Ensemble Logic for Symbolic Representation of Sleep Medicine Guidelines

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Original abstract

The American Academy of Sleep Medicine (AASM) Manual is the clinical standard for polysomnography (PSG) scoring, but its narrative rules can admit multiple reasonable interpretations, contributing to inter-scorer variability and implementation differences across studies and software systems. We present a formal framework for translating sleep-scoring rules into Rational Ensemble Logic (QEL), a dense-time (i.e., a continuous, rational-valued timeline rather than discrete steps) formalism that combines first-order quantification with metric temporal operators. Using an extraction-and-compilation procedure, we identified 18 unique atomic propositions and derived 12 final specifications corresponding to clinically scoreable AASM events. Back-translation of QEL specifications into clinician-facing language retained high semantic fidelity to the original scoring narratives (embedding cosine similarity: 79.3, 95% CI: 79.0--79.7) despite low lexical overlap (ROUGE-L: 18.3, 95 CI: 17.6--18.9). Formalization also clarifies latent ambiguities, including implicit physiological latencies and overlapping exclusions. This framework yields executable, rigorous rule specifications for computational phenotyping, more consistent implementation across datasets, and standardized open-source PSG analysis. This work is a part of the "Symbolic Biomedicine" program championed by the corresponding author.

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• Official / arXiv page
• PDF from original source

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