用多智能体系统实现真实世界痴呆分期与分型,更贴近临床实际。
Dementia-Agents: A Multi-Modal Multi-Agent System for Dementia Staging and Phenotyping

- 构建多智能体框架,分步处理多模态临床数据并保留缺失信息
- 在1066例患者上表现优于单模型和旧系统,提升诊断准确性
- 适合需要可解释性决策的临床医生和研究者使用
痴呆诊断需整合来自不同人员和医生的多模态临床评估,面对不完整且异构的数据。现有大多数人工智能方法仍聚焦阿尔茨海默病(AD),将其视为二分类或三阶段进展建模,局限于受控研究环境。这种病理驱动范式忽视了痴呆作为综合征的广泛性——涵盖多种阶段、表型和病因。本文提出Dementia-Agents,一个契合临床的多智能体框架,用于真实世界的痴呆分期与分型。该框架采用三步流程:(1) 数据智能体将结构化临床记录转化为语义忠实的文本表示,保留缺失信号并分发给领域专家;(2) 五个微调的专家智能体生成各领域预测;(3) 协调智能体进行概率聚合,输出最终分期与分型结果。我们在两个认知神经科服务的1,066名患者真实队列上开发并评估该系统。相比单体多模态大语言模型(MLLMs)和先前医疗多智能体系统,本方法在真实世界综合征级痴呆分期与分型任务中持续提升诊断性能,同时保持领域级可解释性。
原文摘要 · Abstract (English)
Dementia diagnosis requires integrating multi-modal clinical assessments from diverse informants and clinicians under incomplete and heterogeneous data conditions. Yet most AI-driven approaches remain Alzheimer's disease (AD)-centric, framing the problem as binary AD detection or three-stage AD progression modeling within well-curated research settings. This pathology-driven paradigm overlooks the broader, syndrome-level nature of dementia, which spans multiple stages, phenotypes, and etiologies. In this paper, we propose Dementia-Agents, a clinically aligned multi-agent framework for real-world dementia staging and phenotyping. The framework follows a three-step workflow: (1) a data agent translates structured clinical records into semantically faithful textual representations that preserve missing-data signals and routes them to domain-aligned experts; (2) five fine-tuned expert agents generate domain-level predictions; and (3) a coordinator agent performs probabilistic aggregation to produce final staging and phenotyping decisions. We develop and evaluate Dementia-Agents on a real-world clinical cohort of 1,066 patients from two cognitive neurology services. Compared with monolithic multi-modal large language models (MLLMs) and prior medical multi-agent systems, our approach achieves consistent improvements in diagnostic performance for real-world syndrome-level dementia staging and phenotyping, while preserving domain-level interpretability.
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