通过分阶段证据仲裁,提升病理图像分析的准确性与可靠性。
PathoSage: Towards Multi-Source Evidence Adjudication in Pathology via Experience-Aware Agentic Workflow

- 分三阶段处理:检索、收集、仲裁证据,避免信息污染。
- 在多个数据集上显著降低幻觉率与分类分歧,性能超越现有模型。
- 无需训练即可建模工具长期可靠性,适合临床辅助决策场景。
多模态大语言模型与智能体工作流在计算病理学中展现出巨大潜力,但病变级别的推理仍面临挑战。端到端病理学多模态模型常出现形态特征幻觉,而现有智能体系统通常将工具输出与检索知识合并至共享上下文,导致决策易受冲突证据和上下文污染影响。本文提出 PathoSage,一种三阶段框架,显式分离知识检索、证据收集与证据仲裁,用于病灶级多模态病理推理。其核心组件「结构化证据审议」可独立评估异构证据,进行冲突分析,并在全新上下文中生成最终判断,以减少锚定偏差。此外,我们引入无需训练的贝塔-伯努利经验系统,实现持续信用分配,建模工具长期可靠性,并为未来工具使用构建相似性加权先验。实验表明,PathoSage有效缓解了视觉问答中的幻觉问题与分类器分歧,在多个基准测试中优于强基线模型。结果强调显式证据仲裁与可靠性感知工具建模是构建稳健病理智能体的关键。
原文摘要 · Abstract (English)
Recent advances in Multimodal Large Language Models (MLLMs) and agent workflows have shown strong promise for computational pathology, yet reliable patch-level reasoning remains challenging. End-to-end pathology MLLMs often hallucinate morphological features, while recent agentic systems usually merge tool outputs and retrieved knowledge into a shared context, making decisions vulnerable to conflicting evidence and context contamination. We propose PathoSage, a three-stage framework that explicitly separates knowledge retrieval, evidence collection, and evidence adjudication for patch-level pathology multimodal reasoning. Its core component, Structured Evidence Deliberation, independently evaluates heterogeneous evidence from tools, performs conflict analysis, and generates the final judgment in a fresh context to reduce anchoring bias. We further introduce a training-free Beta-Bernoulli experience system with continuous credit assignment to model long-term tool reliability and construct similarity-weighted priors for future tool use. Experiments show that PathoSage effectively mitigates VQA hallucinations and classifier disagreement, outperforming strong pathology MLLM and agentic baselines. Our results highlight explicit evidence adjudication and reliability-aware tool modeling as key ingredients for robust pathology agents.
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