Version-aware question answering over living oncology guidelines

Ravi Kumar, T.; Kaniyar Narayana Iyengar, A. I.; Khan, M. A.; Khakwani, K. Z. R.; Kathuria, K.; Sonbol, M. B.; Riaz, I.; Gupta, V.

doi:10.64898/2026.10.04.756483

bioRxiv · 10.64898/2026.10.04.756483

Version-aware question answering over living oncology guidelines

Ravi Kumar, T.·Kaniyar Narayana Iyengar, A. I.·Khan, M. A.·Khakwani, K. Z. R.·Kathuria, K.·Sonbol, M. B.·Riaz, I.·Gupta, V.

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Abstract

Living clinical guidelines revise recommendations as evidence emerges, so an AI answer can be faithful to a real guideline and still be out of date. Here we examine this failure using ASCOBench, 288 unique questions in 96 three-turn conversations grounded in versioned American Society of Clinical Oncology (ASCO) breast and prostate cancer guidelines, with oncologist-reviewed reference answers. Oncologists corrected one in four version-sensitive answers drafted by a frontier model, against fewer than one in ten factual ones. Across the guideline corpus, 19 recommendations changed between versions, seven of them reversals, yet only 1 of 14 superseded documents states that it has been replaced. With a strong model, retrieval over several guideline versions made stale answers four times more frequent than answering without retrieval. SentryLine, a verification-first system, lowered incorrect answers to 4.2-5.2% from 9.7-22.9% for baselines across three models. Recognizing change before a guideline declares it remains an open problem.

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Ravi Kumar, T., Kaniyar Narayana Iyengar, A. I., Khan, M. A., Khakwani, K. Z. R., Kathuria, K., Sonbol, M. B., Riaz, I., Gupta, V.. 2026-10-11. Version-aware question answering over living oncology guidelines. https://doi.org/10.64898/2026.10.04.756483

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