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# Diagnostic Reasoning

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  1. arXiv

    A chest X-ray agent stops calling tools by default: it first asks whether evidence is needed, then blocks unusable measurements

    The chest X-ray agent X-Ragent splits "should I seek evidence" from "is this measurement usable": the policy invokes region zoom, anatomical parsing and knowledge lookup only when needed, while quantitative measurements such as the cardiothoracic ratio enter reasoning only through an independent validity gate. Training runs in two stages, agentic supervised fine-tuning on 7,715 structured diagnostic trajectories followed by GRPO with an accuracy-gated reward that applies process terms only to correct trajectories. On the fully held-out ChestAgentBench, accuracy rises from 63.1% for the strongest baseline to 71.7%, with gains across all seven interpretation capabilities.

    Alibaba Group (China)National University of SingaporeBeijing Jiaotong UniversityCity University of Hong KongSanta Clara UniversityCarnegie Mellon University
    Yi Wang（First author）
    X-RagentTool-Augmented Reinforcement LearningRad-CoTGRPODiagnostic Reasoning
  2. arXiv

    Dual-agent framework PsyCIDRA raises diagnostic agreement in free-form psychiatric interviewing: 60.5% vs 51.9% rank-1 on held-out simulated cases and 79.6% vs 65.4% agreement with psychologists on whether to propose a hypothesis in a 101-participant study

    The authors present PsyCIDRA, a dual-agent framework in which an interviewer agent conducts free-form psychiatric interviews using working notes, expert-written skills, and ICD-11 retrieval, and a diagnostic reasoning agent then receives only the completed transcript and reports hypotheses with supporting, conflicting, and missing evidence, withholding a final hypothesis when evidence is insufficient; across a 53-case evaluation cohort and 81 held-out simulated cases it achieves higher diagnostic agreement than direct prompting, and in a blinded study of 101 human participants it agrees with psychologists on whether to propose a diagnostic hypothesis in 79.6% versus 65.4% of cases.

    Shahid Sadoughi University of Medical Sciences and Health ServicesYazd UniversityUniversity of Tehran
    Milad Mohammadi（First author）
    PsyCIDRAPsyCPGPsychiatric InterviewingDiagnostic ReasoningLLM Agents

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