Interactive medical questioning is essential in clinical consultations, where physicians must actively gather necessary patient information. Yet existing medical Large Language Models (LLMs) predominantly follow a reactive paradigm, risking diagnostic errors by answering before seeking sufficient details. To bridge this gap, we propose ProMed, a reinforcement learning framework that transitions LLMs toward a proactive paradigm, enabling them to ask clinically valuable questions before decision-making. Central to ProMed is the Shapley Information Gain (SIG) reward, which quantifies a question’s clinical utility as the amount of newly acquired information, while considering its contextual importance via Shapley values. We integrate SIG into a two-stage training pipeline: (1) SIG-Guided Model Initialization uses Monte Carlo Tree Search to construct high-reward interaction trajectories for supervision, and (2) SIG-Augmented Policy Optimization, with a novel SIG-guided Reward Distribution Mechanism that prioritizes informative questions for fine-grained optimization. Experiments on partial-information medical benchmarks show that ProMed significantly outperforms state-of-the-art methods by 6.29% on average and delivers a 54.45% gain over the reactive paradigm, and generalizes robustly to out-of-domain cases. Our codes are available at https://github.com/hxxding/ProMed.

Federated Retrieval (FR) routes queries across multiple external knowledge sources, to mitigate hallucinations of LLMs, when necessary external knowledge is distributed. However, existing methods struggle to retrieve high-quality and relevant documents for ambiguous queries, especially in cross-domain scenarios, which significantly limits their effectiveness in supporting downstream generation tasks. Inspired by Dynamic Information Flow (DIF), we propose DFAMS, a novel framework that leverages DIF to identify latent query intents and construct semantically aligned knowledge partitions for accurate retrieval across heterogeneous sources. Specifically, DFAMS probes the DIF in LLMs by leveraging gradient signals from a few annotated queries and employing Shapley value-based attribution to trace neuron activation paths associated with intent recognition and subdomain boundary detection. Then, DFAMS leverages DIF to train an alignment module via multi-prototype contrastive learning, enabling fine-grained intra-source modeling and inter-source semantic alignment across knowledge bases. Experimental results across five benchmarks show that DFAMS outperforms advanced FR methods by up to 14.37% in knowledge classification accuracy, 5.38% in retrieval recall, and 6.45% in downstream QA accuracy, demonstrating its effectiveness in complex FR scenarios. Our code is publicly available at https://github.com/Artessay/DFAMS.