用多智能体框架提升住院路径决策,准确率比现有模型高25%。
MAP: Evaluation and Multi-Agent Enhancement of Large Language Models for Inpatient Pathways
- 设计三类临床智能体协同完成入院分诊、诊断与治疗规划。
- 在5万余例病例上测试,诊断准确率提升25.10%,优于三名执业医生。
- 首个面向住院路径的大型基准数据集,适合医疗AI研发者参考。
住院路径依赖基于全面患者信息的复杂临床决策,对医生构成重大挑战。尽管大语言模型在医疗领域取得进展,但针对人工智能住院路径系统的研究仍有限,主要因缺乏大规模住院数据集。现有医学评测多集中于问答与检查,忽视住院场景下临床决策的多维度特性。为此,我们基于MIMIC-IV数据库构建了包含51,274例病例的住院路径决策支持(IPDS)基准,覆盖九个分诊科室、17类主要疾病及16种标准化治疗方案。提出多智能体住院路径(MAP)框架,包含分诊、诊断、治疗三类临床智能体,以及一名总控智能体统筹协调。大量实验表明,相比最先进的大语言模型HuatuoGPT2-13B,MAP将诊断准确率提升25.10%;且在临床合规性上表现优异,超越三位持证医生10%-12%,为住院路径系统奠定基础。
原文摘要 · Abstract (English)
Inpatient pathways demand complex clinical decision-making based on comprehensive patient information, posing critical challenges for clinicians. Despite advancements in large language models (LLMs) in medical applications, limited research focused on artificial intelligence (AI) inpatient pathways systems, due to the lack of large-scale inpatient datasets. Moreover, existing medical benchmarks typically concentrated on medical question-answering and examinations, ignoring the multifaceted nature of clinical decision-making in inpatient settings. To address these gaps, we first developed the Inpatient Pathway Decision Support (IPDS) benchmark from the MIMIC-IV database, encompassing 51,274 cases across nine triage departments and 17 major disease categories alongside 16 standardized treatment options. Then, we proposed the Multi-Agent Inpatient Pathways (MAP) framework to accomplish inpatient pathways with three clinical agents, including a triage agent managing the patient admission, a diagnosis agent serving as the primary decision maker at the department, and a treatment agent providing treatment plans. Additionally, our MAP framework includes a chief agent overseeing the inpatient pathways to guide and promote these three clinician agents. Extensive experiments showed our MAP improved the diagnosis accuracy by 25.10% compared to the state-of-the-art LLM HuatuoGPT2-13B. It is worth noting that our MAP demonstrated significant clinical compliance, outperforming three board-certified clinicians by 10%-12%, establishing a foundation for inpatient pathways systems.
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