arXiv:2508.09719cs.LGcs.AI2025-08中稿 · Machine Learning f…

用临床笔记增强概念模型,提升ARDS诊断准确率10%。

Improving ARDS Diagnosis Through Context-Aware Concept Bottleneck Models

  • 用大语言模型从病历中提取新概念,补充传统概念瓶颈模型
  • 在ARDS诊断上实现比现有方法高10%的性能提升
  • 适合关注医疗AI可解释性与真实世界数据应用的研究者

大型公开临床数据集已成为理解疾病异质性和探索个体化治疗的新资源。这些数据源于非研究目的的原始记录,常存在不完整和关键标签缺失的问题。尽管已有多种AI工具用于回顾性标注,如疾病分类,但其可解释性普遍不足。先前工作尝试通过概念瓶颈模型(CBMs)解释预测结果,该模型学习可解释的概念以映射到高层次临床概念,便于人工评估。然而,当概念无法充分解释或表征任务时,模型性能受限。本文以急性呼吸窘迫综合征(ARDS)识别为挑战性案例,证明引入临床笔记中的上下文信息可显著提升CBM性能。本方法利用大语言模型(LLM)处理临床笔记并生成额外概念,在原有基础上实现10%的性能提升。同时,有助于学习更全面的概念,降低信息泄露和依赖虚假捷径的风险,从而更好刻画ARDS特征。

原文摘要 · Abstract (English)

Large, publicly available clinical datasets have emerged as a novel resource for understanding disease heterogeneity and to explore personalization of therapy. These datasets are derived from data not originally collected for research purposes and, as a result, are often incomplete and lack critical labels. Many AI tools have been developed to retrospectively label these datasets, such as by performing disease classification; however, they often suffer from limited interpretability. Previous work has attempted to explain predictions using Concept Bottleneck Models (CBMs), which learn interpretable concepts that map to higher-level clinical ideas, facilitating human evaluation. However, these models often experience performance limitations when the concepts fail to adequately explain or characterize the task. We use the identification of Acute Respiratory Distress Syndrome (ARDS) as a challenging test case to demonstrate the value of incorporating contextual information from clinical notes to improve CBM performance. Our approach leverages a Large Language Model (LLM) to process clinical notes and generate additional concepts, resulting in a 10% performance gain over existing methods. Additionally, it facilitates the learning of more comprehensive concepts, thereby reducing the risk of information leakage and reliance on spurious shortcuts, thus improving the characterization of ARDS.

医疗AI可解释性大模型应用

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