arXiv:2609.01839cs.LGcs.AI2026-09

动态决定何时何地引入外部知识,提升电子病历预测准确率。

Import What You Need: Learning When and How to Augment EHR Graphs with External Knowledge

论文配图:Import What You Need: Learning When and How to Augment EHR Graphs with External Knowledge
图 1 · 摘自论文原文
  • 用强化学习动态选择是否、如何在就诊时引入外部知识图谱。
  • 在MIMIC-III/IV上诊断、死亡率和再入院预测均优于基线,提升显著。
  • 可解释的增强模式,适合医疗图神经网络与知识融合研究者。

从电子健康记录(EHR)进行纵向预测受限于患者轨迹的稀疏性和不规则性,通过外部知识图谱(KG)进行知识增强是缓解该问题的可行方案。然而,现有方法通常以固定、无关上下文的方式添加相同的KG节点和边。我们提出ReTA,一种基于强化学习的动态拓扑增强框架,将知识导入视为每次就诊、预算感知的策略决策。ReTA首先构建离线优化的知识图谱模板池,随后学习每轮就诊从三种操作中选择其一:软导入(丰富节点特征但不改变拓扑)、硬导入(嫁接紧凑子图以创建消息传递捷径)、跳过(当基础编码器已有足够置信度时保持原状)。为稳定训练,ReTA采用解耦编码器,分别处理语义与结构信号,并通过自适应门控融合。在MIMIC-III与MIMIC-IV数据集上,针对诊断预测、死亡率与再入院任务的实验表明,ReTA持续超越强基线,兼具高效性,可跨数据集与知识图谱迁移,并生成可解释的增强模式。在弱监督条件下依然表现稳健,凸显动态决策的优势——在提升准确率的同时控制成本。

原文摘要 · Abstract (English)

Longitudinal prediction from electronic health records (EHRs) is limited by the sparsity and irregularity in patient trajectories, and knowledge augmentation with external knowledge graphs (KGs) offers a promising way to alleviate these issues. However, most existing methods perform fixed, context-agnostic topology augmentation by adding the same KG nodes and edges regardless of a patient's evolving state. We propose ReTA, a Reinforcement learning-based dynamic Topology Augmentation framework that casts KG import as a per-visit, budget-aware policy. ReTA first constructs an offline refined pool of KG-grounded templates, then learns a policy to select one augment action per visit from three options: Soft Import, which enriches node features without modifying graph topology, Hard Import, which grafts a compact KG subgraph onto the visit graph to create message-passing shortcuts, and Skip, which leaves the visit unaugmented when the base encoder is already confident. To stabilize learning, ReTA employs a decoupled encoder that processes semantic and structural signals in separate channels and fuses them via adaptive gating. Experiments on MIMIC-III and MIMIC-IV across diagnosis prediction, mortality, and readmission show that ReTA consistently outperforms strong baselines while remaining efficient, transfers across datasets and knowledge graphs, and yields interpretable augmentation patterns. The robust gains under sparse supervision highlight the advantage of ReTA's dynamic decision to import knowledge, boosting accuracy while curbing costs.

医疗AI知识图谱强化学习图神经网络

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