While large language models (LLMs) have achieved state-of-the-art performance on a wide range of medical question answering (QA) tasks, they still face challenges with hallucinations and outdated knowledge. Retrieval-augmented generation (RAG) is a promising solution and has been widely adopted. However, a RAG system can involve multiple flexible components, and there is a lack of best practices regarding the optimal RAG setting for various medical purposes. To systematically evaluate such systems, we propose the Medical Information Retrieval-Augmented Generation Evaluation (MIRAGE), a first-of-its-kind benchmark including 7,663 questions from five medical QA datasets. Using MIRAGE, we conducted large-scale experiments with over 1.8 trillion prompt tokens on 41 combinations of different corpora, retrievers, and backbone LLMs through the MedRAG toolkit introduced in this work. Overall, MedRAG improves the accuracy of six different LLMs by up to 18% over chain-of-thought prompting, elevating the performance of GPT-3.5 and Mixtral to GPT-4-level. Our results show that the combination of various medical corpora and retrievers achieves the best performance. In addition, we discovered a log-linear scaling property and the "lost-in-the-middle" effects in medical RAG. We believe our comprehensive evaluations can serve as practical guidelines for implementing RAG systems for medicine.
Question Answering (QA) is a benchmark Natural Language Processing (NLP) task where models predict the answer for a given question using related documents, images, knowledge bases and question-answer pairs. Automatic QA has been successfully applied in various domains like search engines and chatbots. However, for specific domains like biomedicine, QA systems are still rarely used in real-life settings. Biomedical QA (BQA), as an emerging QA task, enables innovative applications to effectively perceive, access and understand complex biomedical knowledge. In this work, we provide a critical review of recent efforts in BQA. We comprehensively investigate prior BQA approaches, which are classified into 6 major methodologies (open-domain, knowledge base, information retrieval, machine reading comprehension, question entailment and visual QA), 4 topics of contents (scientific, clinical, consumer health and examination) and 5 types of formats (yes/no, extraction, generation, multi-choice and retrieval). In the end, we highlight several key challenges of BQA and explore potential directions for future works.