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NSIDDx: A Design Framework for Neuro-Symbolic, Practitioner-First Differential Diagnosis in Low-Resource Settings

arXiv · AI, language, vision and robotics · article · Aug 31, 2026 · UTC

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 clini

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