CDPR: Counterfactual Advantage-based Credit Assignment for Cost-Aware Sequential Medical Diagnosis

arXiv cs.AISeptember 1, 2026en

arXiv cs.AI

AI Global Wire

arXiv:2608.28599v1 Announce Type: new Abstract: Clinical diagnosis is a step-by-step, cost-aware process: a physician orders examinations one at a time, observes the results, and updates the diagnosis before reaching a final conclusion. Most medical language models instead treat diagnosis as a one-pass classification task and ignore the trade-off between a test's value and its cost. We model diagnosis as a cost-aware sequential decision process and train the policy with reinforcement learning. The main difficulty is credit assignment: the only reliable signal comes once at the end of a long trajectory, so it scores a wasteful workup the same as an efficient one. We propose CDPR (Counterfactu

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