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c0fff99 | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 | """
Devil's Advocate agent: adversarial challenge to the working diagnosis.
Deliberately contrarian — focuses on must-not-miss diagnoses.
Uses MedGemma 4B (multimodal) to independently examine the image.
Outputs structured JSON.
"""
import json
import logging
from collections.abc import Mapping
from agents.state import PipelineState
from agents.prompts import DEVIL_ADVOCATE_SYSTEM, DEVIL_ADVOCATE_USER
from agents.output_parser import parse_json_response
from models import medgemma_client
logger = logging.getLogger(__name__)
_DA_SCHEMA_KEYS = ("challenges", "must_not_miss", "recommended_workup")
_DA_WRAPPER_KEYS = (
"devils_advocate_output",
"devil_advocate_output",
"devil_advocate",
"output",
"response",
"result",
"data",
)
_DA_SYNONYMS: dict[str, str] = {
# must-not-miss
"must_not_miss_diagnoses": "must_not_miss",
"must_not_miss_differentials": "must_not_miss",
"dangerous_alternatives": "must_not_miss",
"critical_differentials": "must_not_miss",
# workup
"workup": "recommended_workup",
"recommended_tests": "recommended_workup",
"recommended_actions": "recommended_workup",
"next_steps": "recommended_workup",
# challenges
"challenge": "challenges",
"concerns": "challenges",
"counterarguments": "challenges",
}
def _format_bias_summary(bias_out: dict) -> str:
"""Format bias detector output for the Devil's Advocate prompt."""
parts = []
if bias_out.get("discrepancy_summary"):
parts.append(bias_out["discrepancy_summary"])
for b in bias_out.get("identified_biases", []):
parts.append(f"- {b.get('type', 'unknown')}: {b.get('evidence', '')} (severity: {b.get('severity', '?')})")
if bias_out.get("missed_findings"):
parts.append("Missed findings: " + ", ".join(bias_out["missed_findings"]))
return "\n".join(parts) if parts else "No bias analysis available."
def _unwrap_da_payload(parsed: dict) -> dict:
"""Unwrap common container shapes: {"output": {...}}, {"result": {...}}, etc."""
if any(k in parsed for k in _DA_SCHEMA_KEYS):
return parsed
for key in _DA_WRAPPER_KEYS:
inner = parsed.get(key)
if isinstance(inner, Mapping) and any(k in inner for k in _DA_SCHEMA_KEYS):
return dict(inner)
# If there's a single nested object, unwrap it if it contains DA keys.
if len(parsed) == 1:
only_value = next(iter(parsed.values()))
if isinstance(only_value, Mapping) and any(k in only_value for k in _DA_SCHEMA_KEYS):
return dict(only_value)
# One-level scan for any nested object that contains DA keys.
for value in parsed.values():
if isinstance(value, Mapping) and any(k in value for k in _DA_SCHEMA_KEYS):
return dict(value)
return parsed
def _coerce_da_schema(parsed: dict) -> dict:
"""Best-effort normalization when the model returns an unexpected top-level JSON shape."""
if not isinstance(parsed, dict):
return {}
parsed = _unwrap_da_payload(parsed)
if not isinstance(parsed, dict):
return {}
# Map common synonym keys onto the expected schema.
coerced = dict(parsed)
for src, dst in _DA_SYNONYMS.items():
if src in coerced and dst not in coerced:
coerced[dst] = coerced[src]
if any(k in coerced for k in _DA_SCHEMA_KEYS):
return coerced
items = coerced.get("items")
if not isinstance(items, list) or not items:
return coerced
# If the model returned just a list of strings, treat it as a workup list.
if all(isinstance(x, str) for x in items):
return {"recommended_workup": items}
dict_items = [x for x in items if isinstance(x, dict)]
if len(dict_items) != len(items):
return parsed
keys: set[str] = set()
for d in dict_items[:5]:
keys.update(d.keys())
if "claim" in keys or "counter_evidence" in keys:
return {"challenges": dict_items}
if {"why_dangerous", "supporting_signs", "rule_out_test"} & keys or "diagnosis" in keys:
return {"must_not_miss": dict_items}
return coerced
def _normalize_challenges(value: object) -> list[dict[str, str]]:
if value is None:
return []
items = [value] if isinstance(value, Mapping) else value
if isinstance(items, str):
s = items.strip()
return [{"claim": s, "counter_evidence": ""}] if s else []
if not isinstance(items, list):
return []
out: list[dict[str, str]] = []
for item in items:
if item is None:
continue
if isinstance(item, Mapping):
d = dict(item)
claim = str(d.get("claim") or d.get("challenge") or d.get("concern") or "").strip()
counter = str(
d.get("counter_evidence")
or d.get("counterevidence")
or d.get("counter_argument")
or d.get("counterargument")
or d.get("counter")
or d.get("evidence_against")
or ""
).strip()
if claim or counter:
out.append({"claim": claim, "counter_evidence": counter})
continue
s = str(item).strip()
if s:
out.append({"claim": s, "counter_evidence": ""})
return out
def _normalize_must_not_miss(value: object) -> list[dict[str, str]]:
if value is None:
return []
items = [value] if isinstance(value, Mapping) else value
if isinstance(items, str):
s = items.strip()
return [{"diagnosis": s}] if s else []
if not isinstance(items, list):
return []
out: list[dict[str, str]] = []
for item in items:
if item is None:
continue
if isinstance(item, Mapping):
d = dict(item)
diagnosis = str(d.get("diagnosis") or d.get("dx") or d.get("differential") or "").strip()
why = str(d.get("why_dangerous") or d.get("why") or d.get("danger") or "").strip()
signs = str(d.get("supporting_signs") or d.get("evidence") or d.get("support") or "").strip()
test = str(d.get("rule_out_test") or d.get("test") or d.get("rule_out") or "").strip()
if diagnosis or why or signs or test:
out.append(
{
"diagnosis": diagnosis,
"why_dangerous": why,
"supporting_signs": signs,
"rule_out_test": test,
}
)
continue
s = str(item).strip()
if s:
out.append({"diagnosis": s})
return out
def run(state: PipelineState) -> PipelineState:
"""Run the Devil's Advocate agent."""
