Can LLMs Support Medical Knowledge Imputation? An Evaluation-Based Perspective

Medical knowledge graphs (KGs) are essential for clinical decision support and biomedical research, yet they often exhibit incompleteness due to knowledge gaps and structural limitations in medical coding systems. This issue is particularly evident in treatment mapping, where coding systems such as ICD, Mondo, and ATC lack comprehensive coverage, resulting in missing or inconsistent associations between diseases and their potential treatments. To address this issue, we have explored the use of Large Language Models (LLMs) for imputing missing treatment relationships. Although LLMs offer promising capabilities in knowledge augmentation, their application in medical knowledge imputation presents significant risks, including factual inaccuracies, hallucinated associations, and instability between and within LLMs. In this study, we systematically evaluate LLM-driven treatment mapping, assessing its reliability through benchmark comparisons. Our findings highlight critical limitations, including inconsistencies with established clinical guidelines and potential risks to patient safety. This study serves as a cautionary guide for researchers and practitioners, underscoring the importance of critical evaluation and hybrid approaches when leveraging LLMs to enhance treatment mappings on medical knowledge graphs.

No Black Box Anymore: Demystifying Clinical Predictive Modeling with Temporal-Feature Cross Attention Mechanism

Despite the outstanding performance of deep learning models in clinical prediction tasks, explainability remains a significant challenge. Inspired by transformer architectures, we introduce the Temporal-Feature Cross Attention Mechanism (TFCAM), a novel deep learning framework designed to capture dynamic interactions among clinical features across time, enhancing both predictive accuracy and interpretability. In an experiment with 1,422 patients with Chronic Kidney Disease, predicting progression to End-Stage Renal Disease, TFCAM outperformed LSTM and RETAIN baselines, achieving an AUROC of 0.95 and an F1-score of 0.69. Beyond performance gains, TFCAM provides multi-level explainability by identifying critical temporal periods, ranking feature importance, and quantifying how features influence each other across time before affecting predictions. Our approach addresses the "black box" limitations of deep learning in healthcare, offering clinicians transparent insights into disease progression mechanisms while maintaining state-of-the-art predictive performance.