# Neuro-Symbolic Resolution of Recommendation Conflicts in Multimorbidity Clinical Guidelines

arXiv: https://arxiv.org/abs/2604.17340 · HTML: https://mlsanity.com/paper/2604.17340/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 6 of its 28 references that are in the map.
- First posted on arXiv 19 Apr 2026.

## Builds on (most cited first, 6 of 6)

- [Gemini 2.5: Pushing the Frontier with Advanced Reasoning, Multimodality, Long Context, and Next Generation Agentic Capabilities](https://mlsanity.com/paper/2507.06261/) (2025)
- [Logic-LM: Empowering Large Language Models with Symbolic Solvers for Faithful Logical Reasoning](https://mlsanity.com/paper/2305.12295/) (2023)
- [LINC: A Neurosymbolic Approach for Logical Reasoning by Combining Language Models with First-Order Logic Provers](https://mlsanity.com/paper/2310.15164/) (2023)
- [Long-Context LLMs Meet RAG: Overcoming Challenges for Long Inputs in RAG](https://mlsanity.com/paper/2410.05983/) (2024)
- [RAG-DDR: Optimizing Retrieval-Augmented Generation Using Differentiable Data Rewards](https://mlsanity.com/paper/2410.13509/) (2024)
- [LegalWiz: A Multi-Agent Generation Framework for Contradiction Detection in Legal Documents](https://mlsanity.com/paper/2510.03418/) (2025)

## Built on by (most cited first, 1 of 1)

- [More Reasoning Is Not Always Better: Executing Clinical Guidelines with LLMs and Rules](https://mlsanity.com/paper/2610.15912/) (2026)

## Abstract (arXiv)

Clinical guidelines, typically developed by independent specialty societies, inherently exhibit substantial fragmentation, redundancy, and logical contradiction. These inconsistencies, particularly when applied to patients with multimorbidity, not only cause cognitive dissonance for clinicians but also introduce catastrophic noise into AI systems, rendering the standard Retrieval-Augmented Generation (RAG) system fragile and prone to hallucination. To address this fundamental reliability crisis, we introduce a Neuro-Symbolic framework that automates the detection of recommendation redundancies and conflicts. Our pipeline employs a multi-agent system to translate unstructured clinical natural language into rigorous symbolic logic language, which is then verified by a Satisfiability (SAT) solver. By formulating a hierarchical taxonomy of logical rule interactions, we identify a critical category termed Local Conflict - a decision conflict arising from the intersection of comorbidities. Evaluating our system on a curated benchmark of 12 authoritative SGLT2 inhibitor guidelines, we reveal that 90.6% of conflicts are Local, a structural complexity that single-disease guidelines fail to address. While state-of-the-art LLMs fail in detecting these conflicts, our neuro-symbolic approach achieves an F1 score of 0.861. This work demonstrates that logical verification must precede retrieval, establishing a new technical standard for automated knowledge coordination in medical AI.