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 diagnosis prediction


Multi-Ontology Integration with Dual-Axis Propagation for Medical Concept Representation

arXiv.org Artificial Intelligence

Medical ontology graphs map external knowledge to medical codes in electronic health records via structured relationships. By leveraging domain-approved connections (e.g., parent-child), predictive models can generate richer medical concept representations by incorporating contextual information from related concepts. However, existing literature primarily focuses on incorporating domain knowledge from a single ontology system, or from multiple ontology systems (e.g., diseases, drugs, and procedures) in isolation, without integrating them into a unified learning structure. Consequently, concept representation learning often remains limited to intra-ontology relationships, overlooking cross-ontology connections. In this paper, we propose LINKO, a large language model (LLM)-augmented integrative ontology learning framework that leverages multiple ontology graphs simultaneously by enabling dual-axis knowledge propagation both within and across heterogeneous ontology systems to enhance medical concept representation learning. Specifically, LINKO first employs LLMs to provide a graph-retrieval-augmented initialization for ontology concept embedding, through an engineered prompt that includes concept descriptions, and is further augmented with ontology context. Second, our method jointly learns the medical concepts in diverse ontology graphs by performing knowledge propagation in two axes: (1) intra-ontology vertical propagation across hierarchical ontology levels and (2) inter-ontology horizontal propagation within every level in parallel. Last, through extensive experiments on two public datasets, we validate the superior performance of LINKO over state-of-the-art baselines. As a plug-in encoder compatible with existing EHR predictive models, LINKO further demonstrates enhanced robustness in scenarios involving limited data availability and rare disease prediction.


A Comprehensive Survey of Electronic Health Record Modeling: From Deep Learning Approaches to Large Language Models

arXiv.org Artificial Intelligence

Artificial intelligence (AI) has demonstrated significant potential in transforming healthcare through the analysis and modeling of electronic health records (EHRs). However, the inherent heterogeneity, temporal irregularity, and domain-specific nature of EHR data present unique challenges that differ fundamentally from those in vision and natural language tasks. This survey offers a comprehensive overview of recent advancements at the intersection of deep learning, large language models (LLMs), and EHR modeling. We introduce a unified taxonomy that spans five key design dimensions: data-centric approaches, neural architecture design, learning-focused strategies, multimodal learning, and LLM-based modeling systems. Within each dimension, we review representative methods addressing data quality enhancement, structural and temporal representation, self-supervised learning, and integration with clinical knowledge. We further highlight emerging trends such as foundation models, LLM-driven clinical agents, and EHR-to-text translation for downstream reasoning. Finally, we discuss open challenges in benchmarking, explainability, clinical alignment, and generalization across diverse clinical settings. This survey aims to provide a structured roadmap for advancing AI-driven EHR modeling and clinical decision support. For a comprehensive list of EHR-related methods, kindly refer to https://survey-on-tabular-data.github.io/.


KERAP: A Knowledge-Enhanced Reasoning Approach for Accurate Zero-shot Diagnosis Prediction Using Multi-agent LLMs

arXiv.org Artificial Intelligence

Medical diagnosis prediction plays a critical role in disease detection and personalized healthcare. While machine learning (ML) models have been widely adopted for this task, their reliance on supervised training limits their ability to generalize to unseen cases, particularly given the high cost of acquiring large, labeled datasets. Large language models (LLMs) have shown promise in leveraging language abilities and biomedical knowledge for diagnosis prediction. However, they often suffer from hallucinations, lack structured medical reasoning, and produce useless outputs. T o address these challenges, we propose KERAP, a knowledge graph (KG)-enhanced reasoning approach that improves LLM-based diagnosis prediction through a multi-agent architecture. Our framework consists of a linkage agent for attribute mapping, a retrieval agent for structured knowledge extraction, and a prediction agent that iteratively refines diagnosis predictions. Experimental results demonstrate that KERAP enhances diagnostic reliability efficiently, offering a scalable and interpretable solution for zero-shot medical diagnosis prediction.


