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@ARTICLE{Ferber:301910,
author = {D. Ferber and O. S. M. El Nahhas and G. Wölflein and I. C.
Wiest and J. Clusmann and M.-E. Leßmann and S. Foersch and
J. Lammert$^*$ and M. Tschochohei and D. Jäger and M.
Salto-Tellez and N. Schultz and D. Truhn and J. N. Kather},
title = {{D}evelopment and validation of an autonomous artificial
intelligence agent for clinical decision-making in
oncology.},
journal = {Nature cancer},
volume = {6},
number = {8},
issn = {2662-1347},
address = {London},
publisher = {Nature Research},
reportid = {DKFZ-2025-01180},
pages = {1337-1349},
year = {2025},
note = {2025 Aug;6(8):1337-1349},
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.},
cin = {MU01},
ddc = {610},
cid = {I:(DE-He78)MU01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:40481323},
doi = {10.1038/s43018-025-00991-6},
url = {https://inrepo02.dkfz.de/record/301910},
}