Clinical Case Conference Swarm

pip install requests python-dotenv

SWARMS_API_KEY=your_api_key_here

import json
import os

import requests
from dotenv import load_dotenv

load_dotenv()

API_KEY = os.getenv("SWARMS_API_KEY")
BASE_URL = "https://api.swarms.world"

headers = {"x-api-key": API_KEY, "Content-Type": "application/json"}

patient_case = """
Patient: 62-year-old female, never-smoker

Chief Complaint: 8 weeks of progressive right-upper-quadrant discomfort,
20-lb unintentional weight loss, intermittent low-grade fevers.

Imaging:
- CT chest/abdomen/pelvis with contrast: 4.2 cm hypodense mass in
  segment VII of the liver with arterial-phase enhancement and
  washout. Three sub-cm pulmonary nodules in the right lower lobe.
  No lymphadenopathy.
- MRI liver: lesion is T2-hyperintense with restricted diffusion,
  no clear capsule. Background liver is non-cirrhotic.

Pathology (core-needle biopsy of liver lesion):
- Poorly differentiated carcinoma. CK7+, CK20-, TTF-1 weak focal+,
  Hep-Par1 negative, CDX2 negative. Ki-67 ~ 45%.

Labs:
- AFP 6 ng/mL, CEA 3.1 ng/mL, CA 19-9 42 U/mL
- LFTs: AST 64, ALT 71, ALP 220, total bilirubin 1.0
- CBC: Hgb 10.8, MCV 88, platelets 410
- Troponin negative; BNP 380 pg/mL
- ECG: sinus tachycardia at 104, no ischemic changes

Cardiac history:
- Hypertension, HFpEF (EF 55%), prior NSTEMI 2 years ago, on
  aspirin + atorvastatin + metoprolol.

Performance status: ECOG 1.
"""

payload = {
    "name": "Clinical Case Conference Swarm",
    "description": (
        "Virtual tumor board: attending physician synthesizes radiology, "
        "pathology, cardiology, and hospitalist input into a single plan."
    ),
    "swarm_type": "HierarchicalSwarm",
    "max_loops": 1,
    "task": (
        "Conduct a virtual multi-specialty case conference on the patient "
        "below. Each specialist should give an opinion limited to their "
        "domain. The attending must produce a final structured note with: "
        "(1) ranked differential diagnosis with reasoning, (2) recommended "
        "next workup with rationale, (3) initial treatment plan including "
        "cardiac-safety considerations, and (4) open questions for the "
        "treating team.\n\n"
        f"CASE:\n{patient_case}"
    ),
    "agents": [
        {
            "agent_name": "Attending Physician",
            "description": (
                "Conference chair. Reviews specialist input, decides, "
                "and produces the single integrated plan."
            ),
            "system_prompt": (
                "You are the Attending Physician chairing a multi-disciplinary "
                "case conference. You do NOT re-do the specialists' work. "
                "Your job is to: (1) reconcile disagreements between "
                "specialists, (2) commit to a ranked differential, "
                "(3) order the next workup, (4) propose initial therapy "
                "with explicit cardiac-safety considerations given the "
                "patient's HFpEF and prior NSTEMI, and (5) list open "
                "questions for the treating team. Be decisive. Output a "
                "structured plan, not an essay."
            ),
            "model_name": "gpt-4.1",
            "role": "coordinator",
            "max_loops": 1,
            "max_tokens": 8192,
            "temperature": 0.3,
        },
        {
            "agent_name": "Radiologist",
            "description": "Body imaging specialist.",
            "system_prompt": (
                "You are a board-certified diagnostic radiologist with "
                "abdominal-imaging fellowship training. Given the CT and "
                "MRI descriptions, characterize the dominant liver lesion "
                "(LI-RADS where applicable), comment on the pulmonary "
                "nodules, and propose the single most informative next "
                "imaging study. Stay in your lane: do not propose "
                "treatment. Be concise."
            ),
            "model_name": "gpt-4.1",
            "role": "worker",
            "max_loops": 1,
            "max_tokens": 4096,
            "temperature": 0.3,
        },
        {
            "agent_name": "Pathologist",
            "description": "Anatomic and molecular pathology specialist.",
            "system_prompt": (
                "You are an anatomic pathologist with experience in "
                "hepatobiliary and metastatic-of-unknown-primary cases. "
                "Given the IHC panel, interpret the lineage of the "
                "carcinoma, list the most likely primary sites in ranked "
                "order, and propose additional stains or molecular tests "
                "(NGS panel, specific markers) that would narrow it "
                "further. Do not propose treatment."
            ),
            "model_name": "gpt-4.1",
            "role": "worker",
            "max_loops": 1,
            "max_tokens": 4096,
            "temperature": 0.3,
        },
        {
            "agent_name": "Cardiologist",
            "description": "Cardio-oncology and HFpEF specialist.",
            "system_prompt": (
                "You are a cardiologist with cardio-oncology experience. "
                "Given this patient's HFpEF, prior NSTEMI, and current "
                "BNP and tachycardia, assess cardiac risk for the likely "
                "upcoming systemic therapies (platinum doublets, "
                "anthracyclines, immune checkpoint inhibitors, targeted "
                "agents). Recommend baseline cardiac workup and any "
                "drug-class restrictions or monitoring requirements. Do "
                "not stage the cancer or pick the regimen."
            ),
            "model_name": "gpt-4.1",
            "role": "worker",
            "max_loops": 1,
            "max_tokens": 4096,
            "temperature": 0.3,
        },
        {
            "agent_name": "Hospitalist",
            "description": "Internal medicine generalist and care coordinator.",
            "system_prompt": (
                "You are a hospitalist. Your job is the whole-patient "
                "view: nutrition (20-lb weight loss), anemia workup "
                "(Hgb 10.8), elevated ALP, performance-status trajectory, "
                "supportive care, and care-coordination handoffs. Flag "
                "anything that should be addressed before oncologic "
                "therapy begins. Do not duplicate the specialists' work."
            ),
            "model_name": "gpt-4.1",
            "role": "worker",
            "max_loops": 1,
            "max_tokens": 4096,
            "temperature": 0.3,
        },
    ],
}

response = requests.post(
    f"{BASE_URL}/v1/swarm/completions",
    headers=headers,
    json=payload,
    timeout=600,
)

result = response.json()

for output in result.get("output", []):
    print("=" * 60)
    print(output["role"])
    print("=" * 60)
    content = output["content"]
    if isinstance(content, list):
        content = " ".join(str(c) for c in content)
    print(str(content)[:600] + "...")

print(f"\nTotal cost: ${result['usage']['billing_info']['total_cost']:.4f}")
print(f"Execution time: {result['execution_time']:.1f}s")