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The Evidence Ladder for Reinforcement Learning in Healthcare: From Retrospective Policies to Trusted Interventions

arXiv · AI, language, vision and robotics · article · Sep 20, 2026 · UTC

Reinforcement learning (RL) offers a natural language for healthcare decisions whose conse- quences unfold over time, yet most reported progress remains far from routine intervention. Ex- isting surveys organize the field by algorithm or clinical application. We instead review healthcare RL through an evidence ladder: problem formulation, retrospective identification, policy estima- tion, stress testing, prospective evaluation, and lifecycle monitoring. This view connects clinical treatment, patient engagement, and health-system operations while exposing a recurring gap: evi- dence that a poli

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