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Autori principali: Lv, Zhiqi, Tu, Duofan, Li, Jun, Zhao, Mingyue, Zhu, Heqin, Li, Wenliang, Zhou, Shaohua Kevin
Natura: Preprint
Pubblicazione: 2026
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Accesso online:https://arxiv.org/abs/2604.23605
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author Lv, Zhiqi
Tu, Duofan
Li, Jun
Zhao, Mingyue
Zhu, Heqin
Li, Wenliang
Zhou, Shaohua Kevin
author_facet Lv, Zhiqi
Tu, Duofan
Li, Jun
Zhao, Mingyue
Zhu, Heqin
Li, Wenliang
Zhou, Shaohua Kevin
contents The application of large language models (LLMs) in clinical decision support faces significant challenges of "tunnel vision" and diagnostic hallucinations present in their processing unstructured electronic health records (EHRs). To address these challenges, we propose a novel chain-based clinical reasoning framework, called DxChain, which transforms the diagnostic workflow into an iterative process by mirroring a clinician's cognitive trajectory that consists of "Memory Anchoring", "Navigation" and "Verification" phases. DxChain introduces three key methodological innovations to elicit the potential of LLM: (i) a Profile-Then-Plan paradigm to mitigate cold-start hallucinations by establishing a panoramic patient baseline, (ii) a Medical Tree-of-Thoughts (Med-ToT) algorithm for strategic look ahead planning and resource aware navigation, and (iii) a Dialectical Diagnostic Verification procedure utilizing "Angel-Devil" adversarial debates to resolve complex evidence conflicts. Evaluated on two real world benchmarks, MIMIC-IV-Ext Cardiac Disease and MIMIC-IV-Ext CDM, DxChain achieves state-of-the-art performances in both diagnostic accuracy and logical consistency, offering a modular and reliable architecture for next-generation clinical AI. The code is at https://anonymous.4open.science/r/Dx-Chain.
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publishDate 2026
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spellingShingle Thinking Like a Clinician: A Cognitive AI Agent for Clinical Diagnosis via Panoramic Profiling and Adversarial Debate
Lv, Zhiqi
Tu, Duofan
Li, Jun
Zhao, Mingyue
Zhu, Heqin
Li, Wenliang
Zhou, Shaohua Kevin
Artificial Intelligence
The application of large language models (LLMs) in clinical decision support faces significant challenges of "tunnel vision" and diagnostic hallucinations present in their processing unstructured electronic health records (EHRs). To address these challenges, we propose a novel chain-based clinical reasoning framework, called DxChain, which transforms the diagnostic workflow into an iterative process by mirroring a clinician's cognitive trajectory that consists of "Memory Anchoring", "Navigation" and "Verification" phases. DxChain introduces three key methodological innovations to elicit the potential of LLM: (i) a Profile-Then-Plan paradigm to mitigate cold-start hallucinations by establishing a panoramic patient baseline, (ii) a Medical Tree-of-Thoughts (Med-ToT) algorithm for strategic look ahead planning and resource aware navigation, and (iii) a Dialectical Diagnostic Verification procedure utilizing "Angel-Devil" adversarial debates to resolve complex evidence conflicts. Evaluated on two real world benchmarks, MIMIC-IV-Ext Cardiac Disease and MIMIC-IV-Ext CDM, DxChain achieves state-of-the-art performances in both diagnostic accuracy and logical consistency, offering a modular and reliable architecture for next-generation clinical AI. The code is at https://anonymous.4open.science/r/Dx-Chain.
title Thinking Like a Clinician: A Cognitive AI Agent for Clinical Diagnosis via Panoramic Profiling and Adversarial Debate
topic Artificial Intelligence
url https://arxiv.org/abs/2604.23605