arXiv:2511.04506cs.CL2025-11被引 4

构建放射科报告不确定性分析框架,区分显性与隐性不确定并量化其影响。

Modeling Clinical Uncertainty in Radiology Reports: from Explicit Uncertainty Markers to Implicit Reasoning Pathways

  • 用专家验证的LLM排名量化常见模糊表述的不确定性程度。
  • 通过专家定义诊断路径扩展14类常见疾病的隐性缺失发现,提升推理完整性。
  • 发布增强版Lunguage++数据集,支持更可信的诊断推理与临床影响研究。

放射科报告对临床决策至关重要,结构化后可支持自动化分析。报告中常含不确定性,可分为两类:(i) 显性不确定性,即通过模糊表达(如‘可能’)反映对病灶存在与否的疑虑,其语义依赖上下文,规则系统难以准确量化;(ii) 隐性不确定性,指放射科医生省略部分推理过程,仅记录关键发现或诊断,导致无法判断遗漏内容是真实不存在还是因简洁而未提及。本文提出两阶段框架:首先构建专家验证的大型语言模型参考排序,对常见模糊短语进行不确定性评分,并将每项发现映射为概率值;其次设计扩展框架,基于专家定义的14种常见疾病诊断路径,系统补充典型子发现。由此构建了增强版、含不确定性的Lunguage++基准数据集,支持更具鲁棒性的图像分类、更忠实的诊断推理,以及对诊断不确定性临床影响的新探索。

原文摘要 · Abstract (English)

Radiology reports are invaluable for clinical decision-making and hold great potential for automated analysis when structured into machine-readable formats. These reports often contain uncertainty, which we categorize into two distinct types: (i) Explicit uncertainty reflects doubt about the presence or absence of findings, conveyed through hedging phrases. These vary in meaning depending on the context, making rule-based systems insufficient to quantify the level of uncertainty for specific findings; (ii) Implicit uncertainty arises when radiologists omit parts of their reasoning, recording only key findings or diagnoses. Here, it is often unclear whether omitted findings are truly absent or simply unmentioned for brevity. We address these challenges with a two-part framework. We quantify explicit uncertainty by creating an expert-validated, LLM-based reference ranking of common hedging phrases, and mapping each finding to a probability value based on this reference. In addition, we model implicit uncertainty through an expansion framework that systematically adds characteristic sub-findings derived from expert-defined diagnostic pathways for 14 common diagnoses. Using these methods, we release Lunguage++, an expanded, uncertainty-aware version of the Lunguage benchmark of fine-grained structured radiology reports. This enriched resource enables uncertainty-aware image classification, faithful diagnostic reasoning, and new investigations into the clinical impact of diagnostic uncertainty.

医学影像不确定性建模自然语言处理放射科报告

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