ranking quality. To address challenging queries with weak retrieval performance, we introduce a conditional weak-question recovery strategy that applies semantic expansion, relationship-aware augmentation, and selective result merging. A post-retrieval pruning stage further removes redundant or low-relevance snippets while preserving evidence coverage for downstream answer generation. Experimental results on BioASQ evaluation batches demonstrate that the proposed recovery and cleanup strategies substantially improve retrieval robustness and MAP@10 performance on difficult question sets. The final system also incorporates output validation and post-processing steps to ensure formatting consistency and submission reliability across BioASQ phases.

The web is increasingly accessed by AI agents rather than humans. Every agent needs knowledge, especially in the life-sciences, where agentic pipelines are growing fast. Access to the literature is a crucial part of that need, and resources such as Europe PMC, with over 40M indexed records, are widely used to meet it. Yet these resources were not built for AI agents: they take keywords and complex syntax and return whole papers, so every agent must learn the syntax, issue several searches, and read full papers to find the evidence it needs. We introduce EMBL AI Librarian, a knowledge layer that upgrades the Europe PMC interface for AI agents: an agent asks in natural language and receives evidence that answers it. A single LLM orchestrates the whole knowledge retrieval process: it plans complementary subqueries executed by the live Europe PMC search engine, then reads the selected papers and locates the relevant evidence. We evaluate Librarian across four benchmarks: literature synthesis, claim verification, open-domain question answering, and downstream biology tasks such as protocol questions and sequence manipulation. On ScholarQABench, Librarian improves Citation F1 by more than $16$ points over strong recently published baselines. Used as the retrieval layer of an existing claim-verification pipeline, it increases agreement with expert consensus; and on the open-form LitQA2 benchmark, a GPT-5.4 agent scores about $8$ points higher when grounded in Librarian than with web search. Overall, our results show that equipping life-science agents with the Librarian knowledge layer improves performance across a range of tasks. We release our code publicly at https://github.com/petroni-lab/librarian

We describe our BioASQ Task 14B 2026 system. The work centers on two design decisions: how aggressively to re-retrieve when first-stage retrieval is weak, and how to combine multiple language-model answers. Retrieval unions two parallel pipelines - a hybrid first stage (dense BGE + BM25 + RRF, reaching R@200 = 99.3% on the BioASQ-13b historical archive) and an agent-driven pipeline that decomposes the question over PubMed, Europe PMC, and iCite - with a BGE cross-encoder quality gate flagging weakly-supported questions for selective re-retrieval. On Task 12B 2024 validation, a cost-pragmatic re-retrieval policy beats a skill-strict baseline significantly on list F1 and list precision, at 12% lower re-retrieval cost. Holding prompt and model fixed across val and test 13B (different question sets), list F1 rises by +0.132 absolute on the BioASQ-released gold-input pool, consistent with substantial retrieval-side headroom. For Phase B answering we decompose multi-model ensemble lift into a selection component bounded by the per-question oracle and a fusion component that aggregators can exceed. The decomposition predicts before any experiment that LLM-as-judge wins on selection-dominated metrics (yes/no, multi-reference ROUGE) but is structurally insufficient on the recall component of fusion-friendly metrics (factoid rank-1, list recall). On Task 13B 2025 our synonym-union resolver wins list recall on every head, while GPT-5.5 solo retains the list-F1 lead because the resolver's wider item set costs precision. On the Task 14B 2026 preliminary leaderboard our team places first on the combined-exact aggregate on three of the eight (phase x batch) leaderboards, wins four individual question-type cells, and takes #1 on Phase B b3 ideal.

Medical question-answering benchmarks rarely cover the maternal, neonatal, child, and reproductive-health questions a nurse-midwife asks, and, to our knowledge, no public chunk-level relevance benchmark exists for maternal-health guideline retrieval. We release two benchmarks that fill these gaps. mamabench is a scope-filtered QA set of 25,949 items assembled from seven existing expert-authored sources across multiple-choice, short-answer, and rubric-graded tracks; to help users calibrate the LLM judge that scores the rubric track, we re-scope HealthBench's physician-labelled meta-evaluation to the domain. mamaretrieval pairs 3,185 clinical queries with graded (0-6) relevance labels over a 63,650-chunk maternal-health guideline corpus, using a decomposed rubric that distinguishes a chunk that answers a query from one merely on its topic. Three decisions shape both: assemble and filter expert sources rather than author questions, grade relevance rather than binarise it, and measure and disclose the limits of the labels -- scope-classifier agreement, a frontier-judge check, and a pooling-completeness audit -- rather than treat them as an oracle. A companion paper uses the benchmarks to evaluate a deployed on-device assistant; both are released openly for research.

