Jeffrey Duda | Searcharxiv

arXiv2026

ETHOS: Towards a Modular Ethics Framework for Clinical Multi-Agent Systems

The rapid adoption of large language models has enabled the development of clinical multi-agent systems (MAS) capable of integrating multimodal patient data and supporting increasingly complex clinical decision-making. However, the deployment of these systems in real-world healthcare settings raises critical ethical concerns related to safety, fairness, accountability, transparency, and patient trust. While numerous organizations, including the World Health Organization, the National Academy of Medicine, and the FUTURE-AI consortium, have proposed ethical frameworks and governance principles for healthcare AI, these efforts remain largely conceptual. To address this challenge, we present ETHOS (Ethics and Trust through Hierarchical Oversight System), a modular ethics framework designed as a governance meta-agent that can be integrated with any existing multi-agent system without requiring changes to its underlying architecture. ETHOS translates stakeholder-informed ethical requirements into executable runtime oversight through a layered governance approach consisting of deterministic checks, contextual reviews, and a final ethics critic. These components continuously evaluate intermediate reasoning steps and final outputs, enabling the system to identify ethical risks, request revisions, or suppress responses that fail predefined safety and trustworthiness criteria. We demonstrate ETHOS within a hepatology clinical decision-support MAS. Results show that ETHOS improves decision reliability by detecting incomplete, inconsistent, or out-of-scope evidence and appropriately increasing abstention when safe recommendations cannot be supported. By embedding ethical governance directly into system operation, ETHOS provides a practical and auditable mechanism for transforming high-level AI ethics principles into deployable safeguards.

cs.MA↗

arXiv2022

SynthA1c: Towards Clinically Interpretable Patient Representations for Diabetes Risk Stratification

Early diagnosis of Type 2 Diabetes Mellitus (T2DM) is crucial to enable timely therapeutic interventions and lifestyle modifications. As the time available for clinical office visits shortens and medical imaging data become more widely available, patient image data could be used to opportunistically identify patients for additional T2DM diagnostic workup by physicians. We investigated whether image-derived phenotypic data could be leveraged in tabular learning classifier models to predict T2DM risk in an automated fashion to flag high-risk patients without the need for additional blood laboratory measurements. In contrast to traditional binary classifiers, we leverage neural networks and decision tree models to represent patient data as 'SynthA1c' latent variables, which mimic blood hemoglobin A1c empirical lab measurements, that achieve sensitivities as high as 87.6%. To evaluate how SynthA1c models may generalize to other patient populations, we introduce a novel generalizable metric that uses vanilla data augmentation techniques to predict model performance on input out-of-domain covariates. We show that image-derived phenotypes and physical examination data together can accurately predict diabetes risk as a means of opportunistic risk stratification enabled by artificial intelligence and medical imaging. Our code is available at https://github.com/allisonjchae/DMT2RiskAssessment.

cs.LG↗