用AI自动遵循NCCN指南生成乳腺癌个性化治疗方案,准确率高达100%
Developing an Artificial Intelligence Tool for Personalized Breast Cancer Treatment Plans based on the NCCN Guidelines
- 采用分步LLM流程与图结构检索,精准匹配患者信息与指南内容
- 两种AI方法在24个案例中准确率达95.8%至100%,无虚假推荐
- 适合临床医生快速获取带文献页码的权威治疗建议
癌症治疗需基于患者临床状况、病史及循证指南进行个性化。美国国家综合癌症网络(NCCN)提供频繁更新的复杂指南,以流程图和图表形式呈现,使肿瘤科医生难以及时掌握治疗规范。本研究提出两种AI驱动方法:Agentic-RAG与Graph-RAG,用于自动化生成符合NCCN指南的乳腺癌治疗方案。Agentic-RAG采用三步式大语言模型流程,从指南中选择临床标题,检索对应JSON内容,并通过不足检测迭代优化建议。Graph-RAG基于微软开发框架,将JSON数据转换为文本,经总结后构建表示关键治疗关系的图结构,最终通过查询相关图摘要生成推荐。两者均在包含24个患者描述的测试集上评估,每个病例有4个问题。结果显示,Agentic RAG实现100%合规(24/24),无幻觉或错误治疗;Graph-RAG达成95.8%合规(23/24),仅一例错误,无幻觉;ChatGPT-4则达91.6%合规(22/24),两例错误,无幻觉。两种AI方法均提供详尽推荐并附准确的NCCN文档页码引用。
原文摘要 · Abstract (English)
Cancer treatments require personalized approaches based on a patient's clinical condition, medical history, and evidence-based guidelines. The National Comprehensive Cancer Network (NCCN) provides frequently updated, complex guidelines through visuals like flowcharts and diagrams, which can be time consuming for oncologists to stay current with treatment protocols. This study presents an AI (Artificial Intelligence)-driven methodology to accurately automate treatment regimens following NCCN guidelines for breast cancer patients. We proposed two AI-driven methods: Agentic-RAG (Retrieval-Augmented Generation) and Graph-RAG. Agentic-RAG used a three-step Large Language Model (LLM) process to select clinical titles from NCCN guidelines, retrieve matching JSON content, and iteratively refine recommendations based on insufficiency checks. Graph-RAG followed a Microsoft-developed framework with proprietary prompts, where JSON data was converted to text via an LLM, summarized, and mapped into graph structures representing key treatment relationships. Final recommendations were generated by querying relevant graph summaries. Both were evaluated using a set of patient descriptions, each with four associated questions. As shown in Table 1, Agentic RAG achieved a 100% adherence (24/24) with no hallucinations or incorrect treatments. Graph-RAG had 95.8% adherence (23/24) with one incorrect treatment and no hallucinations. Chat GPT-4 showed 91.6% adherence (22/24) with two wrong treatments and no hallucinations. Both Agentic RAG and Graph-RAG provided detailed treatment recommendations with accurate references to relevant NCCN document page numbers.
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