Uncertainty-Aware Large Language Models for Explainable Disease Diagnosis

Fuente: arXiv
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Main Authors: Zhou, Shuang, Wang, Jiashuo, Xu, Zidu, Wang, Song, Brauer, David, Welton, Lindsay, Cogan, Jacob, Chung, Yuen-Hei, Tian, Lei, Zhan, Zaifu, Hou, Yu, Lin, Mingquan, Melton, Genevieve B., Zhang, Rui
Format: Preprint
Published: 2025
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author Zhou, Shuang
Wang, Jiashuo
Xu, Zidu
Wang, Song
Brauer, David
Welton, Lindsay
Cogan, Jacob
Chung, Yuen-Hei
Tian, Lei
Zhan, Zaifu
Hou, Yu
Lin, Mingquan
Melton, Genevieve B.
Zhang, Rui
author_facet Zhou, Shuang
Wang, Jiashuo
Xu, Zidu
Wang, Song
Brauer, David
Welton, Lindsay
Cogan, Jacob
Chung, Yuen-Hei
Tian, Lei
Zhan, Zaifu
Hou, Yu
Lin, Mingquan
Melton, Genevieve B.
Zhang, Rui
contents Explainable disease diagnosis, which leverages patient information (e.g., signs and symptoms) and computational models to generate probable diagnoses and reasonings, offers clear clinical values. However, when clinical notes encompass insufficient evidence for a definite diagnosis, such as the absence of definitive symptoms, diagnostic uncertainty usually arises, increasing the risk of misdiagnosis and adverse outcomes. Although explicitly identifying and explaining diagnostic uncertainties is essential for trustworthy diagnostic systems, it remains under-explored. To fill this gap, we introduce ConfiDx, an uncertainty-aware large language model (LLM) created by fine-tuning open-source LLMs with diagnostic criteria. We formalized the task and assembled richly annotated datasets that capture varying degrees of diagnostic ambiguity. Evaluating ConfiDx on real-world datasets demonstrated that it excelled in identifying diagnostic uncertainties, achieving superior diagnostic performance, and generating trustworthy explanations for diagnoses and uncertainties. To our knowledge, this is the first study to jointly address diagnostic uncertainty recognition and explanation, substantially enhancing the reliability of automatic diagnostic systems.
format Preprint
id arxiv_https___arxiv_org_abs_2505_03467
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Uncertainty-Aware Large Language Models for Explainable Disease Diagnosis
Zhou, Shuang
Wang, Jiashuo
Xu, Zidu
Wang, Song
Brauer, David
Welton, Lindsay
Cogan, Jacob
Chung, Yuen-Hei
Tian, Lei
Zhan, Zaifu
Hou, Yu
Lin, Mingquan
Melton, Genevieve B.
Zhang, Rui
Computation and Language
Explainable disease diagnosis, which leverages patient information (e.g., signs and symptoms) and computational models to generate probable diagnoses and reasonings, offers clear clinical values. However, when clinical notes encompass insufficient evidence for a definite diagnosis, such as the absence of definitive symptoms, diagnostic uncertainty usually arises, increasing the risk of misdiagnosis and adverse outcomes. Although explicitly identifying and explaining diagnostic uncertainties is essential for trustworthy diagnostic systems, it remains under-explored. To fill this gap, we introduce ConfiDx, an uncertainty-aware large language model (LLM) created by fine-tuning open-source LLMs with diagnostic criteria. We formalized the task and assembled richly annotated datasets that capture varying degrees of diagnostic ambiguity. Evaluating ConfiDx on real-world datasets demonstrated that it excelled in identifying diagnostic uncertainties, achieving superior diagnostic performance, and generating trustworthy explanations for diagnoses and uncertainties. To our knowledge, this is the first study to jointly address diagnostic uncertainty recognition and explanation, substantially enhancing the reliability of automatic diagnostic systems.
title Uncertainty-Aware Large Language Models for Explainable Disease Diagnosis
topic Computation and Language
url https://arxiv.org/abs/2505.03467