Guideline2Graph: Profile-Aware Multimodal Parsing for Executable Clinical Decision Graphs
This addresses the challenge of creating auditable clinical decision support systems from complex guidelines, though it is incremental with current evidence limited to one prostate guideline.
The paper tackles the problem of converting multimodal clinical practice guidelines into executable clinical decision graphs, where existing methods often break cross-page continuity. Their decomposition-first pipeline improves edge/triplet precision/recall from 19.6%/16.1% to 69.0%/87.5% and node recall from 78.1% to 93.8% on a prostate-guideline benchmark.
Clinical practice guidelines are long, multimodal documents whose branching recommendations are difficult to convert into executable clinical decision support (CDS), and one-shot parsing often breaks cross-page continuity. Recent LLM/VLM extractors are mostly local or text-centric, under-specifying section interfaces and failing to consolidate cross-page control flow across full documents into one coherent decision graph. We present a decomposition-first pipeline that converts full-guideline evidence into an executable clinical decision graph through topology-aware chunking, interface-constrained chunk graph generation, and provenance-preserving global aggregation. Rather than relying on single-pass generation, the pipeline uses explicit entry/terminal interfaces and semantic deduplication to preserve cross-page continuity while keeping the induced control flow auditable and structurally consistent. We evaluate on an adjudicated prostate-guideline benchmark with matched inputs and the same underlying VLM backbone across compared methods. On the complete merged graph, our approach improves edge and triplet precision/recall from $19.6\%/16.1\%$ in existing models to $69.0\%/87.5\%$, while node recall rises from $78.1\%$ to $93.8\%$. These results support decomposition-first, auditable guideline-to-CDS conversion on this benchmark, while current evidence remains limited to one adjudicated prostate guideline and motivates broader multi-guideline validation.