FD-NL2SQL: Feedback-Driven Clinical NL2SQL that Improves with Use

arXiv cs.CL / 4/20/2026

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Key Points

  • FD-NL2SQL is a feedback-driven clinical NL2SQL assistant designed for SQLite-based oncology trial databases, helping clinicians write multi-constraint SQL without deep schema knowledge.
  • The system uses a schema-aware LLM to decompose a clinician’s natural-language question into predicate-level sub-questions, retrieves semantically similar expert-verified NL2SQL exemplars, and synthesizes executable SQL with validity checks.
  • It improves over time by learning from clinician-approved edits to generated SQL and by applying lightweight logic-based SQL augmentation that keeps only variants yielding non-empty results.
  • An additional LLM automatically reconstructs natural-language questions and predicate decompositions for accepted augmented/edited variants, expanding the exemplar bank without further manual annotation.
  • The demo interface supports interactive refinement by exposing decomposition, retrieval, synthesis, and execution outcomes to users during query building.

Abstract

Clinicians exploring oncology trial repositories often need ad-hoc, multi-constraint queries over biomarkers, endpoints, interventions, and time, yet writing SQL requires schema expertise. We demo FD-NL2SQL, a feedback-driven clinical NL2SQL assistant for SQLite-based oncology databases. Given a natural-language question, a schema-aware LLM decomposes it into predicate-level sub-questions, retrieves semantically similar expert-verified NL2SQL exemplars via sentence embeddings, and synthesizes executable SQL conditioned on the decomposition, retrieved exemplars, and schema, with post-processing validity checks. To improve with use, FD-NL2SQL incorporates two update signals: (i) clinician edits of generated SQL are approved and added to the exemplar bank; and (ii) lightweight logic-based SQL augmentation applies a single atomic mutation (e.g., operator or column change), retaining variants only if they return non-empty results. A second LLM generates the corresponding natural-language question and predicate decomposition for accepted variants, automatically expanding the exemplar bank without additional annotation. The demo interface exposes decomposition, retrieval, synthesis, and execution results to support interactive refinement and continuous improvement.