通过多专家协作与多源证据检索,实现肝病诊断的可解释性提升。
MedCoRAG: Interpretable Hepatology Diagnosis via Hybrid Evidence Retrieval and Multispecialty Consensus
- 融合医学知识图谱与临床指南,动态构建患者专属证据包
- 多代理迭代推理,复杂病例自动触发重检索并生成共识诊断
- 在MIMIC-IV数据集上超越现有方法,诊断可解释性显著增强
准确且可解释地诊断肝病在真实临床环境中仍具挑战性。现有AI诊断方法普遍存在透明度不足、结构化推理缺失和部署困难的问题。尽管近期研究利用大语言模型(LLMs)、检索增强生成(RAG)和多智能体协作,但大多仅从单一来源检索证据,无法支持基于结构化临床数据的迭代式、角色专业化讨论。为此,我们提出MedCoRAG(Medical Collaborative RAG),一个端到端框架:从标准化异常发现生成诊断假设,并通过联合检索与剪枝UMLS知识图谱路径和临床指南,构建患者特异性证据包;随后进行多智能体协同推理:路由代理根据病例复杂度动态分配专科代理,这些代理在证据上迭代推理并按需触发针对性重检索,通用代理则整合所有讨论形成可追溯的共识诊断,模拟多学科会诊过程。在MIMIC-IV肝病病例上的实验表明,MedCoRAG在诊断性能与推理可解释性上均优于现有方法及闭源模型。
原文摘要 · Abstract (English)
Diagnosing hepatic diseases accurately and interpretably is critical, yet it remains challenging in real-world clinical settings. Existing AI approaches for clinical diagnosis often lack transparency, structured reasoning, and deployability. Recent efforts have leveraged large language models (LLMs), retrieval-augmented generation (RAG), and multi-agent collaboration. However, these approaches typically retrieve evidence from a single source and fail to support iterative, role-specialized deliberation grounded in structured clinical data. To address this, we propose MedCoRAG (i.e., Medical Collaborative RAG), an end-to-end framework that generates diagnostic hypotheses from standardized abnormal findings and constructs a patient-specific evidence package by jointly retrieving and pruning UMLS knowledge graph paths and clinical guidelines. It then performs Multi-Agent Collaborative Reasoning: a Router Agent dynamically dispatches Specialist Agents based on case complexity; these agents iteratively reason over the evidence and trigger targeted re-retrievals when needed, while a Generalist Agent synthesizes all deliberations into a traceable consensus diagnosis that emulates multidisciplinary consultation. Experimental results on hepatic disease cases from MIMIC-IV show that MedCoRAG outperforms existing methods and closed-source models in both diagnostic performance and reasoning interpretability.
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