arXiv:2608.19875cs.CLcs.AI2026-08

用知识引导的智能体解决医疗问答中的患者信息模糊问题。

A knowledge-guided agentic framework for mitigating patient-context ambiguity in health queries

论文配图:A knowledge-guided agentic framework for mitigating patient-context ambiguity in health queries
图 1 · 摘自论文原文
  • 构建知识图谱生成多种合理假设,定位缺失的关键患者信息
  • 通过针对性追问提升诊断准确率超57个百分点,召回率提升77.7个百分点
  • 适合医疗AI对话系统开发者,提升模型安全与可解释性

患者向医疗聊天机器人提交的查询常因信息不足而模糊,虽语言清晰但可能对应多个合理答案,取决于未披露的症状、诊断、用药、过敏或饮食限制等。直接让语言模型回答会依赖无依据的假设。本文提出一种知识引导的智能体框架,在下游语言模型前介入,解析初始查询,利用任务专用知识图谱生成若干合理假设,识别区分这些假设所需的缺失患者上下文变量,并提出精准追问。将原始查询与获取的新上下文合并为清晰提示,再交由下游模型生成响应。在两个控制性基准上评估:1,034个症状查询中系统性隐藏临床证据的诊断检索任务,以及487个遗漏关键健康信息的饮食安全分类任务。相比直接回答和不获取新信息的重述方法,该框架在诊断检索中使整体精确Top-1准确率至少提升57.1个百分点,选择性Recall@5提升至少77.7个百分点;在饮食安全分类中所有模型准确率均提升,四款模型取得最高马修斯相关系数。

原文摘要 · Abstract (English)

Patients often submit short, underspecified queries to healthcare chatbots that lack the patient-specific information needed to determine an appropriate response. Although these queries may be linguistically clear, they can support multiple plausible answers depending on undisclosed factors such as symptoms, diagnoses, medications, allergies, or dietary restrictions. A language model answering such a query directly may therefore rely on unsupported assumptions about the patient. We introduce a knowledge-guided agentic framework for mitigating patient-context ambiguity before final response generation. The framework operates between the patient and an otherwise unchanged downstream language model. It interprets the initial query, uses a task-specific knowledge graph to construct a set of plausible hypotheses, identifies the missing patient-context variables needed to distinguish among them, and asks targeted follow-up questions. The original query and the acquired context are then combined into a clarified prompt for the downstream model. We evaluated the framework across five language models using two controlled ambiguity-mitigation benchmarks: diagnosis retrieval from 1,034 symptom queries with clinically relevant evidence systematically masked, and dietary-safety classification from 487 queries with decisive health context omitted. The framework was compared with direct answering of the underspecified query and with rephrasing the same query without acquiring new patient information. In diagnosis retrieval, it increased overall exact Top-1 accuracy by at least 57.1 percentage points and selective exact Recall@5 by at least 77.7 percentage points across the five evaluated models compared with direct prompting. In dietary-safety classification, it improved accuracy across all five models and achieved the highest Matthews correlation coefficient for four...

医疗AI智能体问答系统知识图谱

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