Retrieval-augmented generation (RAG) in clinical settings increasingly requires multilingual retrieval against predominantly English evidence corpora. Multilingual medical retrieval demands three capabilities: cross-lingual alignment, concept discrimination, and evidence retrieval. However, existing benchmarks evaluate these only in isolation, leaving the interaction between biomedical expertise and multilingual coverage unmeasured. We introduce MMed-Bench-IR, a benchmark designed to disentangle these axes across 6 languages and three structurally heterogeneous tasks: (1) cross-lingual medical QA retrieval with 6,127 queries grounded in the Unified Medical Language System (UMLS), (2) concept discrimination over 4,975 confusion sets at three difficulty tiers, and (3) multilingual evidence retrieval for RAG with 2,040 quality-assured queries. The three tasks share zero concept and query overlap by design, ensuring that aggregate scores reflect genuine capability breadth. Evaluation of ten systems across six paradigm families reveals severe cross-lingual failure: biomedical encoders that score 0.818 nDCG@10 in English drop to 0.056 in Japanese, a gap that English-only benchmarks cannot detect.

Meta-analysis is a demanding form of evidence synthesis that combines literature retrieval, PI/ECO-guided study selection, and statistical aggregation. Its structured, verifiable workflow makes it an ideal substrate for evaluating systematic scientific reasoning, yet existing benchmarks lack ground truth across the full retrieval-screening-synthesis pipeline. We introduce MetaSyn, a dataset of 442 expert-curated meta-analyses from Nature Portfolio journals. Each entry pairs a research question with PI/ECO criteria, a retrieval corpus of 140k PubMed articles, verified positive studies, hard negatives that are topically similar but PI/ECO-ineligible, and complete search strategies and date bounds. Benchmarking twelve pipeline configurations (nine RAG variants and a protocol-driven agent) reveals a critical screening bottleneck: despite a retrieval ceiling of 90.9% recall at K=200, no system recovers more than 52.7% of ground-truth included literature. Current LLMs fail to reliably separate eligible studies from PI/ECO-failing distractors in pools of comparable topical relevance. Stage-attributed metrics capture where systems succeed and fail; a single end-to-end score does not.

Electronic prior authorization workflows require FHIR Questionnaire items to carry LOINC codes, yet most items in the HL7 Da Vinci CDS-Library lack these bindings. We treat this as a retrieval problem: given a Questionnaire item's text, find the correct LOINC code in a pool of 97,314 active codes. We compare six methods (TF-IDF, frozen MiniLM, BioBERT, BioLORD, contrastively fine-tuned MiniLM, and a TF-IDF+GPT reranker) on a 54-item evaluation set spanning three query styles (natural question, medium, and terse). No single method wins on every metric. BioLORD, a frozen encoder pre-trained on biomedical ontology definitions, has the best top-rank accuracy (R@1 = 0.185, MRR = 0.246) despite seeing no task-specific data, while a contrastive fine-tune on raw LHC-Forms pairs takes R@5 (0.389) and R@10 (0.426). A distribution-shift ablation shows why the fine-tune in our main table is not the strongest one: adding GPT-generated paraphrases to the raw pairs drops R@5 from 0.389 to 0.296, so the augmented union underperforms raw-only training on every metric except R@1. Performance peaks at 5k training pairs. Error analysis on BioLORD's R@1 failures shows that wrong-specificity and ambiguous-text cases together account for 59% of errors.

Despite advances in information extraction driven by deep learning and large language models, performance gaps remain in highly specialized biomedical fields, where domainspecific complexity poses challenges for generalist models. In this work, we focus on the domain of autoimmunity, where the main entities of interest are autoimmune diseases, autoantibodies (i.e., molecules that may mark or cause these diseases), their molecular targets, their location in the body, and their associated clinical signs. Herein, we present AAbAAC (AutoAntibodies and Autoimmunity Annotated Corpus), a corpus of 115 abstracts selected from PubMed, where we manually annotated entities and their relationships. First, AAbAAC was used to evaluate several methods on the task of named entity recognition (NER), and secondly, to fine-tune NER models. Our study demonstrates the utility of AAbAAC for information extraction in the domain of autoimmunity, showing expected improvement in NER performance after finetuning. This illustrates the value of small-scale annotation efforts for specialized domains and contributes to the computational study of autoimmunity. The AAbAAC corpus is available at https://github.com/f-maury/AAbAAC.

