Interaction-Limited Safe Continuous-Time RL for Dynamical Medical Treatment

Dynamic medical treatment requires deciding treatment intensity and intervention timing, while patient states evolve continuously and adverse events may occur between clinical interactions. Most existing treatment learning methods assume fixed schedules or enforce safety only at discrete decision points. We propose Interaction-Limited Safe Continuous-Time Reinforcement Learning, a framework that jointly optimizes treatment administration and clinical interaction timing under trajectory-level safety constraints. Our key idea is to reformulate the continuous time treatment problem as an option-based semi-Markov decision process, where each option specifies a continuous-time treatment policy and its duration. We develop a safety-tightening mechanism showing that suitably constructed constraints at interaction times guarantee safety over the full continuous-time trajectory with high probability. We further establish finite-sample guarantees for policy learning from logged treatment trajectories and introduce a practical data-driven conservative surrogate. Experiments show that the proposed adaptive interaction-timing mechanism improves both safety and treatment effectiveness over equidistant interaction schemes across different safe policy optimization methods.

MedGym:A Unified Continuous-Time Benchmark for Dynamic Medical Treatment Reinforcement Learning

Medical treatment recommendation poses several challenges to reinforcement learning (RL): patient physiology evolves in continuous time, measurements and interventions are performed at irregular intervals, and treatment effects vary substantially across individuals. Existing RL formulations and simulated environments, however, are based on discrete-time MDP or POMDP abstractions with fixed or pre-specified decision intervals. Thus, it remains difficult to evaluate whether RL methods can handle time-interval-dependent disease progression, personalized treatment response, and safety between consecutive measurement points. To address this gap, we introduce MedGym, a benchmark environment for dynamic treatment recommendation. MedGym models longitudinal patient evolution in a continuous-time framework and constructs a configurable medical RL benchmark from clinical data by using Physics-Informed Neural Networks. The resulting benchmark supports both offline and online RL, and enables direct comparison between discrete-time and continuous-time methods under irregular treatment timing and patient-specific dynamics. Besides, MedGym supports evaluation from clinically important perspectives, including personalization, trajectory-level safety, and the performance gap between model-based offline learning and online deployment. By providing a standardized and configurable benchmark for continuous-time dynamic treatment, MedGym aims to facilitate more realistic and informative evaluation of medical RL methods.

Asymmetric Generative Recommendation via Multi-Expert Projection and Multi-Faceted Hierarchical Quantization

Generative Recommendation (GenRec) models reformulate recommendation as a sequence generation task, representing items as discrete Semantic IDs used symmetrically as both inputs and prediction targets. We identify a critical dual-stage information bottleneck in this design: (1) the Input Bottleneck, where lossy quantization degrades fine-grained semantics, while popularity bias skews the learned representations toward frequent items, and (2) the Output Bottleneck, where imprecise discrete targets limit supervision quality. To address these issues, we propose AsymRec, an asymmetric continuous-discrete framework that decouples input and output representations. Specifically, Multi-expert Semantic Projection (MSP) maps continuous embeddings into the Transformer's hidden space via expert-specialized projections, preserving semantic richness and improving generalization to infrequent items. Multi-faceted Hierarchical Quantization (MHQ) constructs high-capacity, structured discrete targets through multi-view and multi-level quantization with semantic regularization, preventing dimensional collapse while retaining fine-grained distinctions. Extensive experiments demonstrate that AsymRec consistently outperforms state-of-the-art generative recommenders by an average of 15.8 %. The code will be released.