Development and validation of an autonomous artificial intelligence agent for clinical decision-making in oncology.

IF 28.5 1区 医学 Q1 ONCOLOGY
Dyke Ferber, Omar S M El Nahhas, Georg Wölflein, Isabella C Wiest, Jan Clusmann, Marie-Elisabeth Leßmann, Sebastian Foersch, Jacqueline Lammert, Maximilian Tschochohei, Dirk Jäger, Manuel Salto-Tellez, Nikolaus Schultz, Daniel Truhn, Jakob Nikolas Kather
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引用次数: 0

Abstract

Clinical decision-making in oncology is complex, requiring the integration of multimodal data and multidomain expertise. We developed and evaluated an autonomous clinical artificial intelligence (AI) agent leveraging GPT-4 with multimodal precision oncology tools to support personalized clinical decision-making. The system incorporates vision transformers for detecting microsatellite instability and KRAS and BRAF mutations from histopathology slides, MedSAM for radiological image segmentation and web-based search tools such as OncoKB, PubMed and Google. Evaluated on 20 realistic multimodal patient cases, the AI agent autonomously used appropriate tools with 87.5% accuracy, reached correct clinical conclusions in 91.0% of cases and accurately cited relevant oncology guidelines 75.5% of the time. Compared to GPT-4 alone, the integrated AI agent drastically improved decision-making accuracy from 30.3% to 87.2%. These findings demonstrate that integrating language models with precision oncology and search tools substantially enhances clinical accuracy, establishing a robust foundation for deploying AI-driven personalized oncology support systems.

用于肿瘤学临床决策的自主人工智能代理的开发和验证。
肿瘤学的临床决策是复杂的,需要整合多模式数据和多领域的专业知识。我们开发并评估了一种自主临床人工智能(AI)代理,利用GPT-4和多模态精确肿瘤学工具来支持个性化临床决策。该系统结合了用于检测微卫星不稳定性和组织病理学切片中KRAS和BRAF突变的视觉变压器,用于放射图像分割的MedSAM和基于网络的搜索工具,如OncoKB, PubMed和谷歌。对20例真实的多模式患者病例进行评估,AI代理自主使用合适的工具,准确率为87.5%,91.0%的病例得出正确的临床结论,75.5%的病例准确引用相关肿瘤学指南。与单独的GPT-4相比,集成的AI代理将决策准确率从30.3%大幅提高到87.2%。这些发现表明,将语言模型与精确肿瘤学和搜索工具相结合,大大提高了临床准确性,为部署人工智能驱动的个性化肿瘤学支持系统奠定了坚实的基础。
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来源期刊
Nature cancer
Nature cancer Medicine-Oncology
CiteScore
31.10
自引率
1.80%
发文量
129
期刊介绍: Cancer is a devastating disease responsible for millions of deaths worldwide. However, many of these deaths could be prevented with improved prevention and treatment strategies. To achieve this, it is crucial to focus on accurate diagnosis, effective treatment methods, and understanding the socioeconomic factors that influence cancer rates. Nature Cancer aims to serve as a unique platform for sharing the latest advancements in cancer research across various scientific fields, encompassing life sciences, physical sciences, applied sciences, and social sciences. The journal is particularly interested in fundamental research that enhances our understanding of tumor development and progression, as well as research that translates this knowledge into clinical applications through innovative diagnostic and therapeutic approaches. Additionally, Nature Cancer welcomes clinical studies that inform cancer diagnosis, treatment, and prevention, along with contributions exploring the societal impact of cancer on a global scale. In addition to publishing original research, Nature Cancer will feature Comments, Reviews, News & Views, Features, and Correspondence that hold significant value for the diverse field of cancer research.
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