Medical question answering is a high-stakes setting where factual errors can have serious consequences. Retrieval-augmented generation (RAG) is widely viewed as a promising solution, and prior work has reported substantial gains for large medical QA models. We revisit this assumption across a broad range of open-weight instruction-tuned models spanning 7B to 72B parameters. Across five models, ten biomedical QA datasets, four retrieval methods, and four retrieval corpora, we find that retrieval yields only small and inconsistent improvements over a no-retrieval baseline, typically within 1-2 points. In contrast, the choice of backbone model has a much larger effect than the choice of retriever or corpus, and expert and layman retrieval sources perform similarly in most settings. These results suggest that the main bottleneck is not retrieval quality alone, but the model's limited ability to use retrieved evidence effectively.

Drug-information question answering is a high-stakes setting where hallucinated facts can mislead clinical decision-making and the provenance of each cited fact matters as much as the fact itself. We present DrugClaw, a multi-agent retrieval-augmented system that queries a registry of drug and pharmacovigilance skills via a reflection-driven state-machine workflow and returns answers grounded in primary regulatory or peer-reviewed records. We also contribute DrugAudit, a 3,772-item authority-aware benchmark with an evaluation panel that scores upstream-of-gold source match, token-level semantic snippet overlap, and citation faithfulness under a dual-judge LLM-as-judge protocol with inter-judge kappa = 0.88 (almost-perfect). Across DrugAudit plus drug-related subsets of MedQA (751) and PubMedQA (512), DrugClaw is top-1 on every column of the headline table: composite Evidence Index under both judges, judge-mediated answer correctness, primary-source rate (0.918, +10.1 pp over next-best), faithfulness (0.887, +5.9 pp), MedQA (0.920), and PubMedQA (0.693).

Sentence-embedding models for semantic search are overwhelmingly developed and evaluated on English corpora. When applied to clinical retrieval in other languages -- particularly retrieval of ICD-10-CM / CIE-10 codes -- recall degrades in ways often masked by aggregate benchmarks. We study whether large generative language models can serve as data factories to close this gap. We build a two-stage retriever (bi-encoder followed by cross-encoder reranker), fine-tuned from a Spanish biomedical encoder (PlanTL-GOB-ES/bsc-bio-ehr-es) on Gemini-generated synthetic data covering English, Spanish, Catalan, Italian, Portuguese and French, and evaluate against BioBERT-ST and the un-tuned Spanish encoder. The bi-encoder alone matches BioBERT-ST on MRR (0.876 vs. 0.866) and overtakes it on R@3 (0.650 vs. 0.626) and R@5 (0.804 vs. 0.790) without English biomedical pretraining. Adding a cross-encoder reranker lifts aggregate R@5 to 0.822 and dominates on four of five languages (+0.017 Spanish, +0.033 Catalan, +0.018 French, +0.037 Portuguese) at the cost of a small English regression. The trade-off is clinically acceptable: Portuguese reaches R@5 = 0.829 vs. BioBERT-ST's 0.714. Contributions: an open recipe for building domain-specific medical retrievers from LLM-generated data; quantification of the learning gain (MRR 0.755 to 0.876, +15.9% with ~19,500 synthetic pairs); and a characterisation of where gains concentrate by language and rank.

Biomedical retrieval-augmented large language models (LLMs) often face evidence that is incomplete, misleading, or internally contradictory, yet evaluation usually emphasizes answer accuracy under helpful context rather than reliability under conflict. Using HealthContradict, we evaluate six open-weight LLMs under five controlled evidence conditions: no retrieved context, correct-only context, incorrect-only context, and two mixed conditions containing both correct and contradictory documents in opposite orders. In this conflicting-evidence order contrast, where the same two documents are both present and only their order is reversed, accuracy drops for every model and 11.4%--25.2% of predictions flip. To support abstention in these difficult cases, we also evaluate a conflict-aware abstention score that combines model confidence with a detector of evidence conflict. In the two hardest conditions, this score improves selective accuracy over confidence-only, with mean gains of 7.2--33.4 points in incorrect-only (IC') and 3.6--14.4 points in incorrect-first conflicting (ICC') conditions across 75%, 50%, and 25% coverage. These results show that conflicting biomedical evidence is both an uncertainty and robustness problem and motivate evaluation and abstention methods that explicitly account for evidence disagreement.

