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arXiv 最近完成扫描:2026-11-12 18:21 · 全站最近入库:2026-11-12 06:37各信源进度 →

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版本更新 · v2arXiv:2609.37022

Physics-Informed Multi-Agent Coordination for Hospital Patient Flow Optimization

Guoqing Zhang, Rafik Hadfi, Takayuki Ito

原文摘要

Efficient patient flow coordination across autonomous hospital departments is critical for mitigating overcrowding and balancing resource utilization. While classical queueing theory, specifically open Baskett--Chandy--Muntz--Palacios (BCMP) networks, provides an interpretable mathematical topology for healthcare operations, analytical models rely on stationary assumptions and fixed routing matrices that degrade under state-dependent real-world dynamics. Conversely, centralized reinforcement learning approaches struggle to accommodate the decentralized structure of hospital governance, where individual clinical departments function with localized observations, heterogeneous resources, and divergent operational objectives. In this paper, we present a Multi-Agent Systems (MAS) framework titled \emph{Physics-Informed Multi-Agent Coordination}, which embeds empirically calibrated BCMP queueing topologies as physical priors within a decentralized multi-agent reinforcement learning architecture. Formulated as a Decentralized Partially Observable Markov Decision Process (Dec-POMDP) under coupled resource constraints, our method enables autonomous departmental agents to cooperatively negotiate patient routing and dynamic service scaling. To mitigate environmental non-stationarity without inducing excessive communication overhead, agents exchange localized action fingerprints along network edges and optimize a spatially decomposed reward structure. Empirical evaluations driven by real-world MIMIC-IV patient trajectories indicate that this cooperative multi-agent approach substantially reduces cumulative system delay compared to static Markovian approximations, heuristic dispatching, and independent multi-agent baselines, while maintaining clinical safety constraints.

cs.AI · cs.MA

新论文 · v1arXiv:2611.11960

Operation-aware Multimodal Clinical Decision Support System for ICU Discharge Risk Assessment

Guoqing Zhang, Rafik Hadfi, Takayuki Ito

原文摘要

Unplanned 30-day intensive care unit (ICU) readmission is a critical benchmark for evaluating healthcare quality. Most predictive models assume readmission risk depends solely on a patient's individual pathophysiological state, ignoring hospital operational context and resource capacity. In practice, discharge decisions are dynamic trade-offs between patient stability and bed turnover pressures. To address this gap, we develop an Operation-aware Multimodal Clinical Decision Support System (CDSS) for ICU discharge risk assessment. The system combines multi-agent collaborative extraction with self-evolving retrieval-augmented generation (RAG) to eliminate template noise from progress notes, while constructing departmental workload indicators alongside admission flow features, continuous vital signs, and sparse medical codes (ICD/DRG). Addressing severe class imbalance (about 10.5% readmissions) and alarm fatigue, we implement data normalization, class reweighting, and decision-threshold calibration. In 20 independent runs across 20,000 ICU stays from MIMIC-III, empirical findings demonstrate that: vital signs alone have limited predictive capacity under real-world class imbalance (PR-AUC of 0.1387 +/- 0.0086); directly concatenating raw text embeddings degrades decision tree performance (XGBoost and LightGBM PR-AUC drop to 0.3893 and 0.4030); whereas an end-to-end multimodal fine-tuning architecture (Transformer E2E FineTune) utilizing layer-wise parameter freezing and differential learning rates reverses text negative transfer, achieving the highest AUROC of 0.8288 +/- 0.0110, PR-AUC of 0.4373 +/- 0.0310, and F1-Score of 0.4757 +/- 0.0196. Operational indicators supply independent risk signals, laying an engineering foundation for high-utility clinical decision support tools.

cs.LG