AI-aided clinical diagnosis is desired in medical care. Existing deep learning models lack explainability and mainly focus on image analysis. The recently developed Dynamic Uncertain Causality Graph (DUCG) approach is causality-driven, explainable, and invariant across different application scenarios, without problems of data collection, labeling, fitting, privacy, bias, generalization, high cost and high energy consumption. Through close collaboration between clinical experts and DUCG technicians, 46 DUCG models covering 54 chief complaints were constructed. Over 1,000 diseases can be diagnosed without triage. Before being applied in real-world, the 46 DUCG models were retrospectively verified by third-party hospitals. The verified diagnostic precisions were no less than 95%, in which the diagnostic precision for every disease including uncommon ones was no less than 80%. After verifications, the 46 DUCG models were applied in the real-world in China. Over one million real diagnosis cases have been performed, with only 17 incorrect diagnoses identified. Due to DUCG's transparency, the mistakes causing the incorrect diagnoses were found and corrected. The diagnostic abilities of the clinicians who applied DUCG frequently were improved significantly. Following the introduction to the earlier presented DUCG methodology, the recommendation algorithm for potential medical checks is presented and the key idea of DUCG is extracted.

Dynamic Uncertain Causality Graph(DUCG) is a recently proposed model for diagnoses of complex systems. It performs well for industry system such as nuclear power plants, chemical system and spacecrafts. However, the variable state combination explosion in some cases is still a problem that may result in inefficiency or even disability in DUCG inference. In the situation of clinical diagnoses, when a lot of intermediate causes are unknown while the downstream results are known in a DUCG graph, the combination explosion may appear during the inference computation. Monte Carlo sampling is a typical algorithm to solve this problem. However, we are facing the case that the occurrence rate of the case is very small, e.g. $10^{-20}$, which means a huge number of samplings are needed. This paper proposes a new scheme based on conditional stochastic simulation which obtains the final result from the expectation of the conditional probability in sampling loops instead of counting the sampling frequency, and thus overcomes the problem. As a result, the proposed algorithm requires much less time than the DUCG recursive inference algorithm presented earlier. Moreover, a simple analysis of convergence rate based on a designed example is given to show the advantage of the proposed method. % In addition, supports for logic gate, logic cycles, and parallelization, which exist in DUCG, are also addressed in this paper. The new algorithm reduces the time consumption a lot and performs 3 times faster than old one with 2.7% error ratio in a practical graph for Viral Hepatitis B.