用推理能力验证病历与表格数据一致性,提升医疗记录可靠性
Towards Error-Free EHRs: Reasoning-Intensive Consistency Verification Between Clinical Notes and Structured Tables in Electronic Health Records

- 构建需推理的临床一致性验证基准EHR-ReasonCon
- 在MIMIC-III上实现8048个实体的高质量标注
- 基于LLM的EHR-Inspector框架显著优于现有方法
电子健康记录(EHR)中非结构化病历与结构化表格之间的数据一致性对患者安全和临床决策至关重要。然而,现有方法主要依赖数值或事件的表面匹配,难以捕捉真实EHR文档中的临床推理、事件关系和时间变化等深层逻辑。为此,我们提出EHR-ReasonCon——一个基于MIMIC-III并由专家指导标注的推理密集型一致性验证基准,包含8,048个从病历中提取的实体及高质量真值标签。标注过程借助专用表格探索工具,确保证据系统性检索与可靠评估。我们还提出EHR-Inspector,一种基于大语言模型的框架,可分割病历、提取锚点实体与时间引用,并结合表格探索工具验证与结构化数据的一致性。在专家验证的LLM作为裁判指标下,该框架在严苛与宽松标准下均达到最优性能,组件分析揭示其有效性及与人工验证的差异。
原文摘要 · Abstract (English)
Data consistency between unstructured clinical notes and structured tables in Electronic Health Records (EHRs) is essential for patient safety and clinical decision-making. However, existing work on note-table consistency verification mainly relies on surface-level matching of numeric values or simple events. Such approaches fail to capture the reasoning underlying real-world EHR documentation, including clinical interpretation, event relations, and temporal changes. To address this gap, we introduce EHR-ReasonCon, a reasoning-intensive benchmark for note-table consistency verification. Built on MIMIC-III with expert-guided annotations, it comprises 8,048 entities derived from clinical notes and provides high-quality ground-truth labels. The annotation protocol is supported by specialized table-exploration tools to ensure systematic evidence retrieval and reliable consistency assessment. We also propose EHR-Inspector, an LLM-based framework that segments notes, extracts anchor entities and temporal references, and uses table-exploration tools to verify consistency against structured tables. Evaluated using expert-validated LLM-as-a-judge metrics under harsh and lenient criteria, EHR-Inspector achieves state-of-the-art performance across multiple model backbones. Analyses further demonstrate the effectiveness of its components and highlight differences from human verification.
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