Ontology-Aware Design Patterns for Clinical AI Systems: Translating Reification Theory into Software Architecture

Florian Odi Stummer

Home/Archive/arXiv

arXiv · 2604.01661

Ontology-Aware Design Patterns for Clinical AI Systems: Translating Reification Theory into Software Architecture

Florian Odi Stummer

View original source ↗Read source document ↗Export metadata ↓

Abstract

Clinical AI systems routinely train on health data structurally distorted by documentation workflows, billing incentives, and terminology fragmentation. Prior work has characterised the mechanisms of this distortion: the three-forces model of documentary enactment, the reification feedback loop through which AI may amplify coding artefacts, and terminology governance failures that allow semantic drift to accumulate. Yet translating these insights into implementable software architecture remains an open problem. This paper proposes seven ontology-aware design patterns in Gang-of-Four pattern language for building clinical AI pipelines resilient to ontological distortion. The patterns address data ingestion validation (Ontological Checkpoint), low-frequency signal preservation (Dormancy-Aware Pipeline), continuous drift monitoring (Drift Sentinel), parallel representation maintenance (Dual-Ontology Layer), feedback loop interruption (Reification Circuit Breaker), terminology evolution management (Terminology Version Gate), and pluggable regulatory compliance (Regulatory Compliance Adapter). Each pattern is specified with Problem, Forces, Solution, Consequences, Known Uses, and Related Patterns. We illustrate their composition in a reference architecture for a primary care AI system and provide a walkthrough tracing all seven patterns through a diabetes risk prediction scenario. This paper does not report empirical validation; it offers a design vocabulary grounded in theoretical analysis, subject to future evaluation in production systems. Three patterns have partial precedent in existing systems; the remaining four have not been formally described. Limitations include the absence of runtime benchmarks and restriction to the German and EU regulatory context.

Explore related subjects

cs.AI

Keep this discovery

Explore connections, maps & timelines

BibTeX RIS

Florian Odi Stummer. 2026-04-02. Ontology-Aware Design Patterns for Clinical AI Systems: Translating Reification Theory into Software Architecture. https://arxiv.org/abs/2604.01661

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

arXiv2026

Collab-Solver: Collaborative Solving Policy Learning for Mixed-Integer Linear Programming

Mixed-integer linear programming (MILP) has been a fundamental problem in combinatorial optimization. Conventional MILP solving mainly relies on carefully designed heuristics embedded in the branch-and-bound framework. Driven by the strong capabilities of neural networks, recent research is exploring the value of machine learning alongside conventional MILP solving. Although learning-based MILP methods have shown great promise, existing works typically learn policies for individual modules in MILP solvers in isolation, without considering their interdependence, which limits both solving efficiency and solution quality. To address this limitation, we propose Collab-Solver, a novel multi-agent-based policy learning framework for MILP that enables collaborative policy optimization for multiple modules. Specifically, we formulate the collaboration between cut selection and branching in MILP solving as a Stackelberg game. Under this formulation, we develop a two-phase learning paradigm to stabilize collaborative policy learning: the first phase performs data-communicated policy pretraining, and the second phase further orchestrates the policy learning for various modules. Extensive experiments on both synthetic and large-scale real-world MILP datasets demonstrate that the jointly learned policies significantly improve solving performance. Moreover, the policies learned by Collab-Solver have also demonstrated excellent generalization abilities across different instance sets.

cs.AI↗

arXiv2026

Fact Grounded Attention: Eliminating Hallucination in Large Language Models Through Attention Level Knowledge Integration

"The greatest enemy of knowledge is not ignorance, it is the illusion of knowledge." Large Language Models have conquered natural language but remain prisoners of their own probabilistic nature--confidently hallucinating facts they never truly knew. We present Fact Grounded Attention (FGA), a novel architectural modification that transforms unreliable language models into deterministic truth tellers by injecting verifiable knowledge directly into the attention mechanism. Unlike existing approaches that patch hallucinations after generation or prepend retrieved text, FGA intervenes at the mathematical heart of the transformer--the pre-softmax attention scores--creating a model that cannot hallucinate when facts exist in its knowledge base. Our experiments across 1,107 technical queries spanning smartphones, laptops, and electric vehicles demonstrate a transformation from 6.3% accuracy in vanilla Llama 3.2 to 99.7% accuracy with FGA. More critically, knowledge updates occur in under one second without retraining, compared to hours for parameter editing approaches. FGA doesn't just reduce hallucination--it eliminates it entirely for verifiable facts, marking a fundamental shift from probabilistic approximation to deterministic precision in neural language generation.

cs.AI↗

arXiv2026

MemeLens: Multilingual Multitask VLMs for Memes

Memes are a dominant medium for online communication and manipulation because meaning emerges from interactions between embedded text, imagery, and cultural context. Existing meme research is distributed across tasks (e.g., \textit{hate, misogyny, propaganda, sentiment, humour}) and languages, which limits cross-domain generalization. To address this gap, we propose \textsc{MemeLens}, a unified multilingual, multitask explanation-enhanced Vision-Language Model (VLM) for meme understanding. We consolidate $38$ public meme datasets, filter and map dataset-specific labels into a shared taxonomy of $20$ tasks spanning harm, targets, figurative/pragmatic intent, and affect. We present a comprehensive empirical analysis across modeling paradigms, task categories, and datasets. Our findings suggest that robust meme understanding requires multimodal training, varies substantially across semantic categories, and remains sensitive to over-specialization when models are fine-tuned on individual datasets rather than trained in a unified setting. We make the experimental resources (https://github.com/MohamedBayan/MemeLens), model (https://huggingface.co/QCRI/MemeLens-VLM) and datasets (https://huggingface.co/datasets/QCRI/MemeLens) publicly available to the community.

cs.AI↗