A Neurosymbolic Approach for Constructing Planning Domain Models from Clinical Narratives

Surgical procedures such as laparoscopic appendectomy are complex, high-stakes processes, yet formalizing their workflows for decision support remains a significant challenge. Inducing probabilistic planning domain models in this setting is particularly difficult due to the lack of structured event data and the prevalence of implicit actions in clinical narratives, which neither empirical symbolic methods nor Large Language Models (LLMs) can adequately address on their own. We introduce NSPIN, a neurosymbolic framework for inducing probabilistic planning domain models from unstructured clinical narratives. Our method extracts and imputes structured event sequences from raw text using a pretrained LLM, then induces a PPDDL model and refines its preconditions with LLM-proposed revisions, guided by empirical validation. We evaluate the approach on 2,660 laparoscopic appendectomy notes written by 9 surgeons. NSPIN yields models that generalize to unseen notes, and expert clinical review indicates its induced knowledge is largely consistent with surgical practice.

CRAFT: LLM-Based Iterative Refinement for Temporal Reasoning over Clinical Narratives

Understanding the temporal progression of symptoms in clinical narratives is critical for disease monitoring, safety surveillance, and causality assessment. Clinical narratives, however, rarely provide explicit temporal anchors. Current approaches to temporal information reasoning focus predominantly on pairwise relation classification across multi-visit and timestamp-rich records, leaving the reconstruction of structured symptom trajectories from individual anchor-sparse reports largely unaddressed. We propose CRAFT, an LLM framework that pairs a generator with a constraint-based verifier to iteratively produce and refine stage-wise symptom timelines through targeted feedback. We conduct evaluation on MedTempo, a new benchmark of 5,347 vaccine adverse-event narratives spanning three COVID-19 vaccine types, with expert-validated temporal stage annotations for 3,166 reports. Experiments across four LLM backbones demonstrate that CRAFT consistently improves temporal ordering accuracy, with ablation analysis isolating the contribution of generator and verifier components across model capability levels.