arXiv:2603.22752cs.AI2026-03

提出CLiGNet模型,用标签图提升40个专科的病历分类准确率。

CLiGNet: Clinical Label-Interaction Graph Network for Medical Specialty Classification from Clinical Transcriptions

  • 构建专科标签图,融合语义相似度与疾病编码先验知识
  • 在4966条记录上达0.279宏F1,比基线高0.066
  • 适合需高精度专科分类的临床决策支持系统

自动化将临床转录文本分类至40个医学专科对分诊、编码和临床决策支持至关重要。现有研究在广泛使用的MTSamples基准上因在训练测试划分前使用SMOTE过采样导致严重数据泄露。本文首次指出该方法缺陷,并建立无泄露基准(4966条记录),揭示真实任务难度远高于以往报告。随后提出CLiGNet(临床标签交互图网络),结合Bio ClinicalBERT文本编码器与两层图卷积网络,基于语义相似度和ICD-10章节先验构建专科标签图。通过每标签注意力门融合文档与标签图表示,采用焦点二元交叉熵损失处理极端类别不平衡(最高181:1)。在七种基线(从TF-IDF到Clinical Longformer)中,未校准的CLiGNet达到最高宏F1 0.279;消融实验表明,图卷积网络带来的性能增益最大(+0.066宏F1)。加入每标签Platt校准后,期望校准误差仅为0.007,实现排序性能与概率可靠性之间的合理权衡。提供全面失败分析,涵盖专科混淆、稀有类别行为、文档长度影响及词级集成梯度归因,为临床NLP系统部署提供可操作洞察。

原文摘要 · Abstract (English)

Automated classification of clinical transcriptions into medical specialties is essential for routing, coding, and clinical decision support, yet prior work on the widely used MTSamples benchmark suffers from severe data leakage caused by applying SMOTE oversampling before train test splitting. We first document this methodological flaw and establish a leakage free benchmark across 40 medical specialties (4966 records), revealing that the true task difficulty is substantially higher than previously reported. We then introduce CLiGNet (Clinical Label Interaction Graph Network), a neural architecture that combines a Bio ClinicalBERT text encoder with a two layer Graph Convolutional Network operating on a specialty label graph constructed from semantic similarity and ICD 10 chapter priors. Per label attention gates fuse document and label graph representations, trained with focal binary cross entropy loss to handle extreme class imbalance (181 to 1 ratio). Across seven baselines ranging from TF IDF classifiers to Clinical Longformer, CLiGNet without calibration achieves the highest macro F1 of 0.279, with an ablation study confirming that the GCN label graph provides the single largest component gain (increase of 0.066 macro F1). Adding per label Platt scaling calibration yields an expected calibration error of 0.007, demonstrating a principled trade off between ranking performance and probability reliability. We provide comprehensive failure analysis covering pairwise specialty confusions, rare class behaviour, document length effects, and token level Integrated Gradients attribution, offering actionable insights for clinical NLP system deployment.

医疗分类图神经网络临床NLP

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