构建可追踪病历的对话框架,模拟急诊分诊中动态获取关键信息的过程。
ELICITED: EHR-grounded Longitudinal Interactive Conversations for Information-seeking Triage Evaluation and Decision-making

- 基于MIMIC-IV-ED构建角色化、时序可控的对话生成框架
- 实现患者披露与电子病历事件精确对齐,支持五级急诊严重度预测
- 适合研究临床对话中的信息挖掘与智能分诊系统评估
急诊分诊要求临床医生快速识别需立即处理的患者,判断可安全等待者,并合理分配有限资源。然而,就诊时信息仅限主诉和初步生命体征,诸如症状起始与进展、伴随症状、既往史及用药情况等关键细节通常需通过有目的的对话获取。有效分诊依赖于识别信息缺口、提出恰当追问并随新证据更新评估。现有急诊评估基准多基于静态临床快照进行分诊预测,虽能衡量信息完备后的性能,却未捕捉信息获取与解读的交互过程。现有医学对话数据集虽支持临床沟通研究,但对话内容常未与电子健康记录(EHR)中的时序事件关联。本文提出EHR2Dial-Triage——一个基于MIMIC-IV-ED的代理式对话生成框架与基准。该框架在明确的角色设定与时间边界下生成分诊对话,每个被接受的患者陈述均与对应的EHR事件及首次可用的对话轮次关联。该基准支持对信息获取、证据利用、五级急诊严重指数预测及面向患者的沟通能力进行可控评估,为研究对话式分诊作为临床信息采集、推理与沟通的动态过程提供结构化环境。
原文摘要 · Abstract (English)
Emergency-department (ED) triage requires clinicians to rapidly identify patients who need immediate attention, determine who can safely wait, and prioritize limited clinical resources. At presentation, however, information may be limited to a chief complaint and initial vital signs. Clinically important details, including symptom onset and progression, associated symptoms, medical history, and medication use, are often obtained through focused conversation. Effective triage therefore requires clinicians to identify information gaps, ask appropriate follow-up questions, and update their assessment as new evidence becomes available. Most existing ED benchmarks evaluate acuity prediction from a fixed clinical snapshot. Although this formulation measures predictive performance after patient information has been assembled, it does not capture the interactive process through which triage-relevant evidence is elicited and interpreted. Existing medical dialogue datasets support the study of clinical communication, but dialogue statements are not always linked to temporally ordered events in the electronic health record (EHR). We introduce EHR2Dial-Triage, an agentic conversation-generation framework and benchmark grounded in MIMIC-IV-ED. The framework constructs triage conversations under explicit role-based and temporal information boundaries. Each accepted patient disclosure is linked to its supporting EHR event and the first dialogue turn at which it becomes available. EHR2Dial-Triage enables controlled evaluation of information elicitation, evidence use, five-level Emergency Severity Index prediction, and patient-facing communication across models and patient personas. It provides a structured setting for studying conversational triage as a dynamic process of clinical information acquisition, reasoning, and communication.
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