DiaLLMs: EHR Enhanced Clinical Conversational System for Clinical Test Recommendation and Diagnosis Prediction

arXiv.org Artificial Intelligence

Recent advances in Large Language Models (LLMs) have led to remarkable progresses in medical consultation. However, existing medical LLMs overlook the essential role of Electronic Health Records (EHR) and focus primarily on diagnosis recommendation, limiting their clinical applicability. We propose DiaLLM, the first medical LLM that integrates heterogeneous EHR data into clinically grounded dialogues, enabling clinical test recommendation, result interpretation, and diagnosis prediction to better align with real-world medical practice. To construct clinically grounded dialogues from EHR, we design a Clinical Test Reference (CTR) strategy that maps each clinical code to its corresponding description and classifies test results as "normal" or "abnormal". Additionally, DiaLLM employs a reinforcement learning framework for evidence acquisition and automated diagnosis. To handle the large action space, we introduce a reject sampling strategy to reduce redundancy and improve exploration efficiency. Furthermore, a confirmation reward and a class-sensitive diagnosis reward are designed to guide accurate diagnosis prediction. Extensive experimental results demonstrate that DiaLLM outperforms baselines in clinical test recommendation and diagnosis prediction.


Self-Explaining Hypergraph Neural Networks for Diagnosis Prediction

arXiv.org Artificial Intelligence

The burgeoning volume of electronic health records (EHRs) has enabled deep learning models to excel in predictive healthcare. However, for high-stakes applications such as diagnosis prediction, model interpretability remains paramount. Existing deep learning diagnosis prediction models with intrinsic interpretability often assign attention weights to every past diagnosis or hospital visit, providing explanations lacking flexibility and succinctness. In this paper, we introduce SHy, a self-explaining hypergraph neural network model, designed to offer personalized, concise and faithful explanations that allow for interventions from clinical experts. By modeling each patient as a unique hypergraph and employing a message-passing mechanism, SHy captures higher-order disease interactions and extracts distinct temporal phenotypes as personalized explanations. It also addresses the incompleteness of the EHR data by accounting for essential false negatives in the original diagnosis record. A qualitative case study and extensive quantitative evaluations on two real-world EHR datasets demonstrate the superior predictive performance and interpretability of SHy over existing state-of-the-art models.


Memorize and Rank: Elevating Large Language Models for Clinical Diagnosis Prediction

arXiv.org Artificial Intelligence

Clinical diagnosis prediction models, when provided with a patient's medical history, aim to detect potential diseases early, facilitating timely intervention and improving prognostic outcomes. However, the inherent scarcity of patient data and large disease candidate space often pose challenges in developing satisfactory models for this intricate task. The exploration of leveraging Large Language Models (LLMs) for encapsulating clinical decision processes has been limited. We introduce MERA, a clinical diagnosis prediction model that bridges pertaining natural language knowledge with medical practice. We apply hierarchical contrastive learning on a disease candidate ranking list to alleviate the large decision space issue. With concept memorization through fine-tuning, we bridge the natural language clinical knowledge with medical codes. Experimental results on MIMIC-III and IV datasets show that MERA achieves the state-of-the-art diagnosis prediction performance and dramatically elevates the diagnosis prediction capabilities of generative LMs.


