Search arXivSearch

arXiv · 2408.07531

Development of a Large Language Model-based Multi-Agent Clinical Decision Support System for Korean Triage and Acuity Scale (KTAS)-Based Triage and Treatment Planning in Emergency Departments

Abstract

Emergency department (ED) overcrowding and the complexity of rapid decision-making in critical care settings pose significant challenges to healthcare systems worldwide. While clinical decision support systems (CDSS) have shown promise, the integration of large language models (LLMs) offers new possibilities for enhancing triage accuracy and clinical decision-making. This study presents an LLM-driven CDSS designed to assist ED physicians and nurses in patient triage, treatment planning, and overall emergency care management. We developed a multi-agent CDSS utilizing Llama-3-70b as the base LLM, orchestrated by CrewAI and Langchain. The system comprises four AI agents emulating key ED roles: Triage Nurse, Emergency Physician, Pharmacist, and ED Coordinator. It incorporates the Korean Triage and Acuity Scale (KTAS) for triage assessment and integrates with the RxNorm API for medication management. The model was evaluated using the Asclepius dataset, with performance assessed by a clinical emergency medicine specialist. The CDSS demonstrated high accuracy in triage decision-making compared to the baseline of a single-agent system. Furthermore, the system exhibited strong performance in critical areas, including primary diagnosis, critical findings identification, disposition decision-making, treatment planning, and resource allocation. Our multi-agent CDSS demonstrates significant potential for supporting comprehensive emergency care management. By leveraging state-of-the-art AI technologies, this system offers a scalable and adaptable tool that could enhance emergency medical care delivery, potentially alleviating ED overcrowding and improving patient outcomes. This work contributes to the growing field of AI applications in emergency medicine and offers a promising direction for future research and clinical implementation.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Seungjun Han, Wongyung Choi. 2024-08-27. Development of a Large Language Model-based Multi-Agent Clinical Decision Support System for Korean Triage and Acuity Scale (KTAS)-Based Triage and Treatment Planning in Emergency Departments. https://arxiv.org/abs/2408.07531

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

Small Language Models are the Future of Agentic AI

Large language models (LLMs) are often praised for exhibiting near-human performance on a wide range of tasks and valued for their ability to hold a general conversation. The rise of agentic AI systems is, however, ushering in a mass of applications in which language models perform a small number of specialized tasks repetitively and with little variation. Here we lay out the position that small language models (SLMs) are sufficiently powerful, inherently more suitable, and necessarily more economical for many invocations in agentic systems, and are therefore the future of agentic AI. Our argumentation is grounded in the current level of capabilities exhibited by SLMs, the common architectures of agentic systems, and the economy of LM deployment. We further argue that in situations where general-purpose conversational abilities are essential, heterogeneous agentic systems (i.e., agents invoking multiple different models) are the natural choice. We discuss the potential barriers for the adoption of SLMs in agentic systems and outline a general LLM-to-SLM agent conversion algorithm. Our position, formulated as a value statement, highlights the significance of the operational and economic impact even a partial shift from LLMs to SLMs is to have on the AI agent industry. We aim to stimulate the discussion on the effective use of AI resources and hope to advance the efforts to lower the costs of AI of the present day. Calling for both contributions to and critique of our position, we commit to publishing all such correspondence at https://research.nvidia.com/labs/lpr/slm-agents.

cs.AI

EndoCogniAgent: Closed-Loop Agentic Reasoning with Self-Consistency Validation for Endoscopic Diagnosis

Endoscopic diagnosis is an iterative process in which clinicians acquire, compare, and verify local visual evidence before reaching a conclusion. Current AI systems do not adequately support this process because fine-grained evidence acquisition and multi-step reasoning remain weakly coupled, complicating reconciliation of image-derived findings with their textual interpretations. This gives rise to two failure modes, hallucinated evidence and uncorrected error accumulation, that undermine diagnostic reliability. We propose EndoCogniAgent, a closed-loop agentic framework that formulates endoscopic diagnosis as a controlled state update process for integrating complementary visual and textual evidence. At each reasoning round, a central planner selects an evidence acquisition action, specialized expert tools extract spatial and semantic observations as structured textual evidence, and a self-consistency validation mechanism examines this evidence along two dimensions, knowledge consistency against the input image and temporal consistency with prior validated findings, before updating the diagnostic state. Validated observations are admitted into the evolving state to condition subsequent planning, while insufficiently supported or conflicting findings are retained with corrective feedback that redirects the planner toward additional verification. We further introduce EndoAgentBench, a workflow-oriented benchmark comprising 6,132 question-answer pairs from 11 endoscopic datasets, to evaluate diagnostic agents across a comprehensive diagnostic chain, from fine-grained visual perception to high-level diagnostic reasoning. EndoCogniAgent achieves 85.23% overall accuracy on perception tasks and 71.13% clinical acceptance rate on reasoning tasks. Blinded clinician evaluation further shows consistent improvements in diagnostic response quality over the evaluated baselines.

cs.AI

Ultra Strong Machine Learning: LLM-Generated Explanations Do Not Yet Suffice for Teaching Humans Active Learning Strategy

Active learning is a general learning mechanism shared by artificial and human learners. Whether AI can teach humans such a strategy that transfers across domains is an open question. Ultra Strong Machine Learning (USML), a system whose explanations quantifiably improve human out-of-sample performance compared to self-learning, is uniquely positioned to answer this question. Prior USML work relied on hand-crafted explanation templates that require expert effort for each new domain and do not scale. We developed an explanation pipeline combining Inductive Logic Programming (ILP) with large language models (LLMs) to automate explanation generation and scoring. We tested whether these explanations achieve USML in a human trial teaching active learning strategies across three related domains. Our exploratory results show that concise, expert-written explanations benefit learners with higher initial performance, while pipeline-generated explanations provide no advantage over self-learning despite being rated as higher quality from an LLM-as-judge evaluation. This case study reveals a systematic gap that LLM quality metrics do not predict human learning outcomes. Our findings point to explanation complexity relative to task difficulty as a key factor, and call for explanation methods and evaluation criteria grounded in human cognitive constraints rather than LLM preference.

cs.AI