arXiv:2509.24314cs.AI2025-09被引 6

MedMMV通过多智能体协作提升医疗推理的可靠性与可验证性。

MedMMV: A Controllable Multimodal Multi-Agent Framework for Reliable and Verifiable Clinical Reasoning

  • 采用多智能体框架,通过短周期推理滚动生成多样化路径
  • 在6个医学基准上准确率最高提升12.7%,且推理更可信
  • 适合需高可靠性临床决策支持的场景,尤其关注防幻觉

多模态大模型在医学基准测试和初步临床试验中表现优异,但我们的试点审计发现:早期证据解读不稳定会引发幻觉,导致推理路径分叉并产生全局不一致结论。这凸显了需要具备抑制随机性与幻觉能力、且推理过程可审计的临床推理代理。我们提出MedMMV——一种可控的多模态多智能体框架,通过多样化短滚动(short rollouts)稳定推理,借助幻觉检测器监督将中间步骤锚定在结构化证据图中,并由联合不确定性评分器聚合候选路径。在六个医学基准上,MedMMV准确率最高提升12.7%,且显著增强可靠性。盲评结果显示,医生认为其推理真实性大幅提升,同时未牺牲信息量。通过可验证的多智能体流程控制不稳定性,该框架为高风险领域如临床决策支持中的可信AI部署提供了稳健路径。

原文摘要 · Abstract (English)

Recent progress in multimodal large language models (MLLMs) has demonstrated promising performance on medical benchmarks and in preliminary trials as clinical assistants. Yet, our pilot audit of diagnostic cases uncovers a critical failure mode: instability in early evidence interpretation precedes hallucination, creating branching reasoning trajectories that cascade into globally inconsistent conclusions. This highlights the need for clinical reasoning agents that constrain stochasticity and hallucination while producing auditable decision flows. We introduce MedMMV, a controllable multimodal multi-agent framework for reliable and verifiable clinical reasoning. MedMMV stabilizes reasoning through diversified short rollouts, grounds intermediate steps in a structured evidence graph under the supervision of a Hallucination Detector, and aggregates candidate paths with a Combined Uncertainty scorer. On six medical benchmarks, MedMMV improves accuracy by up to 12.7% and, more critically, demonstrates superior reliability. Blind physician evaluations confirm that MedMMV substantially increases reasoning truthfulness without sacrificing informational content. By controlling instability through a verifiable, multi-agent process, our framework provides a robust path toward deploying trustworthy AI systems in high-stakes domains like clinical decision support.

医疗AI多智能体可验证推理

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