arXiv:2410.19955cs.LGcs.AI2024-10被引 4

用医学知识图谱和化验单信号,让AI像医生一样逐步推理诊断。

Bridging Stepwise Lab-Informed Pretraining and Knowledge-Guided Learning for Diagnostic Reasoning

  • 构建疾病知识图谱,融合语义与层级关系,增强模型理解力。
  • 设计化验单引导任务,使模型遵循临床步骤进行推理。
  • 在两个数据集上提升诊断准确率,适合医疗AI可解释性研究者。

尽管电子健康记录(EHR)在辅助诊断预测中应用日益广泛,但大多数数据驱动模型难以融入有意义的医学知识,常依赖有限本体,缺乏结构化推理能力和全面覆盖。这引出一个重要问题:医学知识能否提升预测模型,支持类人医生的分步临床推理?为此,我们提出DuaLK双专家框架,结合两种互补信息源:外部知识方面,构建诊断知识图谱(KG),利用大语言模型(LLM)丰富其层次与语义关系;为对齐患者数据,进一步引入基于化验单信号的代理任务,引导模型遵循临床一致的逐步推理流程。在两个公开EHR数据集上的实验表明,DuaLK在四项临床预测任务中持续优于现有基线。结果凸显了将结构化医学知识与个体临床信号结合,在实现更精准、可解释诊断预测方面的潜力。代码已开源于https://github.com/humphreyhuu/DuaLK。

原文摘要 · Abstract (English)

Despite the growing use of Electronic Health Records (EHR) for AI-assisted diagnosis prediction, most data-driven models struggle to incorporate clinically meaningful medical knowledge. They often rely on limited ontologies, lacking structured reasoning capabilities and comprehensive coverage. This raises an important research question: Will medical knowledge improve predictive models to support stepwise clinical reasoning as performed by human doctors? To address this problem, we propose DuaLK, a dual-expertise framework that combines two complementary sources of information. For external knowledge, we construct a Diagnosis Knowledge Graph (KG) that encodes both hierarchical and semantic relations enriched by large language models (LLM). To align with patient data, we further introduce a lab-informed proxy task that guides the model to follow a clinically consistent, stepwise reasoning process based on lab test signals. Experimental results on two public EHR datasets demonstrate that DuaLK consistently outperforms existing baselines across four clinical prediction tasks. These findings highlight the potential of combining structured medical knowledge with individual-level clinical signals to achieve more accurate and interpretable diagnostic predictions. The source code is publicly available on https://github.com/humphreyhuu/DuaLK.

医疗AI知识图谱临床推理EHR

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