构建递归多模态医疗智能框架,支持长时序临床推理与转诊优化。
MedRLM: Recursive Multimodal Health Intelligence for Long-Context Clinical Reasoning, Sensor-Guided Screening, Evidence-Grounded Decision Support, and Community-to-Tertiary Referral Optimization

- 通过递归分解患者数据,分步处理电子病历、影像、传感器等多源信息。
- 引入临床证据图记忆库,关联患者数据与指南、生物标志物和转诊标准。
- 支持异常信号触发深度分析,高风险病例自动进入医生审核流程。
真实世界临床决策需基于异构且长期的患者信息进行推理,而非孤立回答医学问题。当前医疗大模型与检索增强生成系统多依赖单步提示或检索,在临床证据分散于长电子健康记录、医学影像、传感器流、指南及转诊约束时易失效。本文提出MedRLM:一种用于长时序临床推理、传感器引导筛查及社区至三级转诊支持的递归多模态健康智能框架。该框架不将所有信息压缩为单一提示,而是将患者案例视为可递归检视、分解、检索、验证与合成的外部临床环境。协调专用代理处理临床文本、纵向EHR、医学影像、生理传感器信号、指南检索、不确定性审计与转诊规划,并引入临床证据图记忆库,连接患者特定观察与检索证据、标准化定义、传感器衍生生物标志物及转诊标准。当检测到异常生理或行为模式时,传感器引导的递归触发机制激活深度推理;不确定性门控精炼支持高风险或低置信度病例的临床审查。我们还设计了基于公开与授权临床数据集的真实评估方案,涵盖EHR、放射学、心电图、ICU时间序列及转诊代理结果。MedRLM旨在推动医疗AI从静态问答迈向可审计、多模态、流程感知的临床决策支持。
原文摘要 · Abstract (English)
Real-world clinical decision support requires reasoning over heterogeneous and longitudinal patient information rather than answering isolated medical questions. However, current medical large language models and retrieval-augmented generation systems often rely on single-step prompting or retrieval, which can be fragile when clinical evidence is distributed across long electronic health records, medical images, sensor streams, guidelines, and referral constraints. This paper proposes MedRLM, a Recursive Multimodal Health Intelligence framework for long-context clinical reasoning, sensor-guided screening, and community-to-tertiary referral support. Instead of compressing all patient information into one prompt, MedRLM treats the patient case as an external clinical environment that can be recursively inspected, decomposed, retrieved, verified, and synthesized. The framework coordinates specialized agents for clinical text, longitudinal EHR, medical imaging, physiological sensor signals, guideline retrieval, uncertainty auditing, and referral planning. It further introduces a Clinical Evidence Graph Memory to connect patient-specific observations with retrieved evidence, standardized definitions, sensor-derived biomarkers, and referral criteria. A sensor-guided recursive triggering mechanism activates deeper reasoning when abnormal physiological or behavioral patterns are detected, while uncertainty-gated refinement supports clinician review for high-risk or low-confidence cases. We also outline a real-data evaluation design using public and credentialed clinical datasets spanning EHR, radiology, ECG, ICU time series, and referral-proxy outcomes. MedRLM aims to move medical AI from static question answering toward auditable, multimodal, and workflow-aware clinical decision support.
Thank you to arXiv for use of its open access interoperability. PaperDance 不是 arXiv 官方产品;中文卡片由大模型生成,请以原文为准。