Guideline-as-Oracle: Zero-Annotation Training of an Ophthalmic Telephone Triage Agent
Mirrored from arXiv — NLP / Computation & Language for archival readability. Support the source by reading on the original site.
Computer Science > Computation and Language
Title:Guideline-as-Oracle: Zero-Annotation Training of an Ophthalmic Telephone Triage Agent
Abstract:Scaling supervision for multi-turn medical agents is difficult because expert dialogue annotation is costly and clinical conversations are privacy-restricted. We introduce Guideline-as-Oracle (GAO), which compiles American Academy of Ophthalmology guidance into a 70-row operational rule table and uses it as the sole source of instance-level supervision for 3,000 training dialogues, reserving human labeling for evaluation. Because converting rules into dialogues is itself a design problem, we catalog eight construction strategies, including cited-row tier assignment, one-fact boundary pairs, metadata-only repair, and label repair, and characterize the evidential status of each: labeling mechanism, null, confounded, or evaluated only as a package. Fine-tuning a 9B backbone on this corpus yields GAO-Triage, improving agreement with a 201-case operational reference from 61.7% to 74.1% (exact McNemar p=0.0046) and emergent-case recall from 9.5% to 69.0%; the gains persist across a second seed and patient simulator. None of the seven general-purpose systems we test dominates GAO-Triage on both metrics, and GAO-Triage requires no frontier model at inference time. Permuting label-dialogue assignments collapses the model to a constant-routine predictor, indicating that the signal lies in guideline-derived assignment rather than dialogue surface form. Label repair coincides with the disappearance of a late-training safety degradation.
| Subjects: | Computation and Language (cs.CL); Artificial Intelligence (cs.AI) |
| Cite as: | arXiv:2608.04772 [cs.CL] |
| (or arXiv:2608.04772v1 [cs.CL] for this version) | |
| https://doi.org/10.48550/arXiv.2608.04772
arXiv-issued DOI via DataCite (pending registration)
|
Access Paper:
- View PDF
- HTML (experimental)
- TeX Source
References & Citations
Bookmark
Bibliographic and Citation Tools
Code, Data and Media Associated with this Article
Demos
Recommenders and Search Tools
arXivLabs: experimental projects with community collaborators
arXivLabs is a framework that allows collaborators to develop and share new arXiv features directly on our website.
Both individuals and organizations that work with arXivLabs have embraced and accepted our values of openness, community, excellence, and user data privacy. arXiv is committed to these values and only works with partners that adhere to them.
Have an idea for a project that will add value for arXiv's community? Learn more about arXivLabs.
More from arXiv — NLP / Computation & Language
-
Geometric and Behavioral Stratification in Transformer Residual Streams
Aug 14
-
Perturbation-based Regional Interpretability through Subtraction Mapping (PRISM): naming-error dissociations in language models and post-stroke aphasia
Aug 14
-
I-SDPO: Instance-Level Adaptive Self-Distillation Policy Optimization
Aug 14
-
Comment on "Modeling rapid language learning by distilling Bayesian priors into artificial neural networks"
Aug 14
Discussion (0)
Sign in to join the discussion. Free account, 30 seconds — email code or GitHub.
Sign in →No comments yet. Sign in and be the first to say something.