# Propagating construction-time knowledge quality into medical question answering: A framework grounded in clinical guidelines

arXiv: https://arxiv.org/abs/2608.28360 · HTML: https://mlsanity.com/paper/2608.28360/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 27 of its 47 references that are in the map.
- First posted on arXiv 28 Aug 2026.

## Builds on (most cited first, 27 of 27)

- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Self-RAG: Learning to Retrieve, Generate, and Critique through Self-Reflection](https://mlsanity.com/paper/2310.11511/) (2023)
- [From Local to Global: A Graph RAG Approach to Query-Focused Summarization](https://mlsanity.com/paper/2404.16130/) (2024)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [A Survey on RAG Meeting LLMs: Towards Retrieval-Augmented Large Language Models](https://mlsanity.com/paper/2405.06211/) (2024)
- [Reasoning on Graphs: Faithful and Interpretable Large Language Model Reasoning](https://mlsanity.com/paper/2310.01061/) (2023)
- [Graph Retrieval-Augmented Generation: A Survey](https://mlsanity.com/paper/2408.08921/) (2024)
- [HippoRAG: Neurobiologically Inspired Long-Term Memory for Large Language Models](https://mlsanity.com/paper/2405.14831/) (2024)
- [ChatIE: Zero-Shot Information Extraction via Chatting with ChatGPT](https://mlsanity.com/paper/2302.10205/) (2023)
- [Unified Structure Generation for Universal Information Extraction](https://mlsanity.com/paper/2203.12277/) (2022)
- [Corrective Retrieval Augmented Generation](https://mlsanity.com/paper/2401.15884/) (2024)
- [Joint Extraction of Entities and Relations Based on a Novel Tagging Scheme](https://mlsanity.com/paper/1706.05075/) (2017)
- [Revisiting Relation Extraction in the era of Large Language Models](https://mlsanity.com/paper/2305.05003/) (2023)
- [LLMs for Knowledge Graph Construction and Reasoning: Recent Capabilities and Future Opportunities](https://mlsanity.com/paper/2305.13168/) (2023)
- [Can Knowledge Graphs Reduce Hallucinations in LLMs? : A Survey](https://mlsanity.com/paper/2311.07914/) (2023)
- [MedRAG: Enhancing Retrieval-augmented Generation with Knowledge Graph-Elicited Reasoning for Healthcare Copilot](https://mlsanity.com/paper/2502.04413/) (2025)
- [Think-on-Graph 2.0: Deep and Faithful Large Language Model Reasoning with Knowledge-guided Retrieval Augmented Generation](https://mlsanity.com/paper/2407.10805/) (2024)
- [A Comprehensive Survey on Automatic Knowledge Graph Construction](https://mlsanity.com/paper/2302.05019/) (2023)
- [Knowledge Graph-Guided Retrieval Augmented Generation](https://mlsanity.com/paper/2502.06864/) (2025)
- [Generative Knowledge Graph Construction: A Review](https://mlsanity.com/paper/2210.12714/) (2022)
- [Text2KGBench: A Benchmark for Ontology-Driven Knowledge Graph Generation from Text](https://mlsanity.com/paper/2308.02357/) (2023)
- [Leveraging Medical Knowledge Graphs Into Large Language Models for Diagnosis Prediction: Design and Application Study](https://mlsanity.com/paper/2308.14321/) (2023)
- [Embedding Uncertain Knowledge Graphs](https://mlsanity.com/paper/1811.10667/) (2018)
- [Certainty in Uncertainty: Reasoning over Uncertain Knowledge Graphs with Statistical Guarantees](https://mlsanity.com/paper/2510.24754/) (2025)
- [MultiRAG: A Knowledge-guided Framework for Mitigating Hallucination in Multi-source Retrieval Augmented Generation](https://mlsanity.com/paper/2508.03553/) (2025)
- [Clinical Knowledge Graph Construction and Evaluation with Multi-LLMs via Retrieval-Augmented Generation](https://mlsanity.com/paper/2601.01844/) (2026)
- [DIAL-KG: Schema-Free Incremental Knowledge Graph Construction via Dynamic Schema Induction and Evolution-Intent Assessment](https://mlsanity.com/paper/2603.20059/) (2026)

## Abstract (arXiv)

Large language models have facilitated knowledge graph (KG) construction from clinical guidelines, but extracted triples vary in structural validity and evidential support. Meanwhile, graph-augmented question answering (QA) systems typically optimize query relevance during retrieval, with limited reuse of quality information produced during KG construction. This creates a disconnect between construction-time quality control and inference-time evidence use. We investigate whether construction-time triple quality can serve as a persistent signal for downstream evidence selection and presentation. We propose a quality-aware framework that models structural conformance (SchemaConf) and evidential support (EvidScore) as complementary dimensions and fuses them into a per-triple quality signal, Q(t). Rather than using quality solely for filtering, the framework retains Q(t) and derived quality tiers as graph attributes and propagates them into quality-weighted subgraph retrieval and tier-conditioned evidence prompting, while preserving passage-level provenance. Experiments on Chinese diabetes clinical guidelines show that the utility of the quality signal is distribution dependent. Under cross-version and cross-model shift, the fused Q(t) provides stronger triple-quality discrimination than either component alone (AUC 0.748 vs. 0.703 for EvidScore and 0.645 for SchemaConf). In guideline-grounded QA, propagating construction-time quality reduces required-knowledge omission from 16.3% to 5.3% and conflicting outputs from 16.3% to 2.7%, with an evidence-grounded precision of 81.6% and near-zero invalid citations. Blinded clinician ratings favor the full framework over no retrieval (4.68 vs. 4.21 on a five-point scale) and approach the oracle condition (4.80), while cross-generator experiments show consistent trends.