{"title":"中医“多病整体辨证”人工智能方法和系统的开发及其对临床决策的可解释性","authors":"Zhe Chen, Dong Zhang, Pengfei Nie, Guanhao Fan, Zhiyuan He, Hui Wang, Chenyue Zhang, Fengwen Yang, Chunxiang Liu, Junhua Zhang","doi":"10.1111/jebm.70016","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>The development of artificial intelligence (AI) for traditional Chinese medicine (TCM) has played an important role in clinical decision-making, mainly reflected in the intersectionality and variability of symptoms, syndromes, and patterns for TCM multiple diseases holistic differentiation (MDHD). This study aimed to develop a TCM AI method and system for clinical decisions more transparent with explainable structural framework.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This study developed the TCM syndrome elements integration with priori rule and deep learning (TCM-SEI-RD) method and TCM-MDHD system by high-quality expert knowledge datasets, to predict various TCM syndromes and patterns in hierarchical modules. TCM-BERT-CNN model fused the BERT with CNN model capture feature-related sequence, as the benchmark model in the TCM-SEI-RD method, to improve the performance of predicting TCM syndrome elements. The framework of the TCM-MDHD system involved the TCM-SEI-RD method and TCM “diseases—syndromes—patterns” benchmark sequences, to provide distributed results with credibility.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>For predicting results to the overall TCM syndrome elements, the TCM-SEI-RD achieves 95.4%, 94.43%, and 94.89% in precision, recall, and <i>F</i>1 score, respectively, and 3.33%, 2.28%, and 2.81% improvement over the benchmark model. TCM-MDHD system demonstrates credibility grading at each stage in various diseases and uses the practical example to illustrate the process of distributed decision-making results and transparency with credibility.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Our method and system, as the general AI technologies for TCM syndromes and patterns diagnosis in multiple diseases, can provide the clinical diagnostic basis with the best performance for the TCM preparations rational use, and distribute interpretability to the clinical decision-making process.</p>\n </section>\n </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Developing the Artificial Intelligence Method and System for “Multiple Diseases Holistic Differentiation” in Traditional Chinese Medicine and Its Interpretability to Clinical Decision\",\"authors\":\"Zhe Chen, Dong Zhang, Pengfei Nie, Guanhao Fan, Zhiyuan He, Hui Wang, Chenyue Zhang, Fengwen Yang, Chunxiang Liu, Junhua Zhang\",\"doi\":\"10.1111/jebm.70016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>The development of artificial intelligence (AI) for traditional Chinese medicine (TCM) has played an important role in clinical decision-making, mainly reflected in the intersectionality and variability of symptoms, syndromes, and patterns for TCM multiple diseases holistic differentiation (MDHD). This study aimed to develop a TCM AI method and system for clinical decisions more transparent with explainable structural framework.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This study developed the TCM syndrome elements integration with priori rule and deep learning (TCM-SEI-RD) method and TCM-MDHD system by high-quality expert knowledge datasets, to predict various TCM syndromes and patterns in hierarchical modules. TCM-BERT-CNN model fused the BERT with CNN model capture feature-related sequence, as the benchmark model in the TCM-SEI-RD method, to improve the performance of predicting TCM syndrome elements. The framework of the TCM-MDHD system involved the TCM-SEI-RD method and TCM “diseases—syndromes—patterns” benchmark sequences, to provide distributed results with credibility.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>For predicting results to the overall TCM syndrome elements, the TCM-SEI-RD achieves 95.4%, 94.43%, and 94.89% in precision, recall, and <i>F</i>1 score, respectively, and 3.33%, 2.28%, and 2.81% improvement over the benchmark model. TCM-MDHD system demonstrates credibility grading at each stage in various diseases and uses the practical example to illustrate the process of distributed decision-making results and transparency with credibility.