ProtoMedAgent: Multimodal Clinical Interpretability via Privacy-Aware Agentic Workflows

• URL: http://arxiv.org/abs/2605.14113v1
• Date: Wed, 13 May 2026 20:57:37 GMT
• Title: ProtoMedAgent: Multimodal Clinical Interpretability via Privacy-Aware Agentic Workflows
• Abstract summary: ProtoMedAgent formalizes multimodal clinical reporting as an iterative, zero-gradient test-time optimization problem.<n>Online generation is strictly constrained by exact set-theoretic differentials and a reflective Scribe-Critic loop.<n>ProtoMedAgent achieves 91.2% Comparison Set Faithfulness where it fundamentally outperforms standard RAG (46.2%)
• Score: 7.27267618572654
• License: http://creativecommons.org/licenses/by/4.0/
• Abstract: 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\%.

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