Ovarian tumour management has increasingly relied on multidisciplinary tumour board (MDT) deliberation to address treatment complexity and disease heterogeneity. However, most patients worldwide lack access to timely expert consensus, particularly in resource-constrained centres where MDT resources are scarce or unavailable. Here we present OMGs (Ovarian tumour Multidisciplinary intelligent aGent System), a multi-agent AI framework where domain-specific agents deliberate collaboratively to integrate multidisciplinary evidence and generate MDT-style recommendations with transparent rationales. To systematically evaluate MDT recommendation quality, we developed SPEAR (Safety, Personalization, Evidence, Actionability, Robustness) and validated OMGs across diverse clinical scenarios spanning the care continuum. In multicentre re-evaluation, OMGs achieved performance comparable to expert MDT consensus ($4.45 \pm 0.30$ versus $4.53 \pm 0.23$), with higher Evidence scores (4.57 versus 3.92). In prospective multicentre evaluation (59 patients), OMGs demonstrated high concordance with routine MDT decisions. Critically, in paired human-AI studies, OMGs most substantially enhanced clinicians' recommendations in Evidence and Robustness, the dimensions most compromised when multidisciplinary expertise is unavailable. These findings suggest that multi-agent deliberative systems can achieve performance comparable to expert MDT consensus, with potential to expand access to specialized oncology expertise in resource-limited settings.

翻译：卵巢肿瘤管理日益依赖多学科肿瘤委员会（MDT）的集体审议，以应对治疗复杂性与疾病异质性。然而，全球多数患者难以获得及时的专家共识，尤其在资源有限、MDT资源匮乏或缺失的医疗中心。本文提出OMGs（卵巢肿瘤多学科智能体系统），这是一个多智能体人工智能框架，其中领域专用智能体通过协同审议整合多学科证据，生成具有透明推理过程的MDT式诊疗建议。为系统评估MDT建议质量，我们开发了SPEAR（安全性、个性化、证据性、可操作性、鲁棒性）评价体系，并在涵盖诊疗全程的多样化临床场景中验证了OMGs。多中心再评估显示，OMGs取得了与专家MDT共识相当的综合表现（$4.45 \pm 0.30$对比$4.53 \pm 0.23$），且在证据性维度评分更高（4.57对比3.92）。在前瞻性多中心评估（59例患者）中，OMGs与常规MDT决策展现出高度一致性。关键的是，在人机协同对比研究中，OMGs在证据性与鲁棒性维度显著提升了临床医生的建议质量——这两个维度恰是在缺乏多学科专家支持时最易受损的指标。这些发现表明，多智能体审议系统能够达到与专家MDT共识相当的性能，有望在资源受限环境中拓展专业肿瘤诊疗知识的可及性。