Chongqing Health Center for Women and Children, Chongqing, China
Abstract:Objective: This study aims to improve the reliability and robustness of medical named entity recognition (NER) in Chinese atopic dermatitis (AD) clinical texts through explanation-guided learning. Methods: We propose a stability and boundary-aware explanation-guided NER framework. Perturbation-based analysis is used to evaluate explanation stability and entity boundary sensitivity. An adaptive fusion strategy dynamically combines local and global explanation to generate more reliable token-level explanations. The fused explanation signals are further incorporated into model training through stability, boundary-aware, and consistency constraints. Results: Experiments on Chinese AD NER datasets show that the proposed framework improves explanation robustness and achieves consistent performance gains across multiple NER models. The adaptive fusion strategy also provides more stable explanations and stronger boundary perception than individual explanation methods. Conclusion: The proposed method effectively integrates reliable explanation signals into medical NER training, improving both recognition performance and explanation reliability. The framework provides a practical and generalizable solution for explainable medical NER and offers reliable support for downstream clinical decision-making and medical knowledge applications.
Abstract:The clinical diagnosis of skin diseases is susceptible to interference from inter-class similarity of skin lesions, and over-reliance on clinicians'experience easily leads to subjective bias. Although existing deep learning aided diagnosis methods achieve competitive accuracy, they suffer from the black-box opacity of Vision Transformer (ViT) and poor adaptability to medical few-shot scenarios. Moreover, mainstream explainable algorithms generally face the bottleneck of significant accuracy degradation when improving interpretability. This paper proposes an interpretable ViT (IViT) constrained by Quadratic Programming (QP). The introduced pre-trained transfer learning adapts to few-shot feature extraction. A discrete QP feature selection framework is constructed to screen generic and discriminative features consistent with clinical diagnostic logic. A multi-objective loss function is designed to reduce feature redundancy and optimize activation distribution while preserving classification performance. Experimental results on six standard skin disease datasets show that IViT achieves an accuracy of 93.80%, only 0.21% lower than the baseline, with feature redundancy reduced by 29.5%. Its core activation regions are consistent with clinically concerned lesion areas. The proposed model balances accuracy and interpretability, providing a reliable solution for the clinical deployment of few-shot intelligent skin disease diagnosis.