@inproceedings{winter-etal-2024-ddxgym,
    title = "{DD}x{G}ym: Online Transformer Policies in a Knowledge Graph Based Natural Language Environment",
    author = "Winter, Benjamin  and
      Figueroa Rosero, Alexei Gustavo  and
      Loeser, Alexander  and
      Gers, Felix Alexander  and
      Figueroa Rosero, Nancy Katerina  and
      Krestel, Ralf",
    editor = "Calzolari, Nicoletta  and
      Kan, Min-Yen  and
      Hoste, Veronique  and
      Lenci, Alessandro  and
      Sakti, Sakriani  and
      Xue, Nianwen",
    booktitle = "Proceedings of the 2024 Joint International Conference on Computational Linguistics, Language Resources and Evaluation (LREC-COLING 2024)",
    month = may,
    year = "2024",
    address = "Torino, Italia",
    publisher = "ELRA and ICCL",
    url = "https://aclanthology.org/2024.lrec-main.396",
    pages = "4438--4448",
    abstract = "Differential diagnosis (DDx) is vital for physicians and challenging due to the existence of numerous diseases and their complex symptoms. Model training for this task is generally hindered by limited data access due to privacy concerns. To address this, we present DDxGym, a specialized OpenAI Gym environment for clinical differential diagnosis. DDxGym formulates DDx as a natural-language-based reinforcement learning (RL) problem, where agents emulate medical professionals, selecting examinations and treatments for patients with randomly sampled diseases. This RL environment utilizes data labeled from online resources, evaluated by medical professionals for accuracy. Transformers, while effective for encoding text in DDxGym, are unstable in online RL. For that reason we propose a novel training method using an auxiliary masked language modeling objective for policy optimization, resulting in model stabilization and significant performance improvement over strong baselines. Following this approach, our agent effectively navigates large action spaces and identifies universally applicable actions. All data, environment details, and implementation, including experiment reproduction code, are made publicly available.",
}

Differential diagnosis (DDx) is vital for physicians and challenging due to the existence of numerous diseases and their complex symptoms. Model training for this task is generally hindered by limited data access due to privacy concerns. To address this, we present DDxGym, a specialized OpenAI Gym environment for clinical differential diagnosis. DDxGym formulates DDx as a natural-language-based reinforcement learning (RL) problem, where agents emulate medical professionals, selecting examinations and treatments for patients with randomly sampled diseases. This RL environment utilizes data labeled from online resources, evaluated by medical professionals for accuracy. Transformers, while effective for encoding text in DDxGym, are unstable in online RL. For that reason we propose a novel training method using an auxiliary masked language modeling objective for policy optimization, resulting in model stabilization and significant performance improvement over strong baselines. Following this approach, our agent effectively navigates large action spaces and identifies universally applicable actions. All data, environment details, and implementation, including experiment reproduction code, are made publicly available.
Winter, Benjamin Figueroa Rosero, Alexei Gustavo Loeser, Alex er Gers, Felix Alex er Figueroa Rosero, Nancy Katerina Krestel, Ralf
DDxGym: Online Transformer Policies in a Knowledge Graph Based Natural Language Environment