SDM-Q: Cost-Aware Staged Decision-Making for Multi-Omics Classification with Deep Q-Learning

Multi-omics data provide complementary molecular characterizations of disease phenotypes and play an important role in disease diagnosis and subtype classification in precision medicine. However, acquiring complete multi-omics profiles is expensive and time-consuming, while most existing deep learning methods assume full modality availability during inference, resulting in substantial redundancy and limited practicality in clinical settings. To address this issue, we propose SDM-Q, a reinforcement learning framework for adaptive and cost-aware multi-omics classification. Specifically, multi-omics diagnosis is reformulated as a finite-horizon sequential decision problem, where the currently acquired omics modalities define the diagnostic state at each stage. An action--value function determines whether to acquire an additional modality or terminate the decision process and output the final prediction. To balance diagnostic utility and acquisition cost, the reward is defined only at the terminal stage and jointly determined by classification correctness and cumulative modality acquisition cost. A backward stage-wise optimization strategy is introduced to improve policy consistency and training stability. Experiments on four public multi-omics datasets, including ROSMAP, LGG, BRCA, and KIPAN, demonstrate that SDM-Q effectively reduces redundant modality acquisition while maintaining competitive classification performance compared with methods using complete multi-omics inputs. In the BRCA and KIPAN datasets, more than 99\% and 95\% of subjects, respectively, achieve accurate classification using only a single omics modality, while the average number of acquired modalities remains below two for ROSMAP and LGG. These results suggest that cost-aware sequential decision-making provides an effective paradigm for improving the efficiency of precision medicine workflows.

Uncertainty Reasoning with Large Language Models for Explainable Disease Diagnosis

Clinical decision-making requires reasoning over incomplete, imprecise, and linguistically expressed patient narratives. While large language models (LLMs) excel at extracting latent information from natural language, they lack the verifiability and interpretability essential for trustworthy medical AI. We propose a neuro-symbolic reasoning framework that aligns LLMs with formal logic to enable explainable and formally verifiable medical diagnosis. Patient descriptions and clinical guidelines are embedded into a neural knowledge base, where LLMs extract structured medical entities, temporal relations, and fuzzy symptom patterns, which are decoded into a symbolic knowledge base expressed in fuzzy logic and declarative rules. We perform two-stage reasoning: (1) inductive symbolic generalization to capture diagnostic patterns from encoded narratives, and (2) inference verification via a logic programming engine to derive and validate diagnoses consistent with clinical standards. Each symptom is treated as a fuzzy predicate with probabilistic weights, and inference paths are auditable, adjustable, and compatible with physician feedback. Unlike purely statistical methods, our system supports iterative refinement: misalignment between LLM-generated diagnoses and ground truth can be traced, explained, and corrected through formal rules. By combining logic-based transparency, LLM adaptability, and probabilistic robustness, the framework enables human-aligned healthcare inference with strong generalization and verifiable, step-by-step reasoning chains. We validate our framework on public benchmarks, demonstrating effective reconciliation of symbolic reasoning and LLMs with real-world clinical narratives. Results show performance comparable to state-of-the-art LLMs, while additionally providing interpretable reasoning paths and formally verifiable diagnostic conclusions.