Neuro-Symbolic Framework

LLM-based diagnostic systems achieve high semantic accuracy on benchmarks, but open-ended evaluation on clinically uncommon presentations reveals a systematic gap between headline accuracy and verifiable clinical reliability. We evaluate an LLM+rare-disease-RAG pipeline across two cohorts and show that the paradigm produces confident outputs that are frequently unverifiable and systematically resistant to clinician interrogation. We present NSIDDx (Neuro-Symbolic Integrated Differential Diagnosis System), a design framework arguing that DDx systems in low-resource settings must treat the clinician as an active reasoning agent. We instantiate this through a neuro-symbolic pipeline with ternary symptom encoding, contradiction detection, audit strings, and practitioner override - running offline on consumer hardware. We distill five design principles for clinician-in-the-loop clinical NLP and invite the prospective studies needed to validate the claim at scale.

Counterfactual explanations explain machine learning predictions by identifying minimal input changes that would alter a model's decision. Although many existing methods successfully generate prediction-changing alternatives, they often produce unrealistic or infeasible recommendations due to a lack of explicit mechanisms for incorporating domain knowledge and intervention constraints. Neuro-symbolic AI offers a promising direction by combining data-driven predictive models with symbolic reasoning capable of representing human-understandable rules and feasible actions. This paper presents PACE, a modular neuro-symbolic framework for generating feasibility-aware counterfactual explanations. The framework separates prediction and reasoning into two components: a neural predictive model for classification and a symbolic reasoning layer that enforces domain-specific constraints during counterfactual generation. By explicitly modeling feasible interventions, the framework produces explanations consistent with domain knowledge while remaining interpretable and actionable. The approach is model-agnostic and adaptable to domains requiring realistic decision support. A case study is conducted on the Adult Income dataset, combining a multilayer perceptron classifier with Answer Set Programming (ASP) rules encoding feasible modifications to education, occupation, and working hours while preserving immutable attributes. Results highlight the trade-off between counterfactual validity and plausibility and show that symbolic constraints yield explanations that better satisfy domain-specific feasibility requirements, illustrating the potential of neuro-symbolic methods for transparent, feasibility-aware counterfactual explanation in explainable AI.

Combinatorial scheduling poses a significant challenge for language models, requiring them to identify feasible solutions within exponentially large search spaces while satisfying complex constraints. This challenge is especially pronounced in resource-constrained settings, where larger language models are impractical and selection is limited to smaller models which often fail to preserve feasibility when scheduling directly from natural language. To address these limitations, we introduce SDDL, a neuro-symbolic framework that translates natural-language scheduling problems into compact, solver-aligned representations of tasks, resources, constraints, and objectives, while delegating low-level modeling and search to a deterministic compiler and external solver. On a 300-instance, multi-family subset of scheduling problems, SDDL improves independently verified feasibility for every resource-constrained model tested. The two strongest SDDL configurations reach 55.3% and 28.3%, up from direct-generation baselines of 23.7% and 1.3% and solver-code baselines of 21.7% and 7.0%, with a 0.0% median optimality gap among feasible schedules. By expressing problem structure rather than generating solutions or solver code, SDDL enables smaller models to approach the strongest evaluated direct- and solver-code configurations, including substantially larger frontier models.