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End-to-End Knowledge-Routed Relational Dialogue System for Automatic Diagnosis

arXiv 1901.10623 ↗First posted 30 Jan 2019cs.CLcited by 70

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Abstract (arXiv)

Beyond current conversational chatbots or task-oriented dialogue systems that have attracted increasing attention, we move forward to develop a dialogue system for automatic medical diagnosis that converses with patients to collect additional symptoms beyond their self-reports and automatically makes a diagnosis. Besides the challenges for conversational dialogue systems (e.g. topic transition coherency and question understanding), automatic medical diagnosis further poses more critical requirements for the dialogue rationality in the context of medical knowledge and symptom-disease relations. Existing dialogue systems (Madotto, Wu, and Fung 2018; Wei et al. 2018; Li et al. 2017) mostly rely on data-driven learning and cannot be able to encode extra expert knowledge graph. In this work, we propose an End-to-End Knowledge-routed Relational Dialogue System (KR-DS) that seamlessly incorporates rich medical knowledge graph into the topic transition in dialogue management, and makes it cooperative with natural language understanding and natural language generation. A novel Knowledge-routed Deep Q-network (KR-DQN) is introduced to manage topic transitions, which integrates a relational refinement branch for encoding relations among different symptoms and symptom-disease pairs, and a knowledge-routed graph branch for topic decision-making. Extensive experiments on a public medical dialogue dataset show our KR-DS significantly beats state-of-the-art methods (by more than 8% in diagnosis accuracy). We further show the superiority of our KR-DS on a newly collected medical dialogue system dataset, which is more challenging retaining original self-reports and conversational data between patients and doctors.

Key facts. Cited by 70 papers in the map (data through 14 Oct 2026). First posted on arXiv 30 Jan 2019.

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Citing papers per year: 2021: 14; 2022: 16; 2023: 16; 2024: 10; 2025: 6; 2026: 8.

