Guideline2Graph: Profile-Aware Multimodal Parsing for Executable Clinical Decision Graphs

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.

Deep Metric Learning with Chance Constraints

Deep metric learning (DML) aims to minimize empirical expected loss of the pairwise intra-/inter- class proximity violations in the embedding image. We relate DML to feasibility problem of finite chance constraints. We show that minimizer of proxy-based DML satisfies certain chance constraints, and that the worst case generalization performance of the proxy-based methods can be characterized by the radius of the smallest ball around a class proxy to cover the entire domain of the corresponding class samples, suggesting multiple proxies per class helps performance. To provide a scalable algorithm as well as exploiting more proxies, we consider the chance constraints implied by the minimizers of proxy-based DML instances and reformulate DML as finding a feasible point in intersection of such constraints, resulting in a problem to be approximately solved by iterative projections. Simply put, we repeatedly train a regularized proxy-based loss and re-initialize the proxies with the embeddings of the deliberately selected new samples. We apply our method with the well-accepted losses and evaluate on four popular benchmark datasets for image retrieval. Outperforming state-of-the-art, our method consistently improves the performance of the applied losses. Code is available at: https://github.com/yetigurbuz/ccp-dml