Autonomous Agents for Auditable Cardiovascular Artificial Intelligence Development

Figures

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  Fig. 1 |. Study design. Abbreviations: AUROC, area under the receiver operating characteristic curve; CNN, convolutional neural network.

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  Fig. 2 |. Performance gains across native and cross-institution validation. (a) Yale 12-lead signal model and (b) EchoNext-mini. Each bar is labelled with its AUROC and 95% CI; the gain over baseline and its p value are shown within each agent bar. Abbreviations: AUROC, area under the receiver operating characteristic curve; CI, confidence interval.

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  Fig. 3 |. The agentic search process (Yale model). (a) Best-so-far validation score over successive experiments for the Iteration Agent, which follows a single improving trajectory. (b) Lineage tree of the Evolution Agent, in which many variants branch from the shared seed and high-performing lineages are explored preferentially; node colour shows validation AUROC and the highlighted path marks the best lineage. Abbreviations: AUROC, area under the receiver operating characteristic curve.

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  Fig. 4 |. Code modifications by the agents. (a, b) Percentage of accepted variants that modified each pipeline axis, for the Iteration and Evolution agents on the (a) Yale model and (b) EchoNext-mini. (c) Recurring modifications across the four agent-by-model runs; each cell label is the number of variants that explored a motif and, in parentheses, the number retained as improving, with marker size showing the number explored and colour the number retained, separated by an architectural-versus-recipe divider. Abbreviations: EMA, exponential moving average; LR, learning rate; SE, squeeze-and-excite; TTA, test-time augmentation.

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  Fig. 5 |. Code novelty. (a, b) Validation AUROC, on a common axis, versus each candidate’s code divergence from its own agen’s starting point (1 minus cosine similarity), for the (a) Yale 12-lead signal model and (b) EchoNext-mini; (c, d) Distribution of divergence from each model’s starting point. Abbreviations: AUROC, area under the receiver operating characteristic curve; IQR, interquartile range.