Integrating Physician Diagnostic Logic into Large Language Models: Preference Learning from Process Feedback

The use of large language models in medical dialogue generation has garnered significant attention, with a focus on improving response quality and fluency. While previous studies have made progress in optimizing model performance for single-round medical Q&A tasks, there is a need to enhance the model's capability for multi-round conversations to avoid logical inconsistencies. To address this, we propose an approach called preference learning from process feedback~(PLPF), which integrates the doctor's diagnostic logic into LLMs. PLPF involves rule modeling, preference data generation, and preference alignment to train the model to adhere to the diagnostic process. Experimental results using Standardized Patient Testing show that PLPF enhances the diagnostic accuracy of the baseline model in medical conversations by 17.6%, outperforming traditional reinforcement learning from human feedback. Additionally, PLPF demonstrates effectiveness in both multi-round and single-round dialogue tasks, showcasing its potential for improving medical dialogue generation.

Plug-and-Play Medical Dialogue System

Medical dialogue systems aim to provide accurate answers to patients, necessitating specific domain knowledge. Recent advancements in Large Language Models (LLMs) have demonstrated their exceptional capabilities in the medical Q&A domain, indicating a rich understanding of common sense. However, LLMs are insufficient for direct diagnosis due to the absence of diagnostic strategies. The conventional approach to address this challenge involves expensive fine-tuning of LLMs. Alternatively, a more appealing solution is the development of a plugin that empowers LLMs to perform medical conversation tasks. Drawing inspiration from in-context learning, we propose PlugMed, a Plug-and-Play Medical Dialogue System that facilitates appropriate dialogue actions by LLMs through two modules: the prompt generation (PG) module and the response ranking (RR) module. The PG module is designed to capture dialogue information from both global and local perspectives. It selects suitable prompts by assessing their similarity to the entire dialogue history and recent utterances grouped by patient symptoms, respectively. Additionally, the RR module incorporates fine-tuned SLMs as response filters and selects appropriate responses generated by LLMs. Moreover, we devise a novel evaluation method based on intent and medical entities matching to assess the efficacy of dialogue strategies in medical conversations more effectively. Experimental evaluations conducted on three unlabeled medical dialogue datasets, including both automatic and manual assessments, demonstrate that our model surpasses the strong fine-tuning baselines.