用知识图谱和可信推理框架提升处方审核安全与可追溯性
A Hybrid Knowledge-Grounded Framework for Safety and Traceability in Prescription Verification
- 构建混合医药知识库，融合关系型与图结构数据实现双重验证
- 通过分步可验证查询，使大模型在处方审核中输出可追踪证据
- 适合医疗AI安全、临床决策支持系统研发人员参考
药物错误对患者安全构成重大威胁，药师审核（PV）作为最后一道防线却负担过重。直接使用大语言模型（LLMs）处理零容错的处方审核不可行，因其存在事实不可靠、缺乏可追溯性及复杂推理能力弱等问题。为此，我们提出PharmGraph-Auditor系统，采用虚拟知识图谱（VKG）范式构建可信的混合药品知识库（HPKB），通过严格映射层整合关系型组件（用于集合约束满足）与图组件（用于拓扑推理）。为构建该知识库，提出迭代模式优化（ISR）算法，实现从医学文本中协同演化图结构与关系模式。审计阶段引入基于知识库的验证链（CoV）新范式，将审核任务分解为一系列可验证查询，生成混合查询计划，从最合适的存储中检索证据，使大模型转变为透明推理引擎。实验表明该系统具备强大的知识提取能力，显著提升处方审核的安全性与效率。
原文摘要 · Abstract (English)
Medication errors pose a significant threat to patient safety, making pharmacist verification (PV) a critical, yet heavily burdened, final safeguard. The direct application of Large Language Models (LLMs) to this zero-tolerance domain is untenable due to their inherent factual unreliability, lack of traceability, and weakness in complex reasoning. To address these challenges, we introduce PharmGraph-Auditor, a novel system designed for safe and evidence-grounded prescription auditing. The core of our system is a trustworthy Hybrid Pharmaceutical Knowledge Base (HPKB), implemented under the Virtual Knowledge Graph (VKG) paradigm. This architecture strategically unifies a relational component for set constraint satisfaction and a graph component for topological reasoning via a rigorous mapping layer. To construct this HPKB, we propose the Iterative Schema Refinement (ISR) algorithm, a framework that enables the co-evolution of both graph and relational schemas from medical texts. For auditing, we introduce the KB-grounded Chain of Verification (CoV), a new reasoning paradigm that transforms the LLM from an unreliable generator into a transparent reasoning engine. CoV decomposes the audit task into a sequence of verifiable queries against the HPKB, generating hybrid query plans to retrieve evidence from the most appropriate data store. Experimental results demonstrate robust knowledge extraction capabilities and show promises of using PharmGraph-Auditor to enable pharmacists to achieve safer and faster prescription verification.
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