arXiv:2508.15811v2 Announce Type: replace-cross Abstract: Generative query suggestion using large language models offers a powerful way to enhance conversational systems, but aligning outputs with nuanced user preferences remains a critical challenge. To address this, we introduce a multi-stage framework designed for progressive alignment between the generation policy and user intent. Our pipeline begins with prompt engineering as a cold-start strategy, followed by the Supervised Fine-Tuning stage, in which we introduce a distillation method on click logs to create a robust foundational model. To better model user preferences while capturing their inherent uncertainty, we develop a Gaussian Reward Model (GaRM) that represents user preferences as probability distributions rather than point estimates. Finally, we employ reinforcement learning to align the generation policy with these preferences, guided by a composite reward function that integrates GaRM with auxiliary heuristics to mitigate reward hacking. To maintain training stability, this process is enhanced by a novel out-of-distribution regularization method and a two-stage reward fusion technique. Extensive experiments demonstrate that our framework significantly outperforms baselines on both automatic and human evaluations and yields a 34\% relative increase in user engagement as measured by click-through rate in live A/B tests.

arXiv:2510.02967v3 Announce Type: replace-cross Abstract: This paper presents the development and evaluation of a Retrieval-Augmented Generation (RAG) system for querying the United Kingdom's National Institute for Health and Care Excellence (NICE) clinical guidelines using Large Language Models (LLMs). The extensive length and volume of these guidelines can impede their utilisation within a time-constrained healthcare system, a challenge this project addresses through the creation of a system capable of providing users with precisely matched information in response to natural language queries. The system's retrieval architecture, composed of a hybrid embedding mechanism, was evaluated against a corpus of 10,195 text chunks derived from three hundred guidelines. It demonstrates high performance, with a Mean Reciprocal Rank (MRR) of 0.814, a Recall of 81% at the first chunk and of 99.1% within the top ten retrieved chunks, when evaluated on 7901 queries. The most significant impact of the RAG system was observed during the generation phase. When evaluated on a manually curated dataset of seventy question-answer pairs, RAG-enhanced models showed substantial gains in performance. Faithfulness, the measure of whether an answer is supported by the source text, was increased by 64.7 percentage points to 99.5% for the RAG-enhanced O4-Mini model and significantly outperformed the medical-focused Meditron3-8B LLM, which scored 43%. Clinical evaluation by seven Subject Matter Experts (SMEs) further validated these findings, with GPT-4.1 achieving 98.7% accuracy while reducing unsafe responses by 67% compared to O4-Mini (from 3.0 to 1.0 per evaluator). This study thus establishes RAG as an effective, reliable, and scalable approach for applying generative AI in healthcare, enabling cost-effective access to medical guidelines.

npj Digital Medicine, Published online: 15 December 2025; doi:10.1038/s41746-025-02218-5

H&E-based MSI/MMR testing with AI in colorectal cancer: a multi-centred blinded evaluation