Jul 2026· IEEE journal of biomedical and health informatics· Vol PP, pp. 1-12· 0 citations
Medicine
TL;DR
This paper proposes symbolic preference distillation (SyPD), a reasoning optimization strategy that leverages specialized domain knowledge to perform SLMs' error analysis and generate symbolic knowledge via a teacher, and proposes a preference distillation method that guides an SLM to align with high-quality and clinically relevant reasoning derived from the teacher LLM through preference signals and symbolic knowledge, without requiring access to the teacher's output probabilities.
Abstract
Large language models (LLMs) have demonstrated strong performance in mental health analysis tasks when equipped with advanced reasoning capabilities. However, their substantial parameter sizes and high computational demands present significant barriers for routine clinical use. Recent studies have explored reasoning distillation as a means to transfer these capabilities to small language models (SLMs). However, SLMs often struggle with complex reasoning tasks due to their limited capacity to model both general cognitive abilities and specialized domain knowledge. In this paper, we propose symbolic preference distillation (SyPD), to enhance the complex reasoning abilities of SLMs in mental health analysis tasks. First, to handle challenging or ambiguous cases, we introduce a reasoning optimization strategy that leverages specialized domain knowledge to perform SLMs' error analysis and generate symbolic knowledge via a teacher. Second, to further boost SLM's reasoning ability, we propose a preference distillation method that guides an SLM to align with high-quality and clinically relevant reasoning derived from the teacher LLM through preference signals and symbolic knowledge, without requiring access to the teacher's output probabilities. By anchoring the optimization to the model's own pre aligned distribution, our method enables post-hoc correction of failure cases while gaining domain-specific knowledge. Experimental results demonstrate that our proposed SyPD, with only 1.1 billion parameters, achieves an average weighted F1-score of 0.815 on mental disorder diagnosis on the interpretable mental health instruction (IMHI) bench mark. It outperforms the state-of-the-art instruction-tuned MentaLLaMA-Chat-13B model by 6.14%, and the few-shot tuned GPT-4 model by 15.44%.
Developing artificial intelligence capable of clinical language comprehension and reliable diagnostic reasoning has remained a core challenge in biomedical engineering. While Large Language Models (LLMs) demonstrate significant potential in general natural language processing tasks, their direct application in the medical domain is severely constrained by parametric hallucinations and data silos. This paper introduces an end-to-end, resource-efficient, multilingual speech-driven Question-Answering (QA) framework optimized for localized clinical support. To accommodate deployment on consumer-grade execution environments, we implement Parameter-Efficient Fine-Tuning (PEFT) using Low-Rank Adaptation (LoRA) and 4-bit Quantized LoRA (QLoRA) configurations across open-source 3B and 7B parameter architectures. Human preference alignment is enforced via a stateful Reinforcement Learning with Human Feedback (RLHF) loop applying Proximal Policy Optimization (PPO). Crucially, to mitigate the vulnerabilities of passive information retrieval, we introduce an Active Validation Loop powered by Corrective Retrieval-Augmented Generation (CRAG). This validation engine is decoupled from the model harness using the Model Context Protocol (MCP), standardizing asynchronous lookups across dense vector repositories, clinical guidelines, and real-time electronic health registries.
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