Toward Auditable Neuro-Symbolic Reasoning in Pathology: SQL as an Explicit Trace of Evidence

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Autori principali: Cao, Kewen, Chen, Jianxu, Zhang, Yongbing, Zhang, Ye, Wang, Hongxiao
Natura: Preprint
Pubblicazione: 2026
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author Cao, Kewen
Chen, Jianxu
Zhang, Yongbing
Zhang, Ye
Wang, Hongxiao
author_facet Cao, Kewen
Chen, Jianxu
Zhang, Yongbing
Zhang, Ye
Wang, Hongxiao
contents Automated pathology image analysis is central to clinical diagnosis, but clinicians still ask which slide features drive a model's decision and why. Vision-language models can produce natural language explanations, but these are often correlational and lack verifiable evidence. In this paper, we introduce an SQL-centered agentic framework that enables both feature measurement and reasoning to be auditable. Specifically, after extracting human-interpretable cellular features, Feature Reasoning Agents compose and execute SQL queries over feature tables to aggregate visual evidence into quantitative findings. A Knowledge Comparison Agent then evaluates these findings against established pathological knowledge, mirroring how pathologists justify diagnoses from measurable observations. Extensive experiments evaluated on two pathology visual question answering datasets demonstrate our method improves interpretability and decision traceability while producing executable SQL traces that link cellular measurements to diagnostic conclusions.
format Preprint
id arxiv_https___arxiv_org_abs_2601_01875
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Toward Auditable Neuro-Symbolic Reasoning in Pathology: SQL as an Explicit Trace of Evidence
Cao, Kewen
Chen, Jianxu
Zhang, Yongbing
Zhang, Ye
Wang, Hongxiao
Artificial Intelligence
Quantitative Methods
Automated pathology image analysis is central to clinical diagnosis, but clinicians still ask which slide features drive a model's decision and why. Vision-language models can produce natural language explanations, but these are often correlational and lack verifiable evidence. In this paper, we introduce an SQL-centered agentic framework that enables both feature measurement and reasoning to be auditable. Specifically, after extracting human-interpretable cellular features, Feature Reasoning Agents compose and execute SQL queries over feature tables to aggregate visual evidence into quantitative findings. A Knowledge Comparison Agent then evaluates these findings against established pathological knowledge, mirroring how pathologists justify diagnoses from measurable observations. Extensive experiments evaluated on two pathology visual question answering datasets demonstrate our method improves interpretability and decision traceability while producing executable SQL traces that link cellular measurements to diagnostic conclusions.
title Toward Auditable Neuro-Symbolic Reasoning in Pathology: SQL as an Explicit Trace of Evidence
topic Artificial Intelligence
Quantitative Methods
url https://arxiv.org/abs/2601.01875