用数字孪生和强化学习实现动态调整治疗方案的智能医疗系统
Treatment Response Optimized Clinical Decision Support AI System via Digital Twin Simulation

- 结合数字孪生模拟患者治疗轨迹,实时优化决策
- 在卵巢癌数据集上表现优于传统方法,仅少数情况需医生介入
- 兼顾安全与效率,适合临床辅助决策场景
临床决策支持人工智能系统(CDSAS)需在严格安全约束下实时适应患者变化。本文提出一种在线自适应框架,整合治疗效应(TE)估计以量化临床获益、患者数字孪生(DT)用于模拟治疗轨迹,并采用强化学习(RL)进行序列决策。系统初始基于历史医疗记录训练,运行于持续学习循环中。为保障安全,引入规则模块监控生命体征并阻止禁忌治疗;内部模型分歧强烈的病例会被标记供医生审查,实验中通过预训练结果模型模拟。我们在合成临床模拟器和真实世界卵巢癌数据集(TCGA)上验证该框架。在模拟与真实场景中,本方法在治疗推荐的有效性与稳定性上均优于标准计算基线。此外,系统保持低延迟,实验中仅少数案例需专家介入,展现出作为安全、可监督的个性化医疗工具的潜力,且可通过实际应用持续优化。
原文摘要 · Abstract (English)
Clinical decision support AI systems (CDSASs) must adapt to evolving patient conditions in real-time while adhering to strict safety constraints. We present an online adaptive framework that integrates Treatment Effect (TE) estimation to quantify clinical benefits, a patient Digital Twin (DT) to simulate treatment trajectories, and Reinforcement Learning (RL) for sequential decision-making. The AI system is initially trained on historical medical records and operates in a continuous learning loop. To ensure safety, a rule-based module monitors vital signs and blocks contraindicated treatments. Cases with strong internal model disagreement are flagged for clinician review, simulated in our experiments via a pre-trained outcome model. We validate our framework using both a synthetic clinical simulator and a real-world ovarian cancer dataset from The Cancer Genome Atlas (TCGA). In both simulated and clinical settings, our method demonstrated superior effectiveness and stability in recommending treatments compared to standard computational baselines. Furthermore, the AI system maintains low latency and requires expert consultation for only a minority of cases in our experimental validation, demonstrating its potential as a safe, clinician-supervised tool for personalized medicine that continuously improves through practical use.
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