arXiv:2409.06351cs.AI2024-09被引 12

多智能体协作诊断系统,零样本遵循医学指南提升影像判读准确性

MAGDA: Multi-agent guideline-driven diagnostic assistance

  • 多LLM智能体协同工作,结合视觉语言模型分析影像并按指南筛选病灶
  • 在胸部X光数据集上优于现有零样本方法,对罕见病也有良好泛化能力
  • 无需训练即可适应罕见病场景,适合基层医疗和资源匮乏地区使用

在急诊科、偏远地区医院或资源有限的诊所中,临床医生常无法及时获得专业放射科医生的影像分析,影响患者诊疗。大型语言模型(LLMs)具备提供决策支持的潜力,尽管其在医学考试中表现优异,但往往不遵循医学指南。本文提出一种新的零样本指南驱动决策支持方法,构建由多个LLM智能体组成的系统,集成对比视觉语言模型,协同完成患者诊断。在仅提供简单诊断指南的前提下,智能体自主生成提示并依据指南筛查影像中的异常,最终输出可理解的推理链条,并通过自洽性优化考虑疾病间的相互依赖关系。该方法为零样本设计,适用于罕见病场景(训练数据稀缺但存在专家描述),在CheXpert与ChestX-ray 14 Longtail两个胸部X光数据集上均展现出优于现有零样本方法的性能,具备良好的稀有病泛化能力。

原文摘要 · Abstract (English)

In emergency departments, rural hospitals, or clinics in less developed regions, clinicians often lack fast image analysis by trained radiologists, which can have a detrimental effect on patients' healthcare. Large Language Models (LLMs) have the potential to alleviate some pressure from these clinicians by providing insights that can help them in their decision-making. While these LLMs achieve high test results on medical exams showcasing their great theoretical medical knowledge, they tend not to follow medical guidelines. In this work, we introduce a new approach for zero-shot guideline-driven decision support. We model a system of multiple LLM agents augmented with a contrastive vision-language model that collaborate to reach a patient diagnosis. After providing the agents with simple diagnostic guidelines, they will synthesize prompts and screen the image for findings following these guidelines. Finally, they provide understandable chain-of-thought reasoning for their diagnosis, which is then self-refined to consider inter-dependencies between diseases. As our method is zero-shot, it is adaptable to settings with rare diseases, where training data is limited, but expert-crafted disease descriptions are available. We evaluate our method on two chest X-ray datasets, CheXpert and ChestX-ray 14 Longtail, showcasing performance improvement over existing zero-shot methods and generalizability to rare diseases.

医疗AI多智能体零样本影像诊断

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