C-MIG: Multi-view Information Gain-based Retrieval-Augmented Generation for Clinical Diagnosis Reasoning

Abstract

Retrieval-augmented generation (RAG) trained with reinforcement learning (RL) is a promising way to ground large language models in medical evidence for clinical diagnosis. However, existing RAG-RL methods face two problems: (1) their process reward is largely singleview, as most methods inherited from opendomain multi-hop QA reward only the quality of the retrieved information; (2) assigning a reliable process reward is hard, as hard matching gives zero to clinically correct but non-verbatim steps such as"Allergic Sinusitis"versus"Allergic Rhinitis", and the alternative of strong-teacher guiding is bounded by the teacher's own medical competence. To address these issues, we propose C-MIG, a Multiview Information Gain-based framework for Clinical diagnosis. We identify two complementary and crucial intermediate steps in clinical diagnosis: what to retrieve and how to refine. We reward both by the information gain each brings, measured as the increase in the predicted likelihood of the ground-truth answer under a base, frozen reference model. The frozen scorer yields a stable and reproducible reward that needs no extra reward model or teacher. Experiments on four medical benchmarks show that C-MIG outperforms RAGRL baselines in and out of domain and stays competitive with far larger medical-specialist and general-purpose LLMs, at only about 3.4% training overhead and no inference-time cost.