Multi-Agent Systems in Emergency Departments: Validation Study on a ED Digital Twin

Emergency departments (ED) face challenges in patient care and resource management. We propose to explore optimization strategies in a realistic and flexible model and develop a hybrid Discrete Event Simulation (DES) and Agent-Based Model (ABM) simulating highly configurable ED environments. We specifically focus on the validation of the modeling approach. We derive configurations for ED sizes, patient load, and staffing from real-world studies. We then validate the model expressivity by matching its key performance indicators and metrics with their values known from literature. We proceed by implementing scientifically established and practice-proven resource optimization strategies. Comparing the documented real-world outcomes with our model's results demonstrates that the DES-ABM based simulation can effectively replicate real-world ER dynamics under interventions. We lastly integrate a Proof-of-Concept multi-agent system (MAS) that can autonomously explore resource allocation strategies within the simulated ER environment based on a temporal ledger of ED event records. This modular DES-ABM-MAS framework offers a powerful tool to explore resource optimization strategies in emergency departments.

One Size Fits None: Rethinking Fairness in Medical AI

Machine learning (ML) models are increasingly used to support clinical decision-making. However, real-world medical datasets are often noisy, incomplete, and imbalanced, leading to performance disparities across patient subgroups. These differences raise fairness concerns, particularly when they reinforce existing disadvantages for marginalized groups. In this work, we analyze several medical prediction tasks and demonstrate how model performance varies with patient characteristics. While ML models may demonstrate good overall performance, we argue that subgroup-level evaluation is essential before integrating them into clinical workflows. By conducting a performance analysis at the subgroup level, differences can be clearly identified-allowing, on the one hand, for performance disparities to be considered in clinical practice, and on the other hand, for these insights to inform the responsible development of more effective models. Thereby, our work contributes to a practical discussion around the subgroup-sensitive development and deployment of medical ML models and the interconnectedness of fairness and transparency.