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arXiv 2610.20191cs.AIcs.IR
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HEM-Med:用于安全多中心药物推荐的分层智能体记忆框架

HEM-Med: A Hierarchical Agentic Memory Framework for Safe Multi-Center Medication Recommendation

Key Laboratory of Computing Power Network and Information Security, Ministry of Education(教育部算力网络与信息安全重点实验室);Shandong Computer Science Center (National Supercomputer Center in Jinan)(山东省计算中心(国家超级计算济南中心));Qilu University of Technology (Shandong Academy of Sciences)(齐鲁工业大学(山东省科学院));Shandong Provincial Key Laboratory of Computing Power Internet and Service Computing(山东省算力互联网与服务计算重点实验室);Shandong Fundamental Research Center for Computer Science(山东省计算机科学基础研究中心);University of Technology Sydney(悉尼科技大学)

Min Xiao, Jin Li, Shoujin Wang, Yeguang Zhen, Yishuo Li, Wenpeng Lu

AI总结:

本文针对现有多中心药物推荐方法的两大缺口,提出HEM-Med分层智能体记忆框架,经多中心eICU数据集验证,其在推荐准确性和安全性上均优于多种基线方法。

摘要:

药物推荐(MR)对临床决策支持至关重要。现有MR方法大多针对单中心学习设计,仅涉及一家独立医院,而实际中对不同规模医院的多中心MR需求日益增长。在多中心场景下,大型医疗中心的丰富数据可提升低资源中心的推荐性能。尽管该任务已有少量初步尝试,但仍存在两个关键缺口:缺口1:现有多中心方法无法将可迁移的跨医院临床经验与医院特定处方模式解耦,限制了临床可行性和医师接受度;缺口2:它们通常忽略MR的多标签安全约束,包括药物相互作用风险和本地处方可行性,而这些是安全部署于实际场景的关键。为解决上述缺口,本文提出HEM-Med,一种用于多中心MR的新型分层智能体记忆框架。针对缺口1,设计了解耦的分层记忆模块,构建患者级药物情境归因记录,并将其解耦为跨医院经验记忆和医院特定残差记忆;针对缺口2,引入安全感知药物集生成模块,将双层级经验检索与安全感知集解码相结合,以生成临床相关、更安全且适配本地的药物推荐。在真实多中心eICU数据集上的实验表明,HEM-Med在推荐准确性和安全性方面均优于代表性的迁移学习、基于大语言模型(LLM)及MR的基线方法。

英文摘要:

Medication recommendation (MR) is critical for clinical decision support. While existing MR methods are mostly designed for single-center learning, where only one independent hospital is involved, multi-center MR with hospitals of different scales has become increasingly demanding in practice. In multi center settings, abundant data from large medical centers can improve recommendation performance for low-resource centers. Despite a few preliminary attempts on this task, two critical gaps remain. Gap 1: Existing multi-center methods fail to disentangle transferable cross-hospital clinical experience from hospital-specific prescribing patterns, limiting clinical feasibility and physician acceptance. Gap 2: They commonly overlook multi label safety constraints of MR, including drug-drug interaction risks and local formulary feasibility, which are essential for safe real-world deployment. To address these gaps, we propose HEM-Med, a novel hierarchical agentic memory framework for multi-center MR. To address Gap 1, we design a disentangled hierarchical memory module that builds patient-level medication context attribution records and disentangles them into cross hospital experience memory and hospital-specific residual memory. To address Gap 2, we introduce a safety-aware medication set generation module, which integrates dual-level experience retrieval with safety-aware set decoding to produce clinically relevant, safer, and locally adaptive medication recommendations. Experiments on a real-world multi-center eICU dataset show that HEM-Med outperforms representative transfer learning, LLM-based, and MR baselines in terms of both recommendation accuracy and safety.

机构、总结、中文摘要均由AI分析而来,可能存在错误,请以论文正文为准。

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