构建可模拟疾病演进的医疗世界模型,助力个性化诊疗决策
Medical world models: representing medical states, modelling clinical dynamics and guiding intervention policies

- 用世界模型思想建模患者状态随时间演化
- 整合状态表征、动态模拟与干预规划三能力
- 适合临床决策支持与数字孪生研究者参考
医学诊断与治疗是动态过程,患者状态随时间变化,临床干预影响未来结果。当前医疗AI多输出静态标签或评分,难以揭示疾病发展路径或干预效果。医疗世界模型借鉴人工智能中的世界模型理念,学习患者状态演变的内部模拟器,旨在帮助医生预测病情恶化、比较不同干预下的未来走向,并实现个体化治疗。现有工作分散于基础模型、纵向建模、疾病模拟、治疗效应估计、强化学习与数字孪生等领域。本文提出一个发展路线图,推动医疗AI从孤立的诊断与预测迈向可模拟疾病演化并支持干预决策的医疗世界模型。该路线图围绕三个耦合能力展开:患者状态构建、临床动态建模与干预决策支持。通过对比代表性系统,阐明各能力贡献及组件整合路径。最后指出将合理推演转化为临床可用模拟器的关键挑战。相关文献见 https://github.com/1999kevin/awesome_medical_world_models。
原文摘要 · Abstract (English)
Medical diagnosis and treatment are dynamic processes in which patient states evolve over time and clinical interventions alter future outcomes. Although current medical AI can detect disease, estimate risk and generate reports, many systems still return static labels or scores, offering limited insight into how illness may progress or how alternative interventions may reshape its trajectory. Medical world models adapt the world-model idea from artificial intelligence to healthcare by learning internal simulators of patient-state dynamics. Their long-term goal is to help clinicians anticipate deterioration, compare treatment-conditioned futures and tailor care to individual patients. Yet relevant work remains scattered across foundation models, longitudinal modelling, disease simulation, treatment-effect estimation, reinforcement learning and digital twins. To bridge this gap, this review outlines a roadmap for advancing medical AI from isolated diagnosis and prediction toward medical world models that simulate disease evolution and support intervention decisions. This roadmap is organized around three coupled capabilities: patient-state construction, clinical dynamics modelling and intervention decision support. Across representative systems, the comparison highlights what each capability contributes and how partial components can be integrated into more mature perception--dynamics--planning systems. Finally, we identify the challenges involved in turning plausible rollouts into clinically useful simulators. Related literature is available at https://github.com/1999kevin/awesome_medical_world_models.
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