arXiv:2601.03482cs.AIcs.LG2026-01中稿 · AAAI被引 1

用大模型生成干预建议,再用个人实验验证效果,实现真正个性化医疗。

Personalization of Large Foundation Models for Health Interventions

  • 大模型基于群体数据生成候选干预方案,带不确定性估计。
  • 个人实验(N-of-1)提供个体因果证据,验证推荐有效性。
  • 融合预测与因果验证,解决隐私、性能、可解释性矛盾。

大型基础模型(LFMs)在预防、诊断和治疗中推动医疗AI变革,但其能否提供真正个性化治疗仍存疑。研究揭示多重挑战:通用性悖论——模型在一个临床研究中表现优异,但在另一研究中仅达随机水平,说明个性化与外部有效性存在冲突;此外还存在隐私-性能悖论、规模-特异性悖论和自动化-共情悖论。大模型缺乏个体层面的因果理解,而“个案试验”(N-of-1 trials)作为个性化医学中的因果推断金标准,通过局部交叉自我实验,在保护隐私的同时提供个体因果证据。本文认为,大模型无法替代个案试验。两者应互补:大模型擅长从多模态数据中快速生成假设,个案试验则负责个体层面的因果验证。提出一种混合框架:由大模型生成带不确定性的干预候选列表,触发后续个案试验。明确预测与因果的边界,并直面这些悖论,是实现负责任个性化医疗的关键。

原文摘要 · Abstract (English)

Large foundation models (LFMs) transform healthcare AI in prevention, diagnostics, and treatment. However, whether LFMs can provide truly personalized treatment recommendations remains an open question. Recent research has revealed multiple challenges for personalization, including the fundamental generalizability paradox: models achieving high accuracy in one clinical study perform at chance level in others, demonstrating that personalization and external validity exist in tension. This exemplifies broader contradictions in AI-driven healthcare: the privacy-performance paradox, scale-specificity paradox, and the automation-empathy paradox. As another challenge, the degree of causal understanding required for personalized recommendations, as opposed to mere predictive capacities of LFMs, remains an open question. N-of-1 trials -- crossover self-experiments and the gold standard for individual causal inference in personalized medicine -- resolve these tensions by providing within-person causal evidence while preserving privacy through local experimentation. Despite their impressive capabilities, this paper argues that LFMs cannot replace N-of-1 trials. We argue that LFMs and N-of-1 trials are complementary: LFMs excel at rapid hypothesis generation from population patterns using multimodal data, while N-of-1 trials excel at causal validation for a given individual. We propose a hybrid framework that combines the strengths of both to enable personalization and navigate the identified paradoxes: LFMs generate ranked intervention candidates with uncertainty estimates, which trigger subsequent N-of-1 trials. Clarifying the boundary between prediction and causation and explicitly addressing the paradoxical tensions are essential for responsible AI integration in personalized medicine.

个性化医疗大模型因果推断个案试验

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