Artificial intelligence has significantly revolutionized healthcare, particularly through large language models (LLMs) that demonstrate superior performance in static medical question answering benchmarks. However, evaluating the potential of LLMs for real-world clinical applications remains challenging due to the intricate nature of doctor-patient interactions. To address this, we introduce AI Hospital, a multi-agent framework emulating dynamic medical interactions between Doctor as player and NPCs including Patient and Examiner. This setup allows for more practical assessments of LLMs in simulated clinical scenarios. We develop the Multi-View Medical Evaluation (MVME) benchmark, utilizing high-quality Chinese medical records and multiple evaluation strategies to quantify the performance of LLM-driven Doctor agents on symptom collection, examination recommendations, and diagnoses. Additionally, a dispute resolution collaborative mechanism is proposed to enhance medical interaction capabilities through iterative discussions. Despite improvements, current LLMs (including GPT-4) still exhibit significant performance gaps in multi-turn interactive scenarios compared to non-interactive scenarios. Our findings highlight the need for further research to bridge these gaps and improve LLMs’ clinical decision-making capabilities. Our data, code, and experimental results are all open-sourced at https://github.com/LibertFan/AI_Hospital.

Large Reasoning Models (LRMs) perform strongly in complex reasoning tasks via Chain-of-Thought (CoT) prompting, but often suffer from verbose outputs, increasing computational overhead. Existing fine-tuning-based compression methods either operate post-hoc pruning, risking disruption to reasoning coherence, or rely on sampling-based selection, which fails to remove redundant content thoroughly. To address these limitations, this work begins by framing two key patterns of redundant reflection in LRMs—Confidence Deficit, wherein the model reflects on correct intermediate steps, and Termination Delay, where reflection continues after a verified, confident answer—through a confidence-guided perspective. Based on this, we introduce ConCISE (Confidence-guided Compression In Step-by-step Efficient Reasoning), a framework designed to generate concise reasoning chains, integrating Confidence Injection to boost reasoning confidence, and Early Stopping to terminate reasoning when confidence is sufficient. Extensive experiments demonstrate that compared to baseline methods, fine-tuning LRMs on ConCISE-generated data yields a better balance between compression and task performance, reducing length by up to ～50% under SimPO, while maintaining high task accuracy.