Using AI to Optimize Patient Transfer and Resource Utilization During Mass-Casualty Incidents: A Simulation Platform
Bibliographic record
Abstract
Mass casualty incidents (MCIs) overwhelm healthcare systems and demand rapid, accurate patient-hospital allocation decisions under extreme pressure. Here, we developed and validated a deep reinforcement learning-based decision-support AI agent to optimize patient transfer decisions during simulated MCIs by balancing patient acuity levels, specialized care requirements, hospital capacities, and transport logistics. To integrate this AI agent, we developed MasTER, a web-accessible command dashboard for MCI management simulations. Through a controlled user study with 30 participants (6 trauma experts and 24 non-experts), we evaluated three interaction approaches with the AI agent (human-only, human-AI collaboration, and AI-only) across 20- and 60-patient MCI scenarios in the Greater Toronto Area. Results demonstrate that increasing AI involvement significantly improves decision quality and consistency. The AI agent outperforms trauma surgeons (p < 0.001) and enables non-experts to achieve expert-level performance when assisted, contrasting sharply with their significantly inferior unassisted performance (p < 0.001). These findings establish the potential for our AI-driven decision support to enhance both MCI preparedness training and real-world emergency response management.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".