Yankai Jiang
Publications
Evidence-Grounded AI for Musculoskeletal Care
Musculoskeletal diseases are among the leading causes of disability worldwide and create the greatest global need for rehabilitation. Because recovery, remodelling and degeneration often unfold over months to years, musculoskeletal care requires longitudinal management that repeatedly integrates evolving patient evidence, external medical knowledge and stage-specific functional goals. In routine practice, this evidence is fragmented across visits, departments and hospital systems, limiting individualized, evidence-based care. Here we report OrthoPilot, a clinical artificial intelligence system powered by a large language model that integrates hospital data streams with authoritative external knowledge for continuous musculoskeletal management. OrthoPilot autonomously retrieves real-time imaging, laboratory, pathology and order data and converts evolving patient states into evidence-based decisions from admission diagnosis to rehabilitation planning. We established a specialist-validated benchmark from real-world electronic health records spanning 1,000 disease codes. In a reader study across the complete care pathway, OrthoPilot was compared with 81 orthopaedic physicians and surpassed experts with 25 years of experience in diagnostic reasoning, clinical decision-making and management planning. It also outperformed all evaluated intelligent systems across 60 external clinical centres. In a prospective study of 1,870 complex cases, OrthoPilot increased full-chain management success by 10.6%. During an 8-month randomised deployment involving 8,240 inpatients, it increased cumulative cases per bed by 9.7% and improved patient-reported access to health information. These results move clinical AI from predicting isolated events toward executing longitudinal management across complete musculoskeletal care pathways.
A Self-Evolving Agentic System for Automated Generation and Execution of Biological Protocols
Autonomous wet-lab experimentation requires more than plausible protocol text: biological intent, quantitative procedures, device constraints and experimental feedback must remain aligned from protocol and SOP design to code and physical execution. We developed ProtoPilot, a self-evolving multi-agent system, together with an expert-grounded benchmark and evaluation framework for testing this conversion as an experimental automation problem. The framework spans 294 synthetic-biology and molecular-biology tasks derived from 98 gold-standard protocols, wet-lab expert rubrics, device-level validity gates and real experimental tests. ProtoPilot incorporates layer-wise verifiability, multi-agent orchestration and a runtime-updated skill library to generate protocols, expand SOPs, synthesize SDK-compliant code and revise workflows from wet-lab feedback. It achieved a Top@3 expert-preference rate of 90.2%, an overall protocol-to-code gate pass rate of 89.5% and an Opentrons pass rate of 88.24%, compared with 32.35% for OpenTrons-AI. Wet-lab validation produced interpretable readouts, Sanger-confirmed products and feedback-corrected PCA-assembled DNA targets, establishing a verifiable route to autonomous experimentation. Together, these results show that the evaluation framework captures execution-relevant requirements for autonomous wet-lab automation, and that ProtoPilot can meet them by converting protocol and code generation into validated execution and feedback-guided revision.
Beyond Static Tools: Test-Time Tool Evolution for Scientific Reasoning
The central challenge of AI for Science is not reasoning alone, but the ability to create computational methods in an open-ended scientific world. Existing LLM-based agents rely on static, pre-defined tool libraries, a paradigm that fundamentally fails in scientific domains where tools are sparse, heterogeneous, and intrinsically incomplete. In this paper, we propose Test-Time Tool Evolution (TTE), a new paradigm that enables agents to synthesize, verify, and evolve executable tools during inference. By transforming tools from fixed resources into problem-driven artifacts, TTE overcomes the rigidity and long-tail limitations of static tool libraries. To facilitate rigorous evaluation, we introduce SciEvo, a benchmark comprising 1,590 scientific reasoning tasks supported by 925 automatically evolved tools. Extensive experiments show that TTE achieves state-of-the-art performance in both accuracy and tool efficiency, while enabling effective cross-domain adaptation of computational tools. The code and benchmark have been released at https://github.com/lujiaxuan0520/Test-Time-Tool-Evol.