arXiv:2512.23743cs.SEcs.AI2025-12

用符号验证消除医疗编码幻觉,兼顾准确与安全

Hybrid-Code v2: Zero-Hallucination Clinical ICD-10 Coding via Neuro-Symbolic Verification and Automated Knowledge Base Expansion

  • 神经网络生成候选编码,符号层逐层校验有效性
  • 在MIMIC-III上达85%覆盖、92%精确度,零幻觉
  • 自动扩展知识库,适合临床高安全要求场景

自动化临床ICD-10编码是重要医疗任务,需平衡覆盖率、精确度与安全性。神经方法性能强但存在生成无效编码的幻觉问题,规则系统无幻觉却难扩展。本文提出Hybrid-Code v2,通过神经符号框架实现构造性零类型一幻觉,同时保持良好覆盖率与精确度。系统融合神经候选生成与符号知识库验证层,实施格式、证据支撑、否定检测、时间一致性及排除规则等多层校验。此外,引入自动知识库扩展机制,从无标注文本中提取并验证编码模式。在MIMIC-III数据集上,该方法实现85%覆盖率、92%精确度、0%类型一幻觉,相比规则系统提升40%覆盖率,且消除神经基线中的6%-18%幻觉。该架构为医疗AI提供语法有效性形式化保障,兼具强实证表现,可推广至高安全要求领域。

原文摘要 · Abstract (English)

Automated clinical ICD-10 coding is a high-impact healthcare task requiring a balance between coverage, precision, and safety. While neural approaches achieve strong performance, they suffer from hallucination-generating invalid or unsupported codes-posing unacceptable risks in safety-critical clinical settings. Rule-based systems eliminate hallucination but lack scalability and coverage due to manual knowledge base (KB) curation. We present Hybrid-Code v2, a neuro-symbolic framework that achieves zero Type-I hallucination by construction while maintaining competitive coverage and precision. The system integrates neural candidate generation with a symbolic KB verification layer that enforces validity constraints through multi-layer verification, including format, evidence grounding, negation detection, temporal consistency, and exclusion rules. In addition, we introduce an automated KB expansion mechanism that extracts and validates coding patterns from unlabeled clinical text, addressing the scalability limitations of rule-based systems. Evaluated on the MIMIC-III dataset against ClinicalBERT, BioBERT, rule-based systems, and GPT-4, Hybrid-Code v2 achieves 85% coverage, 92% precision, and 0% Type-I hallucination, outperforming rule-based systems by +40% coverage while eliminating hallucination observed in neural baselines (6-18%). The proposed architecture provides a formal safety guarantee for syntactic validity while preserving strong empirical performance. These results demonstrate that neuro-symbolic verification can enforce safety constraints in neural medical AI systems without sacrificing effectiveness, offering a generalizable design pattern for deploying trustworthy AI in safety-critical domains.

医疗编码神经符号零幻觉ICD-10

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