arXiv:2610.07739 · v2
Cite What You Explore: Budget-Aware LLM Reasoning over Medical KGs with Verifiable Evidence
摘要
Post-discharge risk prediction from electronic health records (EHRs) is difficult because many dependencies that link discharge-time observations to downstream complications, such as comorbidity cascades and drug-disease interactions, are absent from the record. External medical knowledge graphs (KGs) can supply these missing dependencies, but tracing them in a clinical setting demands three properties. KG exploration must remain cost-bounded, retrieved evidence must be differentiated by source quality, and the resulting rationale must be citable for review. Large language models (LLMs) can plan and verify over structured evidence, making them natural candidates for KG reasoning, but existing LLM-based methods do not satisfy these three properties jointly. In this paper, we propose BAR, a Budget-Aware LLM Reasoning framework over medical KGs with three contributions. First, BAR refines the raw KG into disease-specific evidence graphs whose edges carry support scores and provenance records, turning the KG into a quality-annotated reasoning space rather than a static feature source. Second, an LLM reasons over this graph through a plan-navigate-verify loop that decomposes the question into steps, retrieves evidence under a patient-specific budget, and revises when verification fails. Third, a reasoning policy is trained with a reward that compares predictions with and without acquired evidence, combined with acquisition cost and citation-integrity terms. Across 8 diseases and 3 prediction horizons on MIMIC-III and MIMIC-IV, BAR achieves higher performance and citation precision than strong baselines while using fewer LLM tokens. Its gain over EHR-only prediction grows at longer horizons, and its advantage carries over to an external benchmark.
作者备注：Accepted to NeurIPS 2026. This revision corrects cohort statistics and efficiency reporting, removes incorrectly reported per-disease standard deviations, clarifies experimental protocols, and adds evaluations. Code: https://github.com/ChenC2002/BAR