提出可解释的斜视诊断框架,提升模型推理透明度与临床可信度。
DECIS: Dual-Evidence Corrective Verification for Interpretable Strabismus Diagnostic Decision-Making

- 分四步结构化诊断:生成假设、双证据约束、证据校验、生成报告
- 在细粒度数据集上将F1分数从72.0%提升至91.3%
- 结合眼位照片与临床规则,减少幻觉,适合医疗场景应用
斜视是一种常见眼病,需精细分型以制定个性化治疗方案。现有深度学习方法仅输出诊断结果,缺乏透明推理;而近期大视觉语言模型(LVLMs)虽能联合图像理解与报告生成,但在依赖证据和规则驱动的医学任务中仍易产生幻觉。为此,本文提出DECIS框架,将黑箱端到端生成转化为结构化诊断流程:候选假设生成、双证据约束上下文、基于证据的校验修正、报告生成。具体地,引入双证据约束上下文(DECC)机制,整合九方位眼位照片的视觉证据与临床诊断规则形成约束性上下文。进一步设计基于证据的校验修正(EBCV)机制,通过视觉证据、热力图线索及临床规则验证当前诊断假设的一致性,不一致时触发假设修正。在细粒度斜视基准测试上,DECIS不仅超越其他先进系统,加权F1分数由72.0%提升至91.3%,且生成报告的临床可靠性(一致性、对齐性、完整性)显著提升。结果表明,DECIS为构建准确、基于证据、临床可解释的斜视诊断系统提供了有效方案。
原文摘要 · Abstract (English)
Strabismus is a common ocular disorder that requires fine-grained subtype diagnosis for individualized treatment planning. However, existing deep learning methods mainly provide diagnostic predictions without transparent reasoning, while recent large vision-language models (LVLMs), although promising for joint image understanding and report generation, remain highly prone to hallucination in this evidence-sensitive and rule-driven medical task. To address these challenges, we propose DECIS, a Dual-Evidence Corrective verification for Interpretable Strabismus diagnostic decision-making framework. DECIS transforms black-box end-to-end generation into a structured diagnostic process consisting of candidate hypothesis generation, dual-evidence constrained context, evidence-based corrective verification, and report generation. Specifically, we introduce a Dual-Evidence Constrained Context (DECC) mechanism that jointly organizes visual evidence from the photograph of the nine cardinal positions of gaze and evidence-based clinical diagnostic rules into a constrained context for reliable diagnostic reasoning. We further develop an Evidence-Based Corrective Verification (EBCV) mechanism that verifies whether the current diagnostic hypothesis is supported by visual evidence, heatmap-based visual cues, and evidence-based clinical diagnostic rules. Hypothesis refinement is triggered when inconsistency is detected. Experiments on a fine-grained strabismus benchmark demonstrate that DECIS not only outperforms other state-of-the-art diagnostic systems, improving the weighted F1 score from 72.0% to 91.3%, but also improves the clinical reliability (consistency, alignment, and completeness) of generated diagnostic reports. These results demonstrate that DECIS provides an effective solution for building accurate, evidence-based, and clinically interpretable strabismus diagnosis systems.
Thank you to arXiv for use of its open access interoperability. PaperDance 不是 arXiv 官方产品;中文卡片由大模型生成,请以原文为准。