让医疗AI学会从病例中积累经验,持续改进诊断能力。
Evo-MedAgent: Beyond One-Shot Diagnosis with Agents That Remember, Reflect, and Improve

- 构建记忆模块,让AI在诊断间复盘、反思并优化决策策略。
- 在胸部X光诊断测试中,准确率提升至0.79(GPT-5-mini)和0.87(Gemini-3 Flash)。
- 无需训练即可部署,适合希望提升现有模型表现的医疗场景。
工具增强的大语言模型(LLM)代理可通过调用专业分类器、分割模型和视觉问答模块来解读胸片。然而,这些代理仍逐案孤立处理:无法积累跨案例经验、纠正重复错误,或在不依赖昂贵强化学习的情况下调整工具使用行为。与放射科医生通过实践不断进步不同,当前代理保持静态。本文提出Evo-MedAgent,一种自进化记忆模块,使医疗代理具备测试时的跨案例学习能力。其记忆包含三个互补存储:(1) 回顾性临床病历,用于检索相似历史案例的经验;(2) 自适应程序启发式规则库,通过反思动态演化,类似医生精炼内部诊断标准;(3) 工具可靠性控制器,追踪各工具的信任度。在ChestAgentBench上,Evo-MedAgent将多选题(MCQ)准确率从0.68提升至0.79(GPT-5-mini),从0.76提升至0.87(Gemini-3 Flash)。使用强基线模型时,进化记忆比调用外部工具更有效提升定性诊断性能。由于无需训练,其每例开销仅为一次检索和一次反思调用,可部署于任意冻结模型之上。
原文摘要 · Abstract (English)
Tool-augmented large language model (LLM) agents can orchestrate specialist classifiers, segmentation models, and visual question-answering modules to interpret chest X-rays. However, these agents still solve each case in isolation: they fail to accumulate experience across cases, correct recurrent reasoning mistakes, or adapt their tool-use behavior without expensive reinforcement learning. While a radiologist naturally improves with every case, current agents remain static. In this work, we propose Evo-MedAgent, a self-evolving memory module that equips a medical agent with the capacity for inter-case learning at test time. Our memory comprises three complementary stores: (1)~\emph{Retrospective Clinical Episodes} that retrieve problem-solving experiences from similar past cases, (2)~an \emph{Adaptive Procedural Heuristics} bank curating priority-tagged diagnostic rules that evolves via reflection, much like a physician refining their internal criteria, and (3)~a \emph{Tool Reliability Controller} that tracks per-tool trustworthiness. On ChestAgentBench, Evo-MedAgent raises multiple-choice question (MCQ) accuracy from 0.68 to 0.79 on GPT-5-mini, and from 0.76 to 0.87 on Gemini-3 Flash. With a strong base model, evolving memory improves performance more effectively than orchestrating external tools on qualitative diagnostic tasks. Because Evo-MedAgent requires no training, its per-case overhead is bounded by one additional retrieval pass and a single reflection call, making it deployable on top of any frozen model.
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