Reasoning benchmarks measure clinical performance on clean inputs. We evaluate the step before reasoning: retrieval over real EHR notes, where negation, temporality, and family-versus-patient attribution can flip a correct answer to a wrong one. EpiKG carries an assertion label and a temporality tag with every fact in a patient knowledge graph, then routes retrieval by question intent. ClinicalBench is a 400-question test over 43 MIMIC-IV patients across 9 assertion-sensitive categories. A 7-condition ablation tests each piece of EpiKG across six LLMs (Claude Opus 4.6, GPT-OSS 20B, MedGemma 27B, Gemma 4 31B, MedGemma 1.5 4B, Qwen 3.5 35B). Three physicians blindly adjudicated 100 paired items. The author-blind primary endpoint, leave-author-out paired exact McNemar on 50 unanimous-strict items rated by two external physicians, yields +22.0 percentage points (95 percent Newcombe CI [+5.1, +31.5], p=0.0192). The architectural novelty, intent-aware KG-RAG over a Contriever dense-RAG baseline (C2b to C4g_kw on the change-excluded n=362 endpoint), is +8.84 percentage points (paired McNemar p=1.79e-3); +12.43 percentage points under oracle intent. Sensitivities agree directionally: three-rater physician majority +24.0 percentage points (subject to single-author circularity); deterministic keyword reproducibility proxy +39.5 percentage points. Across the six models, the gain shrinks as the LLM-alone baseline rises (beta=-1.123, r=-0.921, p=0.009). With n=6 this looks more like regression to the mean than encoding substituting for model size. Physician adjudication identified 56 percent of auto-generated reference answers as defective, a methodological finding indicating that NLP-pipeline clinical-QA benchmarks require physician adjudication to be usable. ClinicalBench, the frozen evaluator, three-rater adjudication data, and the EpiKG output stack are publicly released.

Manually curated biomedical repositories -- spanning bioactivity, genomics, and chemistry -- are expensive to maintain, lag behind primary literature, and discard experimental context, obscuring nuances needed to assess data correctness and coverage. We show that PubMed itself can be autonomously and cost-effectively turned into structured datasets that are larger, more nuanced, and more accurate than the curated databases they replace. We present three coupled contributions: (1) an LLM-based entity-tagging pipeline, grounded in nine biomedical ontologies, that tags 4.5B entities across 19 categories in a 22.5M-paper, 2.5T-token PubMed corpus; (2) hybrid sparse-dense retrieval supporting entity-filtered semantic queries over the tagged corpus; and (3) Starling, a multi-agent deep research system that, given only a natural-language task description, designs precision- and recall-targeted retrieval filters, induces an extraction schema, and emits structured records with nuance-rich fields and supporting passages. Across six tasks -- blood-brain barrier permeability, oral bioavailability, acute toxicity (LD50), gene-disease associations, protein subcellular localization, and chemical reactions -- Starling produces ~6.3M records (91K-3M per task); several are, to our knowledge, the largest public datasets for their property. Frontier-model rejection of our extractions is 0.6-7.7% across tasks, far below error rates we measure on widely used curated counterparts (e.g., 16.5% on BBB_Martins, 7.3% on Bioavailability_Ma). Beyond scale and accuracy, the supporting passages carry nuance tabular databases discard -- e.g., oral bioavailability may depend on fed vs. fasted state. Together, the corpus, retrieval, and agent establish a foundation for AI-driven therapeutic design. Code and datasets: https://github.com/starling-labs/starling.

Zero-shot single-cell cell-type annotation aims to determine a cell's type from a given set of expressed genes without any training. Existing knowledge-graph-based RAG approaches retrieve evidence by expanding from source entities and relying on iterative LLM reasoning. However, in this setting each query contains tens to hundreds of genes, where no single gene is decisive and the label emerges only from their collective co-occurrence. Such hyper-entity queries fundamentally challenge local, entity-wise exploration strategies, which reason from individual genes, leading to poor scalability and substantial LLM cost. We propose GATHER (Graph-Aware Traversal with Hyper-Entity Retrieval), a convergence-centric retriever tailored to hyper-entity queries. It performs global multi-source graph traversal and identifies topological convergence points -- nodes jointly reachable from many input genes. These convergence nodes act as high-information hyper-entities that capture entity synergy. By incorporating node- and path-importance scoring, GATHER selects informative evidence entirely without LLM involvement during retrieval. Instantiated on a self-constructed cell-centric biological knowledge graph (VCKG), GATHER outperforms strong KG-RAG baselines (ToG, ToG-2, RoG, PoG) on two datasets (Immune and Lung), achieving the highest exact-match accuracy (27.45% and 59.64%) with only a single LLM call per sample, compared to 2--61 calls for KG-RAG baselines. Our results demonstrate that convergence nodes compress multi-entity signals into compact, high-information evidence that conveys more per item than multi-hop paths, providing an efficient global alternative to local entity-wise reasoning.

