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CohortFlow: A Steerable Clinical Cohort Curation Agent with Localized Semantic Correction

Summary

CohortFlow turns natural language corrections into localized updates of a structured cohort specification and reconciles them with a persistent execution graph, avoiding reprocessing of unchanged requirements. Using the same 8B model, it reaches 77.0% requirement-level micro-F1 versus 76.4% for full regeneration (not statistically significant), while cutting mean correction latency by 64.8% after completion and 44.3% during execution, with 38.1% fewer model calls.

SourcearXiv AIAuthor: Neil Chen, Adrian Serapio, Hanxue Gu, Evan Lee, Kang Wang, Yang Yang
CohortFlow: A Steerable Clinical Cohort Curation Agent with Localized Semantic Correction
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[Submitted on 26 Oct 2026]

Title:CohortFlow: A Steerable Clinical Cohort Curation Agent with Localized Semantic Correction

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Abstract:Language model agents for clinical cohort curation should accommodate evolving eligibility criteria without repeatedly processing unchanged requirements. We introduce CohortFlow, a steerable agent that represents natural language corrections as localized updates to a structured cohort specification and reconciles them with a persistent execution graph. Explicitly recorded semantic dependencies enable affected computations to be selectively invalidated while preserving valid prior results. On 100 scenarios derived from clinical-trial eligibility criteria, comprising 126 correction turns, localized steering achieves 77.0% requirement micro-F1 versus 76.4% for full regeneration using the same 8B model, a small numerical advantage that is not statistically significant ($p=0.493$). It reduces mean correction latency by 64.8% after completion and 44.3% during execution, with 38.1% fewer model calls. In a separate proof-of-concept evaluation over MIMIC, all 13 cohort states execute successfully, while correction trajectories demonstrate selective preservation of unaffected computations and recomputation of changed or dependent nodes. Together, these results show that localized semantic steering can substantially reduce correction latency and model calls while maintaining strong requirement-level accuracy.

Subjects:

Artificial Intelligence (cs.AI)

Cite as: arXiv:2610.36100 [cs.AI]

(or arXiv:2610.36100v1 [cs.AI] for this version)

https://doi.org/10.48550/arXiv.2610.36100

arXiv-issued DOI via DataCite (pending registration)

Submission history

From: Neil Chen [view email] [v1] Mon, 26 Oct 2026 18:16:29 UTC (788 KB)

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Key points

  • Represents natural language corrections as localized updates to a structured cohort specification, reconciled with a persistent execution graph.
  • Explicit semantic dependencies allow selective invalidation of affected computations while preserving valid prior results.
  • On 100 scenarios from clinical-trial eligibility criteria with 126 correction turns, achieves 77.0% requirement micro-F1 versus 76.4% for full regeneration (p=0.493).
  • Cuts mean correction latency by 64.8% after completion and 44.3% during execution, with 38.1% fewer model calls; all 13 MIMIC cohort states execute successfully.

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