Cerebra用多智能体协作分析病历影像,帮医生更准判断痴呆风险。
Cerebra: A Multidisciplinary AI Board for Multimodal Dementia Characterization and Risk Assessment
- 组建多智能体团队分工处理电子病历、病程记录和医学影像数据
- 痴呆风险预测AUROC达0.80,诊断准确率0.86,生存预测C-index为0.81
- 支持隐私保护部署,医生可交互式追问结果,适合临床决策场景
现代临床实践越来越依赖对异构、动态且不完整的患者数据进行推理。尽管多模态基础模型在多项临床任务中表现提升,但现有模型大多静态、不透明,且与真实临床流程脱节。我们提出Cerebra,一个交互式多智能体AI团队,协调专门处理电子健康记录(EHR)、临床笔记和医学影像的智能体。其输出整合为面向临床医生的仪表板,结合可视化分析与对话界面,使医生能在诊疗现场探询预测依据并上下文化风险评估。Cerebra通过结构化表示实现隐私保护部署,在模态缺失时仍保持鲁棒性。我们在覆盖300万患者的四家独立医疗系统数据集上评估Cerebra,其性能持续优于最先进单模态模型及大型多模态语言模型基线。在痴呆风险预测中,其最高AUROC达0.80,显著高于单模态最强模型的0.74和语言模型基线的0.68;在痴呆诊断中,AUROC为0.86;生存预测的C-index为0.81。由经验丰富的医生参与的读者研究显示,使用Cerebra后专家在前瞻性痴呆风险估计中的准确率提升了17.5个百分点。这些结果表明,Cerebra在可解释、稳健的临床决策支持方面具有巨大潜力。
原文摘要 · Abstract (English)
Modern clinical practice increasingly depends on reasoning over heterogeneous, evolving, and incomplete patient data. Although recent advances in multimodal foundation models have improved performance on various clinical tasks, most existing models remain static, opaque, and poorly aligned with real-world clinical workflows. We present Cerebra, an interactive multi-agent AI team that coordinates specialized agents for EHR, clinical notes, and medical imaging analysis. These outputs are synthesized into a clinician-facing dashboard that combines visual analytics with a conversational interface, enabling clinicians to interrogate predictions and contextualize risk at the point of care. Cerebra supports privacy-preserving deployment by operating on structured representations and remains robust when modalities are incomplete. We evaluated Cerebra using a massive multi-institutional dataset spanning 3 million patients from four independent healthcare systems. Cerebra consistently outperformed both state-of-the-art single-modality models and large multimodal language model baselines. In dementia risk prediction, it achieved AUROCs up to 0.80, compared with 0.74 for the strongest single-modality model and 0.68 for language model baselines. For dementia diagnosis, it achieved an AUROC of 0.86, and for survival prediction, a C-index of 0.81. In a reader study with experienced physicians, Cerebra significantly improved expert performance, increasing accuracy by 17.5 percentage points in prospective dementia risk estimation. These results demonstrate Cerebra's potential for interpretable, robust decision support in clinical care.
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