arXiv:2503.18968cs.AI2025-03被引 73

MedAgent-Pro通过分步证据推理提升医学多模态诊断可靠性

MedAgent-Pro: Towards Evidence-based Multi-modal Medical Diagnosis via Reasoning Agentic Workflow

  • 构建分层诊断流程,疾病级规划与患者级推理分离
  • 融合指南检索与视觉工具,实现定量评估与逻辑验证
  • 临床专家评测证明其可靠且贴近真实诊疗场景

现代医学诊断依赖对文本和图像数据的综合分析,需基于医学知识进行系统化、严谨的推理。尽管大视觉语言模型(VLMs)与代理方法在整合多模态患者数据方面展现出潜力,但常直接给出答案,缺乏量化分析,降低可信度与临床可用性。本文提出MedAgent-Pro,一种遵循现代医学诊断原则的代理式推理范式,将流程分解为顺序组件,实现逐步、基于证据的推理。其工作流包含疾病级标准化计划生成与患者级个性化步骤推理。为支持疾病级规划,设计基于RAG的代理以检索医疗指南,确保符合临床标准;针对患者级推理,引入视觉模型等专业工具实现定量评估。同时,每一步均进行可靠性验证,确保逻辑严密与结论有据。在多个解剖区域、成像模态与疾病类型上的大量实验表明,MedAgent-Pro优于主流VLMs、代理系统及前沿专家模型。消融实验与临床专家的人工评估进一步验证其鲁棒性与临床相关性。代码已开源:https://github.com/jinlab-imvr/MedAgent-Pro。

原文摘要 · Abstract (English)

In modern medicine, clinical diagnosis relies on the comprehensive analysis of primarily textual and visual data, drawing on medical expertise to ensure systematic and rigorous reasoning. Recent advances in large Vision-Language Models (VLMs) and agent-based methods hold great potential for medical diagnosis, thanks to the ability to effectively integrate multi-modal patient data. However, they often provide direct answers and draw empirical-driven conclusions without quantitative analysis, which reduces their reliability and clinical usability. We propose MedAgent-Pro, a new agentic reasoning paradigm that follows the diagnosis principle in modern medicine, to decouple the process into sequential components for step-by-step, evidence-based reasoning. Our MedAgent-Pro workflow presents a hierarchical diagnostic structure to mirror this principle, consisting of disease-level standardized plan generation and patient-level personalized step-by-step reasoning. To support disease-level planning, an RAG-based agent is designed to retrieve medical guidelines to ensure alignment with clinical standards. For patient-level reasoning, we propose to integrate professional tools such as visual models to enable quantitative assessments. Meanwhile, we propose to verify the reliability of each step to achieve evidence-based diagnosis, enforcing rigorous logical reasoning and a well-founded conclusion. Extensive experiments across a wide range of anatomical regions, imaging modalities, and diseases demonstrate the superiority of MedAgent-Pro to mainstream VLMs, agentic systems and state-of-the-art expert models. Ablation studies and human evaluation by clinical experts further validate its robustness and clinical relevance. Code is available at https://github.com/jinlab-imvr/MedAgent-Pro.

医学诊断多模态智能代理证据推理

Thank you to arXiv for use of its open access interoperability. PaperDance 不是 arXiv 官方产品;中文卡片由大模型生成,请以原文为准。