Retrieval-Augmented Generation (RAG) offers a well-established path to grounding large language model (LLM) outputs in external knowledge, yet the question of which retrieval strategy works best in a high-stakes domain such as biomedicine has not received the controlled, multi-metric treatment it deserves. This paper presents a systematic empirical comparison of five retrieval strategies -- Dense Vector Search, Hybrid BM25 + Dense retrieval, Cross-Encoder Reranking, Multi-Query Expansion, and Maximal Marginal Relevance (MMR) -- within a biomedical question-answering RAG pipeline. All strategies share a fixed generation model (GPT-4o-mini), a common vector store (ChromaDB), and OpenAI's text-embedding-3-small embeddings, ensuring that observed differences are attributable to retrieval alone. Evaluation is conducted on 250 question-answer pairs drawn from a preprocessed subset of the BioASQ benchmark (rag-mini-bioasq) using four DeepEval metrics: contextual precision, contextual recall, faithfulness, and answer relevancy, each reported with 95% confidence intervals. A no-context ablation is included as a lower bound. Cross-Encoder Reranking achieves the best composite score (0.827) and highest contextual precision (0.852), confirming that query-document interaction yields measurable retrieval gains. Multi-Query Expansion, despite its recall-oriented design, produces the weakest contextual precision (0.671), suggesting naive query diversification introduces retrieval noise. MMR sacrifices answer relevancy for diversity, while the Dense baseline (composite 0.822) falls within 0.005 points of the top strategy. All RAG conditions dramatically outperform the no-context ablation on answer relevancy (0.658-0.701 vs. 0.287), confirming the practical value of retrieval. The full pipeline, hyperparameters, and evaluation code are publicly available.

Reliable biomedical and clinical retrieval requires more than strong ranking performance: it requires a practical way to find systematic model failures and curate the training evidence needed to correct them. Late-interaction models such as ColBERT provide a first solution thanks to the interpretable token-level interaction scores they expose between document and query tokens. Yet this interpretability is shallow: it explains a particular document--query pairwise score, but does not reveal whether the model has learned a clinical concept in a stable, reusable, and context-sensitive way across diverse expressions. As a result, these scores provide limited support for diagnosing misunderstandings, identifying irreasonably distant biomedical concepts, or deciding what additional data or feedback is needed to address this. In this short position paper, we propose Diagnosable ColBERT, a framework that aligns ColBERT token embeddings to a reference latent space grounded in clinical knowledge and expert-provided conceptual similarity constraints. This alignment turns document encodings into inspectable evidence of what the model appears to understand, enabling more direct error diagnosis and more principled data curation without relying on large batteries of diagnostic queries.

Effective biomedical information retrieval requires modeling domain semantics and hierarchical relationships among biomedical texts. Existing biomedical generative retrievers build on coarse binary relevance signals, limiting their ability to capture semantic overlap. We propose BioHiCL (Biomedical Retrieval with Hierarchical Multi-Label Contrastive Learning), which leverages hierarchical MeSH annotations to provide structured supervision for multi-label contrastive learning. Our models, BioHiCL-Base (0.1B) and BioHiCL-Large (0.3B), achieve promising performance on biomedical retrieval, sentence similarity, and question answering tasks, while remaining computationally efficient for deployment.

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.

Adapting general-purpose LLMs into domain-specialized dense retrievers typically requires large-scale training on mixed-domain data. We show that merging independently trained domain-specialized experts consistently exceeds this approach across four decoder-only LLM families (0.6B-7B), four merging methods, and twelve medical and general retrieval tasks from MTEB, suggesting that parameter-space composition captures complementary domain strengths that large-scale mixed-domain training averages out. To further maximize expert quality, we introduce Synthesize-Train-Merge (STM), a modular framework that synthesizes hard negatives with a top-tier LLM and fine-tunes domain-specialized experts via LoRA before merging them, without continual pre-training. Synthesized hard negatives yield the largest gains for smaller models, and STM achieves strong performance on biomedical retrieval tasks while maintaining competitive general-domain results across all four backbone families.