arXiv:2608.26414cs.CLcs.IR2026-08中稿 · EMNLP

用患者病例匹配临床指南流程图,提升诊疗决策效率。

Case2Flow: Bridging Patient Cases and Guideline Flowcharts through Multimodal Retrieval

论文配图:Case2Flow: Bridging Patient Cases and Guideline Flowcharts through Multimodal Retrieval
图 1 · 摘自论文原文
  • 构建病例-流程图对数据集,实现多模态检索。
  • 提出CRISP方法,召回率最高提升18.71个百分点。
  • 适合临床辅助决策系统研发者使用。

临床指南包含丰富的循证决策逻辑,但医生在指南中定位具体决策路径仍困难,尤其跨指南比较时更为复杂。尽管指南文本已支持端到端问答,流程图却未被充分用于决策支持,而其能有效表达可操作的临床路径。为此,我们提出Case2Flow任务:从指南文档集合中为给定患者病例检索最相关的流程图。为此构建了FlowAtlas,一个包含202个流程图的精选语料库,源自2,080份医学指南,并通过管道生成1,911对对齐的病例-流程图样本。评估发现现有多模态检索方法存在系统性缺陷,如过度依赖关键词、受流程图无信息背景区域干扰导致虚假匹配。针对此,我们提出CRISP——一种无需训练的评分方法,通过抑制无信息区域、弱化模糊词匹配、引入双向查询-图像对齐,增强晚期交互式检索效果。CRISP使Recall@1最高提升18.71个百分点;盲评医师对公开病例叙述的评估也初步验证了其可行性。

原文摘要 · Abstract (English)

Medical guidelines encode rich, evidence-based decision logic, yet the specific decision artifact a clinician needs is hard to locate within a guideline, let alone across guidelines covering plausible diseases and treatments. While guideline passages have supported end-to-end question answering, flowcharts remain largely underused in decision support despite their ability to encode actionable clinical pathways. We therefore introduce Case2Flow, a task designed to retrieve the most relevant guideline flowchart for a given patient case from a collection of guideline documents. To support it, we construct FlowAtlas, a curated corpus of 202 flowcharts extracted from 2,080 medical guidelines, together with a pipeline that synthesises 1,911 aligned case-flowchart pairs. Our evaluation of multimodal retrieval methods reveals systematic failure modes, including overreliance on keywords and spurious token-patch matches induced by uninformative background regions in flowcharts. Motivated by this, we propose CRISP, a training-free scoring method that sharpens late-interaction retrieval by suppressing uninformative patches, discounting ambiguous token matches, and incorporating bidirectional query-image alignment. CRISP improves Recall@1 by up to 18.71 percentage points, while a blinded physician assessment on published case narratives provides preliminary feasibility evidence beyond synthetic queries.

临床决策多模态检索流程图医疗AI

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