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Paper · arXiv

PCQC: Privileged Counterfactual Question Credit for Multi-Turn Medical Dialogue

Large language models (LLMs) have made substantial progress on medical question-answering, yet effective medical dialogue also requires learning to ask questions that uncover relevant patient information. To train such dialogue policies, a common pipeline combines supervised fine-tuning with reinforcement learning (RL) based on final diagnostic correctness. However, this outcome-based supervision does not directly distinguish the contributions of individual questions and provides no question-level feedback for unexecuted alternatives. To address this gap, we introduce PCQC (Privileged Counterfactual Question Credit), which uses privileged patient information during training to learn from ...

AuthorsChenxuan Li, Jiayi Wan, Xinrong Chen et al.
Primary categorycs.LG
Published23 September 2026
Last updated at source23 September 2026
cs.LG
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