Conversational diagnosis requires multi-turn history-taking, where an agent asks clarifying questions to refine differential diagnoses under incomplete information. Existing approaches often rely on the parametric knowledge of a model or assume that patients provide rich and concrete information, which is unrealistic. To address these limitations, we propose a conversational diagnosis system that explores a diagnostic knowledge graph to reason in two steps: (i) generating diagnostic hypotheses from the dialogue context, and (ii) verifying hypotheses through clarifying questions, which are repeated until a final diagnosis is reached. Since evaluating the system requires a realistic patient simulator that responds to the system's questions, we adopt PatientSim, a persona-driven patient simulator, together with patient profiles from MIMIC-IV. We further adapt it with low-specificity symptom reporting to reflect how real-world patients describe symptoms vaguely during early clinical encounters. Experiments show improved diagnostic accuracy and efficiency over strong baselines, and physician evaluations support the realism of our simulator and the clinical utility of the generated clarifying questions. Our code will be released upon publication.
In this work, we propose a novel goal-oriented dialog task, automatic symptom detection. We build a system that can interact with patients through dialog to detect and collect clinical symptoms automatically, which can save a doctor's time interviewing the patient. Given a set of explicit symptoms provided by the patient to initiate a dialog for diagnosing, the system is trained to collect implicit symptoms by asking questions, in order to collect more information for making an accurate diagnosis. After getting the reply from the patient for each question, the system also decides whether curre…
Generative seq2seq dialogue systems are trained to predict the next word in dialogues that have already occurred. They can learn from large unlabeled conversation datasets, build a deeper understanding of conversational context, and generate a wide variety of responses. This flexibility comes at the cost of control, a concerning tradeoff in doctor/patient interactions. Inaccuracies, typos, or undesirable content in the training data will be reproduced by the model at inference time. We trade a small amount of labeling effort and some loss of response variety in exchange for quality control. Mo…
Open University of the Netherlands（荷兰开放大学）；University of Applied Sciences Western Switzerland（瑞士西部应用科学大学）
Personal Health Systems (PHS) are mobile solutions tailored to monitoring patients affected by chronic non communicable diseases. A patient affected by a chronic disease can generate large amounts of events. Type 1 Diabetic patients generate several glucose events per day, ranging from at least 6 events per day (under normal monitoring) to 288 per day when wearing a continuous glucose monitor (CGM) that samples the blood every 5 minutes for several days. This is a large number of events to monitor for medical doctors, in particular when considering that they may have to take decisions concerni…
Spoken dialog systems have seen applications in many domains, including medical for automatic conversational diagnosis. State-of-the-art dialog managers are usually driven by deep reinforcement learning models, such as deep Q networks (DQNs), which learn by interacting with a simulator to explore the entire action space since real conversations are limited. However, the DQN-based automatic diagnosis models do not achieve satisfying performances when adapted to new, unseen diseases with only a few training samples. In this work, we propose the Prototypical Q Networks (ProtoQN) as the dialog man…
University of Amsterdam（阿姆斯特丹大学）；Shandong University（山东大学）
Background Based Conversations (BBCs) have been introduced to help conversational systems avoid generating overly generic responses. In a BBC, the conversation is grounded in a knowledge source. A key challenge in BBCs is Knowledge Selection (KS): given a conversational context, try to find the appropriate background knowledge (a text fragment containing related facts or comments, etc.) based on which to generate the next response. Previous work addresses KS by employing attention and/or pointer mechanisms. These mechanisms use a local perspective, i.e., they select a token at a time based sol…
Doctors often rely on their past experience in order to diagnose patients. For a doctor with enough experience, almost every patient would have similarities to key cases seen in the past, and each new patient could be viewed as a mixture of these key past cases. Because doctors often tend to reason this way, an efficient computationally aided diagnostic tool that thinks in the same way might be helpful in locating key past cases of interest that could assist with diagnosis. This article develops a novel mathematical model to mimic the type of logical thinking that physicians use when consideri…
Computer-aided diagnosis for medical imaging is a well-studied field that aims to provide real-time decision support systems for physicians. These systems attempt to detect and diagnose a plethora of medical conditions across a variety of image diagnostic technologies including ultrasound, x-ray, MRI, and CT. When designing AI models for these systems, we are often limited by little training data, and for rare medical conditions, positive examples are difficult to obtain. These issues often cause models to perform poorly, so we needed a way to design an AI model in light of these limitations. …
Thinking in Graphs with CoMAP: A Shared Visual Workspace for Designing Project-Based Learning
School of Computer Science and Technology, East China Normal University（华东师范大学计算机科学与技术学院）；Shanghai Institute of Artificial Intelligence for Education, East China Normal University（华东师范大学上海智能教育研究院）
Towards Conversational Medical AI with Eyes, Ears and a Voice
Google DeepMind（谷歌DeepMind）；Google Research（谷歌研究）；Beth Israel Deaconess Medical Center, Harvard Medical School（贝塞斯达医院, 哈佛医学院）；Stanford University（斯坦福大学）
CEA, LIST（法国原子能与替代能源委员会信息技术与系统实验室）；Faculté de Médecine Paris-Sud（巴黎南大学医学院）
In medicine, a communicating virtual patient or doctor allows students to train in medical diagnosis and develop skills to conduct a medical consultation. In this paper, we describe a conversational virtual standardized patient system to allow medical students to simulate a diagnosis strategy of an abdominal surgical emergency. We exploited the semantic properties captured by distributed word representations to search for similar questions in the virtual patient dialogue system. We created two dialogue systems that were evaluated on datasets collected during tests with students. The first syst…
