Personalized multi-agent reinforcement learning framework for adaptive chronic disease therapy management

Long-term, flexible therapy strategies are needed for chronic diseases like cardiovascular ailments, diabetes, and chronic kidney disease and they have to deal with patient heterogeneity, changing physiological states and privacy constraints. This research suggests a framework for privacy-preserving and personalized artificial intelligence that combines Federated Learning (FL), a Res-HyperTransformerNet deep prediction model, Personalized Multi-Agent Reinforcement Learning (PMARL) and Explainable Artificial Intelligence (XAI) for adaptive chronic disease management. The framework is structured with two main aims: (i) to create an accurate and privacy-aware predictive model for chronic disease risk using diverse data sources, and (ii) to permit adaptive, individual therapy optimization through multi-agent reinforcement learning. Federated learning is utilized to conduct the training of Res-HyperTransformerNet over distributed Internet of Medical Things (IoMT) nodes without the requirement of transferring raw patient data. The embeddings that are created from patient data are then passed on to a PMARL module, where several agents optimize therapy dimensions like medications, diet, physical activity, and mental health interventions independently. To make the clinical support more understandable, the SHAP-based explainability method is used for both predictive and decision-making parts. The framework is tested using two public datasets—the CDC Chronic Disease dataset and the UCI Chronic Kidney Disease Risk Factor dataset. The performance is measured by employing classification metrics (accuracy, precision, recall, F1-score, MCC) as well as reinforcement learning metrics (reward score, convergence steps, episode return) and federated system metrics (communication overhead, convergence rounds, and training time). The experiments indicate that the proposed framework demonstrated improved performance in terms of predictive accuracy and policy convergence speed compared to the baseline deep learning and reinforcement learning models, and at the same time it is more cost-effective when it comes to communication in a federated setting. This means that the proposed method suggests the potential of being a reproducible and open AI framework for adaptive chronic disease therapy management. The combination of ResNet and Transformer blocks, i.e., Federated Res-HyperTransformerNet, achieved strong performance in both datasets, namely CDC Chronic Disease (Dataset 1) and UCI CKD Risk Factor (Dataset 2). The obtained accuracy for Dataset 1 was 98.61% and for Dataset 2, it was 97.75%, under the conducted experimental settings.