# AKIBoards: A Structure-Following Multiagent System for Predicting Acute Kidney Injury

arXiv: https://arxiv.org/abs/2504.20368 · HTML: https://mlsanity.com/paper/2504.20368/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 11 of its 25 references that are in the map.
- First posted on arXiv 29 Apr 2025.

## Builds on (most cited first, 11 of 11)

- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [Distilling the Knowledge in a Neural Network](https://mlsanity.com/paper/1503.02531/) (2015)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [A Unified Approach to Interpreting Model Predictions](https://mlsanity.com/paper/1705.07874/) (2017)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [Qwen2.5 Technical Report](https://mlsanity.com/paper/2412.15115/) (2024)
- [QLoRA: Efficient Finetuning of Quantized LLMs](https://mlsanity.com/paper/2305.14314/) (2023)
- [Phi-4 Technical Report](https://mlsanity.com/paper/2412.08905/) (2024)
- [TabLLM: Few-shot Classification of Tabular Data with Large Language Models](https://mlsanity.com/paper/2210.10723/) (2022)
- [A Simple and Effective Model-Based Variable Importance Measure](https://mlsanity.com/paper/1805.04755/) (2018)
- [Automated Dynamic Bayesian Networks for Predicting Acute Kidney Injury Before Onset](https://mlsanity.com/paper/2304.10175/) (2023)

## Abstract (arXiv)

Diagnostic reasoning entails a physician's local (mental) model based on an assumed or known shared perspective (global model) to explain patient observations with evidence assigned towards a clinical assessment. But in several (complex) medical situations, multiple experts work together as a team to optimize health evaluation and decision-making by leveraging different perspectives. Such consensus-driven reasoning reflects individual knowledge contributing toward a broader perspective on the patient. In this light, we introduce STRUCture-following for Multiagent Systems (STRUC-MAS), a framework automating the learning of these global models and their incorporation as prior beliefs for agents in multiagent systems (MAS) to follow. We demonstrate proof of concept with a prosocial MAS application for predicting acute kidney injuries (AKIs). In this case, we found that incorporating a global structure enabled multiple agents to achieve better performance (average precision, AP) in predicting AKI 48 hours before onset (structure-following-fine-tuned, SF-FT, AP=0.195; SF-FT-retrieval-augmented generation, SF-FT-RAG, AP=0.194) vs. baseline (non-structure-following-FT, NSF-FT, AP=0.141; NSF-FT-RAG, AP=0.180) for balanced precision-weighted-recall-weighted voting. Markedly, SF-FT agents with higher recall scores reported lower confidence levels in the initial round on true positive and false negative cases. But after explicit interactions, their confidence in their decisions increased (suggesting reinforced belief). In contrast, the SF-FT agent with the lowest recall decreased its confidence in true positive and false negative cases (suggesting a new belief). This approach suggests that learning and leveraging global structures in MAS is necessary prior to achieving competitive classification and diagnostic reasoning performance.