让医疗AI主动找证据,从被动阅读变主动搜寻。
ClinSeekAgent: Automating Multimodal Evidence Seeking for Agentic Clinical Reasoning

- 构建能自主查询病历、影像和知识库的智能代理
- 在文本与多模态任务上显著提升诊断准确率,最高增15.1点F1
- 适合研究临床AI推理与自动化医疗决策的开发者
大型语言模型与智能体系统在临床决策支持中展现出潜力,但现有工作多假设证据已预先整理好。真实临床流程则要求智能体主动搜寻、迭代规划并整合异构来源的多模态证据。本文提出ClinSeekAgent,一个自动化的多模态证据动态搜寻框架,将范式从被动消费证据转向主动获取。给定临床问题和原始数据源,ClinSeekAgent通过查询医学知识库、遍历原始电子病历(EHR)并调用医学影像工具获取证据;根据新信息不断修正假设;最终将证据融合为可解释的临床决策。该框架既可用于前沿大模型的推理阶段,也可作为训练阶段的轨迹蒸馏管道。我们构建了ClinSeek-Bench,对比固定证据输入与原始数据自动搜寻两种场景。在仅文本的EHR任务中,ClinSeekAgent使Claude Opus 4.6的总体F1从60.0提升至63.2,MiniMax M2.5从43.1升至47.3,在9个模型中有7个实现风险预测性能正向提升。在多模态任务中,对Claude Opus 4.6的提升达47.5→62.6(+15.1),所有评估模型在三个胸部X光相关任务组中均取得改进。进一步验证其训练价值,我们将智能体搜寻轨迹蒸馏为ClinSeek-35B-A3B,在AgentEHR-Bench上达到34.0平均F1,相较基线Qwen3.5-35B-A3B提升+11.9,逼近Claude Opus 4.6表现。
原文摘要 · Abstract (English)
Large language models (LLMs) and agentic systems have shown promise for clinical decision support, but existing works largely assume that evidence has already been curated and handed to the model. Real-world clinical workflows instead require agents to actively seek, iteratively plan, and synthesize multimodal evidence from heterogeneous sources. In this paper, we introduce ClinSeekAgent, an automated agentic framework for dynamic multimodal evidence seeking that shifts the paradigm from passive evidence consumption to active evidence acquisition. Given only a clinical query and access to raw data sources, ClinSeekAgent gathers evidence by querying medical knowledge bases, navigating raw EHRs, and invoking medical imaging tools; refines its hypotheses as new information emerges; and integrates the collected evidence into grounded clinical decisions. ClinSeekAgent serves both as an inference-time agent for frontier LLMs and as a training-time pipeline for distilling high-quality agent trajectories into compact open-source models. To validate its inference-time effectiveness, we construct ClinSeek-Bench, which pairs Curated Input reasoning from fixed pre-selected evidence with Automated Evidence-Seeking over raw clinical data. On text-only EHR tasks, ClinSeekAgent improves Claude Opus 4.6 from 60.0 to 63.2 overall F1 and MiniMax M2.5 from 43.1 to 47.3, with positive risk-prediction gains in 7 out of 9 evaluated host models. On multimodal tasks, ClinSeekAgent improves Claude Opus 4.6 from 47.5 to 62.6 (+15.1); all evaluated models improve across the three CXR-related task groups. We further validate ClinSeekAgent as a training pipeline by distilling agentic evidence-seeking trajectories into ClinSeek-35B-A3B, which achieves 34.0 average F1 on existing AgentEHR-Bench, improving over its Qwen3.5-35B-A3B baseline by +11.9 points and approaching Claude Opus 4.6.
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