Surgical Alignment in Knowledge Graph Training for Clinical Diagnosis with Large Language Models

The paper investigates how to incorporate biomedical knowledge graphs (KGs) into large language models (LLMs) for clinical diagnosis. It evaluates five KG task formulations, three training paradigms, two KGs, and three base LLMs, finding that all paradigms outperform a non‑finetuned baseline but differ in knowledge transfer behavior. Introducing Gradient Intervention Density (GID) and Gradient Distortion (GD) metrics, the study identifies a ‘surgical alignment’ regime—sparse, localized updates achieved by KG‑judgment training with KL regularization—that improves reasoning quality even when in‑domain accuracy is lower than task‑specific supervised fine‑tuning.

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• llms
• nlp
• fine-tuning
• efficiency
• benchmarks
• safety