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Our method and system, as the general AI technologies for TCM syndromes and patterns diagnosis in multiple diseases, can provide the clinical diagnostic basis with the best performance for the TCM preparations rational use, and distribute interpretability to the clinical decision-making process.</p>\\n </section>\\n </div>\",\"PeriodicalId\":16090,\"journal\":{\"name\":\"Journal of Evidence‐Based Medicine\",\"volume\":\"18 2\",\"pages\":\"\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-04-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Evidence‐Based Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jebm.70016\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Evidence‐Based Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jebm.70016","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
目的人工智能(AI)在中医临床决策中发挥了重要作用,主要体现在中医多病整体辨证(MDHD)的症状、证候和模式的交叉性和变异性上。本研究旨在开发一种更透明、结构框架可解释的中医人工智能临床决策方法和系统。方法利用高质量的专家知识数据集,开发基于先验规则和深度学习的中医证候要素集成(TCM- sei - rd)方法和TCM- mdhd系统,在层次模块中预测各种中医证候和模式。TCM-BERT-CNN模型融合了BERT和CNN模型捕获特征相关序列,作为TCM- sei - rd方法中的基准模型,提高了中医证候要素预测的性能。TCM- mdhd系统的框架包括TCM- sei - rd方法和中医“病-证-型”基准序列,以提供具有可信度的分布式结果。结果对于整体中医证候要素的预测结果,TCM- sei - rd的准确率、召回率和F1评分分别达到95.4%、94.43%和94.89%,比基准模型分别提高3.33%、2.28%和2.81%。TCM-MDHD系统对各种疾病的各个阶段进行可信度分级,并通过实例说明决策结果的分布式过程和具有可信度的透明度。结论我们的方法和系统作为多病中医证型诊断的通用人工智能技术,可为中药制剂的合理使用提供性能最佳的临床诊断依据,并具有可解释性,可用于临床决策过程。
Developing the Artificial Intelligence Method and System for “Multiple Diseases Holistic Differentiation” in Traditional Chinese Medicine and Its Interpretability to Clinical Decision
Aim
The development of artificial intelligence (AI) for traditional Chinese medicine (TCM) has played an important role in clinical decision-making, mainly reflected in the intersectionality and variability of symptoms, syndromes, and patterns for TCM multiple diseases holistic differentiation (MDHD). This study aimed to develop a TCM AI method and system for clinical decisions more transparent with explainable structural framework.
Methods
This study developed the TCM syndrome elements integration with priori rule and deep learning (TCM-SEI-RD) method and TCM-MDHD system by high-quality expert knowledge datasets, to predict various TCM syndromes and patterns in hierarchical modules. TCM-BERT-CNN model fused the BERT with CNN model capture feature-related sequence, as the benchmark model in the TCM-SEI-RD method, to improve the performance of predicting TCM syndrome elements. The framework of the TCM-MDHD system involved the TCM-SEI-RD method and TCM “diseases—syndromes—patterns” benchmark sequences, to provide distributed results with credibility.
Results
For predicting results to the overall TCM syndrome elements, the TCM-SEI-RD achieves 95.4%, 94.43%, and 94.89% in precision, recall, and F1 score, respectively, and 3.33%, 2.28%, and 2.81% improvement over the benchmark model. TCM-MDHD system demonstrates credibility grading at each stage in various diseases and uses the practical example to illustrate the process of distributed decision-making results and transparency with credibility.
Conclusions
Our method and system, as the general AI technologies for TCM syndromes and patterns diagnosis in multiple diseases, can provide the clinical diagnostic basis with the best performance for the TCM preparations rational use, and distribute interpretability to the clinical decision-making process.
期刊介绍:
The Journal of Evidence-Based Medicine (EMB) is an esteemed international healthcare and medical decision-making journal, dedicated to publishing groundbreaking research outcomes in evidence-based decision-making, research, practice, and education. Serving as the official English-language journal of the Cochrane China Centre and West China Hospital of Sichuan University, we eagerly welcome editorials, commentaries, and systematic reviews encompassing various topics such as clinical trials, policy, drug and patient safety, education, and knowledge translation.