arXiv:2410.02551cs.LGcs.AI2024-10被引 51

用大模型协作模拟多学科会诊,提升电子病历预测能力

ColaCare: Enhancing Electronic Health Record Modeling through Large Language Model-Driven Multi-Agent Collaboration

  • 构建医生代理与元代理协同框架,结合结构化数据与文本推理
  • 在3个数据集上显著优于基线,死亡率和再入院预测准确率更高
  • 适合临床决策支持系统研究者,尤其关注可解释医疗AI的开发者

我们提出ColaCare框架,通过大语言模型驱动的多智能体协作增强电子健康记录(EHR)建模。该方法将领域专家模型与大语言模型无缝融合,弥合结构化EHR数据与文本推理之间的鸿沟。受临床多学科团队(MDT)模式启发,ColaCare采用医生代理(DoctorAgents)与元代理(MetaAgent)协同分析患者数据:专家模型处理数值型EHR数据并生成预测,大语言模型生成推理依据与决策报告。元代理协调讨论,促进医生代理间的咨询与循证辩论,模拟临床决策中的多元专业视角。此外,通过检索增强生成(RAG)模块引入《默克诊疗手册》(MSD)医学指南,解决知识时效性问题。在三个EHR数据集上的大量实验表明,ColaCare在临床死亡率与再入院预测任务中表现优异,展现出革新临床决策支持系统与推动个性化精准医疗的潜力。项目代码、案例研究及问卷已公开于https://colacare.netlify.app。

原文摘要 · Abstract (English)

We introduce ColaCare, a framework that enhances Electronic Health Record (EHR) modeling through multi-agent collaboration driven by Large Language Models (LLMs). Our approach seamlessly integrates domain-specific expert models with LLMs to bridge the gap between structured EHR data and text-based reasoning. Inspired by the Multidisciplinary Team (MDT) approach used in clinical settings, ColaCare employs two types of agents: DoctorAgents and a MetaAgent, which collaboratively analyze patient data. Expert models process and generate predictions from numerical EHR data, while LLM agents produce reasoning references and decision-making reports within the MDT-driven collaborative consultation framework. The MetaAgent orchestrates the discussion, facilitating consultations and evidence-based debates among DoctorAgents, simulating diverse expertise in clinical decision-making. We additionally incorporate the Merck Manual of Diagnosis and Therapy (MSD) medical guideline within a retrieval-augmented generation (RAG) module for medical evidence support, addressing the challenge of knowledge currency. Extensive experiments conducted on three EHR datasets demonstrate ColaCare's superior performance in clinical mortality outcome and readmission prediction tasks, underscoring its potential to revolutionize clinical decision support systems and advance personalized precision medicine. All code, case studies and a questionnaire are available at the project website: https://colacare.netlify.app.

电子病历多智能体大模型临床决策

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