Kui Ren
Publications
EHR-Complex: Benchmarking Medical Agents for Complex Clinical Reasoning
Clinical agents promise to democratize access to electronic health records (EHRs), yet existing benchmarks fail to reflect the complexity of practical EHR analysis, e.g., often operating on idealized, clean EHRs via static SQL generation rather than interactive execution. In this work, we introduce EHR-Complex, a large-scale benchmark designed for interactive clinical database reasoning. Built on the large MIMIC-IV substrate (365K patients, 31 tables, 500M+ records), EHR-Complex comprises about 52K tasks spanning six clinical intents, supporting both patient-level and population-level queries, where each task requires an agent to interact with a sandboxed environment by executing SQL queries or Python code. Notably, EHR-Complex considers the real-world SQL task complexity for longitudinal multi-table aggregation and compositional reasoning, resulting in 31.93 SQL structural components per query on average. Evaluation results on EHR-Complex reveal the clinical difficulty of these EHR reasoning scenarios, with the top-performing model achieving only 62.3% exact-match accuracy. Pass^k consistency drops below 50% for nearly all evaluated models at k=4, exposing broad stochastic fragility. A fine-grained analysis of more than 3,800 failed trajectories for representative LLMs reveals three dominant failure modes: SQL logic errors, medical-code lookup failures, and semantic misunderstandings. EHR-Complex provides a rigorous testbed for clinical agents and highlights remaining gaps in robust reasoning for large-scale EHR analysis.
QCFuse: Query-Aware Cache Fusion via Compressed View for Efficient RAG Serving
Retrieval-augmented generation (RAG) improves large language model (LLM) answer quality by grounding generation in external evidence, but processing retrieved contexts makes the prefill stage a dominant serving cost. RAG cache fusion reduces this cost by reusing precomputed key-value (KV) caches for retrieved chunks and selectively recomputing tokens under the current prompt. Existing selectors, however, face a dilemma between quality and efficiency: fast query-agnostic or final-layer query-to-context selectors can miss request-relevant evidence, whereas full-view query-aware selectors require broad context and layer visibility before recomputation and therefore stall the layer-wise cache-fusion pipeline. We present QCFuse, a compressed-view query-aware selector for RAG cache fusion. QCFuse uses chunk-anchor query probing to condition user-query states on compact per-chunk anchors and critical-layer profiling to identify recomputation tokens without all-layer inspection. We implement QCFuse in SGLang and evaluate it on four open-weight LLMs across six datasets. QCFuse reaches full-prefill-level quality. At matched quality, QCFuse achieves an average prefill-time speedup of 1.7x over full prefill and 1.5x over ProphetKV, the strongest quality-preserving baseline.