Evidence map›Paper›PMID 41571772›Full record

ArticleNPJ digital medicine2026

Early diagnosis of axial spondyloarthritis in primary care using multi-agent systems.

Xiaojian Ji, Zhuofeng Li, Lulu Zeng, Lidong Hu, Yanyan Wang, Kui Zhang, Lianjie Shi, Meng Wei, Lifeng Chen, Lin Guo and 14 more

Abstract read
In one paragraph

Article in NPJ digital medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Xiaojian Ji *Department of Rheumatology and Immunology, the First Medical Center, Chinese PLA General Hospital, Beijing, China.ORCID http://orcid.org/0000-0003-4753-191X
Zhuofeng Li *Bioinformatics Division, Department of Automation, BNRIST and MOE Key Lab of Bioinformatics, Tsinghua University, Beijing, China.ORCID http://orcid.org/0009-0008-2781-6698
Lulu Zeng *Department of Rheumatology and Immunology, the First Medical Center, Chinese PLA General Hospital, Beijing, China.ORCID http://orcid.org/0009-0002-3132-8589
Lidong HuDepartment of Rheumatology and Immunology, the First Medical Center, Chinese PLA General Hospital, Beijing, China.ORCID http://orcid.org/0000-0001-5004-187X
Yanyan WangDepartment of Rheumatology and Immunology, Beijing Electric Power Hospital, Beijing, China.ORCID http://orcid.org/0000-0002-9665-9832
Kui ZhangDepartment of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.ORCID http://orcid.org/0000-0002-5578-0142
Lianjie ShiDepartment of Rheumatology and Immunology, Peking University Shougang Hospital, Beijing, China.ORCID http://orcid.org/0000-0001-8882-8870
Meng WeiDepartment of Rheumatology and Immunology, General Hospital of Western Theater Command, Chengdu, China.ORCID http://orcid.org/0000-0002-4142-6230
Lifeng ChenDepartment of Rheumatology and Immunology, General Hospital of Central Theater Command, Wuhan, China.ORCID http://orcid.org/0000-0003-0035-5605
Lin GuoDepartment of Rheumatology and Immunology, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, Liaoning, China.ORCID http://orcid.org/0009-0009-4538-5366
Jing DongDepartment of Medical Innovation Research, Chinese PLA General Hospital, Beijing, China.ORCID http://orcid.org/0000-0001-6294-9535
An'an WangDepartment of Medical Innovation Research, Chinese PLA General Hospital, Beijing, China.ORCID http://orcid.org/0009-0005-2325-2918
Lei SunDepartment of Medical Innovation Research, Chinese PLA General Hospital, Beijing, China.ORCID http://orcid.org/0009-0005-9154-7558
Yimin SongDepartment of Medical Innovation Research, Chinese PLA General Hospital, Beijing, China.ORCID http://orcid.org/0009-0005-5646-8387
Huatao WangDepartment of Medical Innovation Research, Chinese PLA General Hospital, Beijing, China.ORCID http://orcid.org/0009-0005-5894-9221
Jingming WangDepartment of Medical Innovation Research, Chinese PLA General Hospital, Beijing, China.ORCID http://orcid.org/0009-0003-2777-3855
Ying LeiDepartment of Medical Innovation Research, Chinese PLA General Hospital, Beijing, China.ORCID http://orcid.org/0009-0002-4345-0151
Wenqian YueDepartment of Medical Innovation Research, Chinese PLA General Hospital, Beijing, China.ORCID http://orcid.org/0009-0006-7875-0575
Zheng ZhaoDepartment of Rheumatology and Immunology, the First Medical Center, Chinese PLA General Hospital, Beijing, China.ORCID http://orcid.org/0000-0002-7391-4001
Jian ZhuDepartment of Rheumatology and Immunology, the First Medical Center, Chinese PLA General Hospital, Beijing, China.ORCID http://orcid.org/0000-0002-6244-9917
Feng HuangDepartment of Rheumatology and Immunology, the First Medical Center, Chinese PLA General Hospital, Beijing, China.ORCID http://orcid.org/0000-0002-2319-873X
Jing ZhangBioinformatics Division, Department of Automation, BNRIST and MOE Key Lab of Bioinformatics, Tsinghua University, Beijing, China. 28820327@qq.com.ORCID http://orcid.org/0009-0008-2070-5768
Tao LiDepartment of Medical Innovation Research, Chinese PLA General Hospital, Beijing, China. litao30lhospital@163.com.ORCID http://orcid.org/0009-0001-8013-8282
Kunpeng LiDepartment of Rheumatology and Immunology, the First Medical Center, Chinese PLA General Hospital, Beijing, China. lkp_01@163.com.ORCID http://orcid.org/0000-0003-3822-6198

Funding

Beijing Natural Science Foundation-Haidian Original Innovation Joint Fund L242143National Key Research and Development Program of China 2021ZD0140409Youth Independent Innovation Science Fund Project of Chinese PLA General Hospital 22QNFC139
6 · The paper itself

Abstract

Axial spondyloarthritis (axSpA) is an inflammatory disease marked by chronic low back pain, with a global average diagnostic delay of 6.7 years. Early diagnosis is crucial for improving prognosis and reducing disability rates, yet primary care physicians (PCPs) may find it challenging to ensure timely recognition and referrals. This study developed and validated Spondyloarthritis Agents (SpAgents), an early diagnostic system based on a multi-agent framework integrating large language models (LLMs) and imaging models. The SpAgents framework includes PlannerAgent, DataAgent, ToolAgent, and DoctorAgent, supported by long-term memory for dynamic knowledge updates. We enrolled 596 patients, dividing 545 from one hospital into a training dataset (n = 359) and a validation dataset (n = 186), along with an independent cohort of 51 patients from five additional hospitals for testing. SpAgents demonstrated strong diagnostic performance, achieving sensitivity of 0.8615 and specificity of 0.8000 during validation, and 0.9375 and 0.7368 during testing. SpAgents exhibited significantly higher sensitivity (0.9400) and accuracy (0.8600) than both PCPs and junior rheumatologists, with overall performance equivalent to that of senior rheumatologists. Under SpAgents-assisted diagnosis, both PCPs and junior rheumatologists showed marked improvements in sensitivity and accuracy. SpAgents effectively enhance early axSpA identification among PCPs, offering an innovative solution to reduce diagnostic delays.

Identifiers

PMID41571772
PMCPMC12923722

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.