ProtoMedAgent: Multimodal Clinical Interpretability via Privacy-Aware Agentic Workflows

Fuente: arXiv
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Main Authors: Pellicer, Alvaro Lopez, Angelov, Plamen, Bukhari, Marwan, Li, Yi, Soares, Eduardo, Kerns, Jemma
Format: Preprint
Published: 2026
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author Pellicer, Alvaro Lopez
Angelov, Plamen
Bukhari, Marwan
Li, Yi
Soares, Eduardo
Kerns, Jemma
author_facet Pellicer, Alvaro Lopez
Angelov, Plamen
Bukhari, Marwan
Li, Yi
Soares, Eduardo
Kerns, Jemma
contents While interpretable prototype networks offer compelling case-based reasoning for clinical diagnostics, their raw continuous outputs lack the semantic structure required for medical documentation. Bridging this gap via standard Retrieval-Augmented Generation (RAG) routinely triggers ``retrieval sycophancy,'' where Large Language Models (LLMs) hallucinate post-hoc rationalizations to align with visual predictions. We introduce ProtoMedAgent, a framework that formalizes multimodal clinical reporting as an iterative, zero-gradient test-time optimization problem over a strict neuro-symbolic bottleneck. Operating on a frozen prototype backbone, we distill latent visual and tabular features into a discrete semantic memory. Online generation is strictly constrained by exact set-theoretic differentials and a reflective Scribe-Critic loop, mathematically precluding unsupported narrative claims. To safely bound data disclosure, we introduce a semantic privacy gate governed by $k$-anonymity and $\ell$-diversity. Evaluated on a 4,160-patient clinical cohort, ProtoMedAgent achieves 91.2% Comparison Set Faithfulness where it fundamentally outperforms standard RAG (46.2%). ProtoMedAgent additionally leverages a binding $\ell$-diversity phase transition to systematically reduce artifact-level membership inference risks by an absolute 9.8%.
format Preprint
id arxiv_https___arxiv_org_abs_2605_14113
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle ProtoMedAgent: Multimodal Clinical Interpretability via Privacy-Aware Agentic Workflows
Pellicer, Alvaro Lopez
Angelov, Plamen
Bukhari, Marwan
Li, Yi
Soares, Eduardo
Kerns, Jemma
Computer Vision and Pattern Recognition
Artificial Intelligence
Machine Learning
Multiagent Systems
While interpretable prototype networks offer compelling case-based reasoning for clinical diagnostics, their raw continuous outputs lack the semantic structure required for medical documentation. Bridging this gap via standard Retrieval-Augmented Generation (RAG) routinely triggers ``retrieval sycophancy,'' where Large Language Models (LLMs) hallucinate post-hoc rationalizations to align with visual predictions. We introduce ProtoMedAgent, a framework that formalizes multimodal clinical reporting as an iterative, zero-gradient test-time optimization problem over a strict neuro-symbolic bottleneck. Operating on a frozen prototype backbone, we distill latent visual and tabular features into a discrete semantic memory. Online generation is strictly constrained by exact set-theoretic differentials and a reflective Scribe-Critic loop, mathematically precluding unsupported narrative claims. To safely bound data disclosure, we introduce a semantic privacy gate governed by $k$-anonymity and $\ell$-diversity. Evaluated on a 4,160-patient clinical cohort, ProtoMedAgent achieves 91.2% Comparison Set Faithfulness where it fundamentally outperforms standard RAG (46.2%). ProtoMedAgent additionally leverages a binding $\ell$-diversity phase transition to systematically reduce artifact-level membership inference risks by an absolute 9.8%.
title ProtoMedAgent: Multimodal Clinical Interpretability via Privacy-Aware Agentic Workflows
topic Computer Vision and Pattern Recognition
Artificial Intelligence
Machine Learning
Multiagent Systems
url https://arxiv.org/abs/2605.14113