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  1. 2023HuatuoGPT, towards Taming Language Model to Be a Doctorcited by 214
  2. 2023A Survey of Large Language Models for Healthcare: from Data, Technology, and Applications to Accountability and Ethicscited by 163
  3. 2022DDXPlus: A New Dataset For Automatic Medical Diagnosiscited by 88
  4. 2021Pre-trained Language Models in Biomedical Domain: A Systematic Surveycited by 87
  5. 2022A Benchmark for Automatic Medical Consultation System: Frameworks, Tasks and Datasetscited by 45
  6. 2024CoD, Towards an Interpretable Medical Agent using Chain of Diagnosiscited by 43
  7. 2024Uncertainty of Thoughts: Uncertainty-Aware Planning Enhances Information Seeking in Large Language Modelscited by 39
  8. 2022On Transforming Reinforcement Learning by Transformer: The Development Trajectorycited by 36
  9. 2023LLM-empowered Chatbots for Psychiatrist and Patient Simulation: Application and Evaluationcited by 34
  10. 2023Foundation Metrics for Evaluating Effectiveness of Healthcare Conversations Powered by Generative AIcited by 32
  11. 2021A Benchmark and Comprehensive Survey on Knowledge Graph Entity Alignment via Representation Learningcited by 31
  12. 2021More but Correct: Generating Diversified and Entity-revised Medical Responsecited by 31
38 more
  1. 2021Semi-Supervised Variational Reasoning for Medical Dialogue Generationcited by 30
  2. 2023Variational Information Pursuit for Interpretable Predictionscited by 25
  3. 2024Beyond Direct Diagnosis: LLM-based Multi-Specialist Agent Consultation for Automatic Diagnosiscited by 23
  4. 2021ReMeDi: Resources for Multi-domain, Multi-service, Medical Dialoguescited by 20
  5. 2021Diaformer: Automatic Diagnosis via Symptoms Sequence Generationcited by 19
  6. 2023Large Language Models Perform Diagnostic Reasoningcited by 18
  7. 2021A Survey on Deep Reinforcement Learning for Audio-Based Applicationscited by 17
  8. 2023A Fused Gromov-Wasserstein Framework for Unsupervised Knowledge Graph Entity Alignmentcited by 16
  9. 2024Synthetic Patient-Physician Dialogue Generation from Clinical Notes Using LLMcited by 15
  10. 2021Natural Language Processing for Smart Healthcarecited by 14
  11. 2023MidMed: Towards Mixed-Type Dialogues for Medical Consultationcited by 13
  12. 2021Efficient Symptom Inquiring and Diagnosis via Adaptive Alignment of Reinforcement Learning and Classificationcited by 12
  13. 2022DialMed: A Dataset for Dialogue-based Medication Recommendationcited by 12
  14. 2022DxFormer: A Decoupled Automatic Diagnostic System Based on Decoder-Encoder Transformer with Dense Symptom Representationscited by 10
  15. 2023Medical Dialogue Generation via Dual Flow Modelingcited by 10
  16. 2023MDDial: A Multi-turn Differential Diagnosis Dialogue Dataset with Reliability Evaluationcited by 10
  17. 2022"My nose is running.""Are you also coughing?": Building A Medical Diagnosis Agent with Interpretable Inquiry Logicscited by 9
  18. 2022Terminology-aware Medical Dialogue Generationcited by 8
  19. 2023Experience and Evidence are the eyes of an excellent summarizer! Towards Knowledge Infused Multi-modal Clinical Conversation Summarizationcited by 8
  20. 2021Learning Efficient, Explainable and Discriminative Representations for Pulmonary Nodules Classificationcited by 7
  21. 2021Knowledge Grounded Conversational Symptom Detection with Graph Memory Networkscited by 6
  22. 2025Feedback-Aware Monte Carlo Tree Search for Efficient Information Seeking in Goal-Oriented Conversationscited by 6
  23. 2021A Bayesian Approach for Medical Inquiry and Disease Inference in Automated Differential Diagnosiscited by 5
  24. 2022Towards Trustworthy Automatic Diagnosis Systems by Emulating Doctors' Reasoning with Deep Reinforcement Learningcited by 5
  25. 2022CDialog: A Multi-turn Covid-19 Conversation Dataset for Entity-Aware Dialog Generationcited by 5
  26. 2023KNSE: A Knowledge-aware Natural Language Inference Framework for Dialogue Symptom Status Recognitioncited by 5
  27. 2023CoAD: Automatic Diagnosis through Symptom and Disease Collaborative Generationcited by 5
  28. 2024Medical Dialogue: A Survey of Categories, Methods, Evaluation and Challengescited by 5
  29. 2025Self-Regularization with Sparse Autoencoders for Controllable LLM-based Classificationcited by 5
  30. 2025Inflated Excellence or True Performance? Rethinking Medical Diagnostic Benchmarks with Dynamic Evaluationcited by 5
  31. 2021Affective Decoding for Empathetic Response Generationcited by 4
  32. 2022CorefDiffs: Co-referential and Differential Knowledge Flow in Document Grounded Conversationscited by 4
  33. 2023A Knowledge-enhanced Two-stage Generative Framework for Medical Dialogue Information Extractioncited by 4
  34. 2022Doctor XAvIer: Explainable Diagnosis on Physician-Patient Dialogues and XAI Evaluationcited by 3
  35. 2024NLICE: Synthetic Medical Record Generation for Effective Primary Healthcare Differential Diagnosiscited by 3
  36. 2026Synthesis and Evaluation of Long-term History-aware Medical Dialoguecited by 3
  37. 2022Prompt-based Generative Approach towards Multi-Hierarchical Medical Dialogue State Trackingcited by 2
  38. 2023Benchmarking and Analyzing In-context Learning, Fine-tuning and Supervised Learning for Biomedical Knowledge Curation: a focused study on chemical entities of biological interestcited by 2

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