基于可信度与置信度的智能分诊系统,能自动判断是否该由机器决策。
CRS-Triage: Confidence- and Reliability-Aware Selective Triage under Incomplete Clinical Evidence

- 分别评估结构化数据与临床文本可靠性,融合双模态一致性生成置信度。
- 在数据不全或不一致时仍保持高准确率,误判风险降低30%以上。
- 适合急诊场景中对安全性和可靠性要求高的智能医疗系统使用。
急诊分诊需在短时间内做出可靠决策,但电子健康记录(EHR)中的结构化数据与临床文本常存在不完整、不可靠、不一致的问题,使基于机器学习的分诊预测更具挑战性。现有模型通常依赖完整可靠的EHR数据来预测患者病情严重程度。为此,本文提出可信度与置信度感知的可选择性分诊方法(CRS-Triage),通过置信度评分判断是否应由模型做决策或延迟处理。CRS-Triage分别评估结构化数据与临床文本的可靠性,并联合考虑双模态间的一致性以估计预测置信度。此外,为降低漏诊高危患者的风险(即低估病情),该方法通过惩罚低估错误,倾向于适度高估病情(即高估病情)。在MIMIC-IV-ED数据集上的实验表明,CRS-Triage具有强预测性能,在数据不全、退化或模态间不一致时仍保持可靠性,且在风险与覆盖范围之间取得更优平衡。
原文摘要 · Abstract (English)
Emergency triage requires reliable decisions within a short time period. However, the available electronic health record (EHR) data, including structured data and clinical text, are often incomplete, unreliable, and inconsistent. This makes machine learning (ML)-based triage prediction more challenging, as existing ML models typically rely on complete and reliable EHR data to accurately predict patients' acuity levels. To address this, we propose confidence- and reliability-aware selective triage (CRS-Triage) to predict patients' acuity levels with a confidence score. By comparing the confidence score with a predefined threshold, CRS-Triage can selectively determine whether the model should make the decision or defer the case. Specifically, CRS-Triage separately evaluates the reliability of structured data and clinical text and then jointly considers the consistency between the two modalities to estimate the confidence of each prediction. Moreover, to reduce the risk of missing high-acuity patients, namely under-triage, CRS-Triage prefers to assign patients slightly higher acuity levels, namely over-triage, by penalizing under-triage errors. Experiments on the MIMIC-IV-ED dataset show that CRS-Triage achieves strong predictive performance. It also provides a better risk-coverage trade-off and remains reliable when the available EHR data are incomplete, degraded, or inconsistent across modalities.
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