arXiv:2504.20368cs.MAcs.AI2025-04中稿 · International Conf…

用多智能体系统模拟医生会诊,提升急性肾损伤预测准确率

AKIBoards: A Structure-Following Multiagent System for Predicting Acute Kidney Injury

  • 构建结构跟随型多智能体框架,让各智能体共享全局医疗认知
  • 提前48小时预测急性肾损伤,准确率提升至0.195(基准0.141)
  • 适合医疗诊断系统研发者与临床决策支持研究者参考

诊断推理依赖医生基于局部认知模型与共享全局模型的协同判断。在复杂医疗场景中,多名专家通过多视角协作优化评估与决策。为此,我们提出STRUC-MAS框架,实现全局模型的自动学习,并将其作为先验信念嵌入多智能体系统(MAS)中以遵循结构。以急性肾损伤(AKI)预测为例,引入全局结构后,多智能体在平衡精确率-召回率加权投票下表现更优:结构跟随微调(SF-FT)AP达0.195,高于非结构跟随微调(NSF-FT)的0.141;结合检索增强生成(RAG)后,SF-FT-RAG达到0.194,优于NSF-FT-RAG的0.180。高召回智能体初始对真阳性和假阴性案例信心较低,经交互后信心提升(信念强化);而低召回智能体信心下降(信念更新)。结果表明,学习并利用全局结构是实现优异分类与诊断推理的前提。

原文摘要 · Abstract (English)

Diagnostic reasoning entails a physician's local (mental) model based on an assumed or known shared perspective (global model) to explain patient observations with evidence assigned towards a clinical assessment. But in several (complex) medical situations, multiple experts work together as a team to optimize health evaluation and decision-making by leveraging different perspectives. Such consensus-driven reasoning reflects individual knowledge contributing toward a broader perspective on the patient. In this light, we introduce STRUCture-following for Multiagent Systems (STRUC-MAS), a framework automating the learning of these global models and their incorporation as prior beliefs for agents in multiagent systems (MAS) to follow. We demonstrate proof of concept with a prosocial MAS application for predicting acute kidney injuries (AKIs). In this case, we found that incorporating a global structure enabled multiple agents to achieve better performance (average precision, AP) in predicting AKI 48 hours before onset (structure-following-fine-tuned, SF-FT, AP=0.195; SF-FT-retrieval-augmented generation, SF-FT-RAG, AP=0.194) vs. baseline (non-structure-following-FT, NSF-FT, AP=0.141; NSF-FT-RAG, AP=0.180) for balanced precision-weighted-recall-weighted voting. Markedly, SF-FT agents with higher recall scores reported lower confidence levels in the initial round on true positive and false negative cases. But after explicit interactions, their confidence in their decisions increased (suggesting reinforced belief). In contrast, the SF-FT agent with the lowest recall decreased its confidence in true positive and false negative cases (suggesting a new belief). This approach suggests that learning and leveraging global structures in MAS is necessary prior to achieving competitive classification and diagnostic reasoning performance.

医疗诊断多智能体肾损伤预测

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