arXiv:2608.27847cs.AI2026-08

用临床风险指导问诊,减少误诊且更省问题。

From Uncertainty to Clinical Risk: Severity-Aware Conformal Planning for Interactive Medical Diagnosis

论文配图:From Uncertainty to Clinical Risk: Severity-Aware Conformal Planning for Interactive Medical Diagnosis
图 1 · 摘自论文原文
  • 基于严重程度加权的风险感知决策框架,动态规划问诊与诊断
  • 在多个大模型上实现更少提问、更高准确率,重症误诊率显著下降
  • 适合医疗问诊系统研发者,推动安全高效的智能诊断

交互式医疗诊断通过多轮问诊动态获取患者信息,在证据不全时支持精准、高效且安全的临床决策。现有方法通常依赖预测不确定性或标签模糊性引导信息获取,但忽视了漏诊重病的非对称临床风险,且缺乏对是否继续提问或确诊的长期统一规划。为此,我们提出严重程度感知的共形临床规划方法,将交互式诊断建模为风险敏感的序列决策问题。该框架维护诊断信念、安全信念和隐藏证据信念;在保留的诊断轨迹上校准每轮的预测集合与严重程度加权的差异诊断风险;并将校准后的临床风险引入蒙特卡洛树搜索,联合评估长期的‘提问’与‘确诊’路径。在DDXPlus和MediQ数据集上的实验表明,本方法在多个大语言模型上均以更少问题实现更高诊断准确率,同时提升差异诊断质量并降低重症病例中的高风险错误。结果验证了以临床风险而非仅预测不确定性作为规划信号的价值,并展示了该框架在信息获取与风险感知诊断决策中的有效性,也推动未来面向临床风险的交互式诊断研究。

原文摘要 · Abstract (English)

Interactive medical diagnosis dynamically acquires patient information through multiple rounds of questioning, supporting accurate, efficient, and safe clinical decisions under incomplete evidence. Existing methods commonly guide information acquisition with predictive uncertainty or label ambiguity, but overlook the asymmetric clinical risk of missing severe diseases and lack unified long-horizon planning over whether to continue asking questions or commit to a diagnosis. To address these limitations, we propose Severity-Aware Conformal Clinical Planning, which formulates interactive diagnosis as a risk-sensitive sequential decision problem. The framework maintains complementary diagnostic, safety, and masked-evidence beliefs; calibrates turn-specific diagnostic prediction sets and severity-weighted differential-diagnosis risk on held-out diagnostic trajectories; and introduces the calibrated clinical risk into Monte Carlo Tree Search to jointly evaluate long-horizon Ask and Commit trajectories. Experiments on DDXPlus and MediQ show that our method achieves more accurate diagnoses with fewer questions across multiple large language models, while improving differential-diagnosis quality and reducing high-risk errors in severe cases. These findings validate the value of using clinical risk, rather than predictive uncertainty alone, as a planning signal and demonstrate the effectiveness of the proposed framework for information acquisition and risk-aware diagnostic decision making. They also motivate future work on clinical-risk-oriented interactive diagnosis and information-acquisition methods.

医疗诊断风险感知问诊优化

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