Critic–Adviser–Reviser Cyclic Refinement: Towards High-Quality EMR Corpus Generation with LLMs

Abstract

Electronic medical records (EMRs) are vital for healthcare research, but their use is limited by privacy concerns. Synthetic EMR generation offers a promising alternative, yet most existing methods merely imitate real records without adhering to rigorous clinical quality principles. To address this, we introduce LLM-CARe, a stage-wise cyclic refinement framework that progressively improves EMR quality through three stages, each targeting a specific granularity: corpus, section and document. At each stage, a Critic, an Adviser, and a Reviser collaborate iteratively to evaluate, provide feedback, and refine the drafts. This structured, multi-stage process produces records that better satisfy clinical quality standards. Experiments show that LLM-CARe significantly enhances EMR quality across all levels compared to strong baselines and yields improved performance on real-world clinical tasks such as diagnosis prediction. Unlike prior work, our method requires no real EMR text for training or prompting, demonstrating the effectiveness of stage-wise, cyclic refinement for generating high-quality, privacy-preserving EMR datasets.