state["current_step"] = "devil_advocate"
clinical = state["clinical_input"]
diag_out = state.get("diagnostician_output")
bias_out = state.get("bias_detector_output")
image = clinical.get("image")
if diag_out is None or bias_out is None:
state["error"] = "Missing upstream agent outputs."
return state
if image is None:
state["error"] = "No image provided for Devil's Advocate."
return state
try:
diagnostician_analysis = diag_out.get("analysis") or diag_out.get("findings", "")
prompt = DEVIL_ADVOCATE_USER.format(
doctor_diagnosis=clinical["doctor_diagnosis"],
clinical_context=clinical["clinical_context"],
diagnostician_findings=diagnostician_analysis,
bias_summary=_format_bias_summary(bias_out),
)
system_prompt = DEVIL_ADVOCATE_SYSTEM
raw = medgemma_client.generate_with_image(prompt, image, system_prompt=system_prompt)
parsed = _coerce_da_schema(parse_json_response(raw))
challenges = _normalize_challenges(parsed.get("challenges"))
must_not_miss = _normalize_must_not_miss(parsed.get("must_not_miss"))
workup_raw = parsed.get("recommended_workup", [])
normalized_workup: list[str] = []
if isinstance(workup_raw, str):
# Split a single workup string into bullet-like entries.
workup_raw = [x.strip(" -\t") for x in workup_raw.replace(";", "\n").splitlines()]
if isinstance(workup_raw, Mapping):
workup_raw = [dict(workup_raw)]
if isinstance(workup_raw, list):
for item in workup_raw:
if item is None:
continue
if isinstance(item, str):
s = item.strip()
elif isinstance(item, dict):
s = str(
item.get("test")
or item.get("name")
or item.get("action")
or item.get("workup")
or ""
).strip()
if not s:
s = json.dumps(item, ensure_ascii=False)
else:
s = str(item).strip()
if s:
normalized_workup.append(s)
# Deduplicate while preserving order.
normalized_workup = list(dict.fromkeys(normalized_workup))
# If the model returned an empty schema, retry once with a stricter instruction.
if not (challenges or must_not_miss or normalized_workup):
logger.warning("Devil's Advocate produced empty structured output; retrying once.")
strict_system = (
DEVIL_ADVOCATE_SYSTEM
+ "\n\nIMPORTANT: Do not return empty arrays. Provide at least 1 item in each list, "
+ "even if you must express uncertainty and suggest rule-out testing."
)
raw_retry = medgemma_client.generate_with_image(prompt, image, system_prompt=strict_system)
parsed_retry = _coerce_da_schema(parse_json_response(raw_retry))
challenges = _normalize_challenges(parsed_retry.get("challenges"))
must_not_miss = _normalize_must_not_miss(parsed_retry.get("must_not_miss"))
workup_retry = parsed_retry.get("recommended_workup", [])
normalized_workup = []
if isinstance(workup_retry, str):
workup_retry = [x.strip(" -\t") for x in workup_retry.replace(";", "\n").splitlines()]
if isinstance(workup_retry, Mapping):
workup_retry = [dict(workup_retry)]
if isinstance(workup_retry, list):
for item in workup_retry:
if item is None:
continue
if isinstance(item, str):
s = item.strip()
elif isinstance(item, dict):
s = str(
item.get("test")
or item.get("name")
or item.get("action")
or item.get("workup")
or ""
).strip()
if not s:
s = json.dumps(item, ensure_ascii=False)
else:
s = str(item).strip()
if s:
normalized_workup.append(s)
normalized_workup = list(dict.fromkeys(normalized_workup))
state["devils_advocate_output"] = {
"challenges": challenges,
"must_not_miss": must_not_miss,
"recommended_workup": normalized_workup,
}
except Exception as e:
logger.exception("Devil's Advocate agent failed")
state["error"] = f"Devil's Advocate error: {e}"
return state
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