Explainable Diagnosis Prediction through Neuro-Symbolic Integration

arXiv.org Artificial Intelligence

Diagnosis prediction is a critical task in healthcare, where timely and accurate identification of medical conditions can significantly impact patient outcomes. Traditional machine learning and deep learning models have achieved notable success in this domain but often lack interpretability which is a crucial requirement in clinical settings. In this study, we explore the use of neuro-symbolic methods, specifically Logical Neural Networks (LNNs), to develop explainable models for diagnosis prediction. Essentially, we design and implement LNN-based models that integrate domain-specific knowledge through logical rules with learnable thresholds. Our models, particularly $M_{\text{multi-pathway}}$ and $M_{\text{comprehensive}}$, demonstrate superior performance over traditional models such as Logistic Regression, SVM, and Random Forest, achieving higher accuracy (up to 80.52\%) and AUROC scores (up to 0.8457) in the case study of diabetes prediction. The learned weights and thresholds within the LNN models provide direct insights into feature contributions, enhancing interpretability without compromising predictive power. These findings highlight the potential of neuro-symbolic approaches in bridging the gap between accuracy and explainability in healthcare AI applications. By offering transparent and adaptable diagnostic models, our work contributes to the advancement of precision medicine and supports the development of equitable healthcare solutions. Future research will focus on extending these methods to larger and more diverse datasets to further validate their applicability across different medical conditions and populations.


PsyEval: A Comprehensive Large Language Model Evaluation Benchmark for Mental Health

arXiv.org Artificial Intelligence

Recently, there has been a growing interest in utilizing large language models (LLMs) in mental health research, with studies showcasing their remarkable capabilities, such as disease detection. However, there is currently a lack of a comprehensive benchmark for evaluating the capability of LLMs in this domain. Therefore, we address this gap by introducing the first comprehensive benchmark tailored to the unique characteristics of the mental health domain. This benchmark encompasses a total of six sub-tasks, covering three dimensions, to systematically assess the capabilities of LLMs in the realm of mental health. We have designed corresponding concise prompts for each sub-task. And we comprehensively evaluate a total of eight advanced LLMs using our benchmark. Experiment results not only demonstrate significant room for improvement in current LLMs concerning mental health but also unveil potential directions for future model optimization.


Medical Profile Model: Scientific and Practical Applications in Healthcare

arXiv.org Artificial Intelligence

The paper researches the problem of representation learning for electronic health records. We present the patient histories as temporal sequences of diseases for which embeddings are learned in an unsupervised setup with a transformer-based neural network model. Additionally the embedding space includes demographic parameters which allow the creation of generalized patient profiles and successful transfer of medical knowledge to other domains. The training of such a medical profile model has been performed on a dataset of more than one million patients. Detailed model analysis and its comparison with the state-of-the-art method show its clear advantage in the diagnosis prediction task. Further, we show two applications based on the developed profile model. First, a novel Harbinger Disease Discovery method allowing to reveal disease associated hypotheses and potentially are beneficial in the design of epidemiological studies. Second, the patient embeddings extracted from the profile model applied to the insurance scoring task allow significant improvement in the performance metrics.


Xplainer: From X-Ray Observations to Explainable Zero-Shot Diagnosis

arXiv.org Artificial Intelligence

Automated diagnosis prediction from medical images is a valuable resource to support clinical decision-making. However, such systems usually need to be trained on large amounts of annotated data, which often is scarce in the medical domain. Zero-shot methods address this challenge by allowing a flexible adaption to new settings with different clinical findings without relying on labeled data. Further, to integrate automated diagnosis in the clinical workflow, methods should be transparent and explainable, increasing medical professionals' trust and facilitating correctness verification. In this work, we introduce Xplainer, a novel framework for explainable zero-shot diagnosis in the clinical setting. Xplainer adapts the classification-by-description approach of contrastive vision-language models to the multi-label medical diagnosis task. Specifically, instead of directly predicting a diagnosis, we prompt the model to classify the existence of descriptive observations, which a radiologist would look for on an X-Ray scan, and use the descriptor probabilities to estimate the likelihood of a diagnosis. Our model is explainable by design, as the final diagnosis prediction is directly based on the prediction of the underlying descriptors. We evaluate Xplainer on two chest X-ray datasets, CheXpert and ChestX-ray14, and demonstrate its effectiveness in improving the performance and explainability of zero-shot diagnosis. Our results suggest that Xplainer provides a more detailed understanding of the decision-making process and can be a valuable tool for clinical diagnosis.