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Jul 22

LiveMedBench: A Contamination-Free Medical Benchmark for LLMs with Automated Rubric Evaluation

The deployment of Large Language Models (LLMs) in high-stakes clinical settings demands rigorous and reliable evaluation. However, existing medical benchmarks remain static, suffering from two critical limitations: (1) data contamination, where test sets inadvertently leak into training corpora, leading to inflated performance estimates; and (2) temporal misalignment, failing to capture the rapid evolution of medical knowledge. Furthermore, current evaluation metrics for open-ended clinical reasoning often rely on either shallow lexical overlap (e.g., ROUGE) or subjective LLM-as-a-Judge scoring, both inadequate for verifying clinical correctness. To bridge these gaps, we introduce LiveMedBench, a continuously updated, contamination-free, and rubric-based benchmark that weekly harvests real-world clinical cases from online medical communities, ensuring strict temporal separation from model training data. We propose a Multi-Agent Clinical Curation Framework that filters raw data noise and validates clinical integrity against evidence-based medical principles. For evaluation, we develop an Automated Rubric-based Evaluation Framework that decomposes physician responses into granular, case-specific criteria, achieving substantially stronger alignment with expert physicians than LLM-as-a-Judge. To date, LiveMedBench comprises 2,756 real-world cases spanning 38 medical specialties and multiple languages, paired with 16,702 unique evaluation criteria. Extensive evaluation of 38 LLMs reveals that even the best-performing model achieves only 39.2%, and 84% of models exhibit performance degradation on post-cutoff cases, confirming pervasive data contamination risks. Error analysis further identifies contextual application-not factual knowledge-as the dominant bottleneck, with 35-48% of failures stemming from the inability to tailor medical knowledge to patient-specific constraints.

  • 7 authors
·
Feb 10 2

MedMASLab: A Unified Orchestration Framework for Benchmarking Multimodal Medical Multi-Agent Systems

While Multi-Agent Systems (MAS) show potential for complex clinical decision support, the field remains hindered by architectural fragmentation and the lack of standardized multimodal integration. Current medical MAS research suffers from non-uniform data ingestion pipelines, inconsistent visual-reasoning evaluation, and a lack of cross-specialty benchmarking. To address these challenges, we present MedMASLab, a unified framework and benchmarking platform for multimodal medical multi-agent systems. MedMASLab introduces: (1) A standardized multimodal agent communication protocol that enables seamless integration of 11 heterogeneous MAS architectures across 24 medical modalities. (2) An automated clinical reasoning evaluator, a zero-shot semantic evaluation paradigm that overcomes the limitations of lexical string-matching by leveraging large vision-language models to verify diagnostic logic and visual grounding. (3) The most extensive benchmark to date, spanning 11 organ systems and 473 diseases, standardizing data from 11 clinical benchmarks. Our systematic evaluation reveals a critical domain-specific performance gap: while MAS improves reasoning depth, current architectures exhibit significant fragility when transitioning between specialized medical sub-domains. We provide a rigorous ablation of interaction mechanisms and cost-performance trade-offs, establishing a new technical baseline for future autonomous clinical systems. The source code and data is publicly available at: https://github.com/NUS-Project/MedMASLab/

  • 9 authors
·
Mar 10

Learning to Be A Doctor: Searching for Effective Medical Agent Architectures

Large Language Model (LLM)-based agents have demonstrated strong capabilities across a wide range of tasks, and their application in the medical domain holds particular promise due to the demand for high generalizability and reliance on interdisciplinary knowledge. However, existing medical agent systems often rely on static, manually crafted workflows that lack the flexibility to accommodate diverse diagnostic requirements and adapt to emerging clinical scenarios. Motivated by the success of automated machine learning (AutoML), this paper introduces a novel framework for the automated design of medical agent architectures. Specifically, we define a hierarchical and expressive agent search space that enables dynamic workflow adaptation through structured modifications at the node, structural, and framework levels. Our framework conceptualizes medical agents as graph-based architectures composed of diverse, functional node types and supports iterative self-improvement guided by diagnostic feedback. Experimental results on skin disease diagnosis tasks demonstrate that the proposed method effectively evolves workflow structures and significantly enhances diagnostic accuracy over time. This work represents the first fully automated framework for medical agent architecture design and offers a scalable, adaptable foundation for deploying intelligent agents in real-world clinical environments.

  • 6 authors
·
Apr 15, 2025

MedAgentBoard: Benchmarking Multi-Agent Collaboration with Conventional Methods for Diverse Medical Tasks

The rapid advancement of Large Language Models (LLMs) has stimulated interest in multi-agent collaboration for addressing complex medical tasks. However, the practical advantages of multi-agent collaboration approaches remain insufficiently understood. Existing evaluations often lack generalizability, failing to cover diverse tasks reflective of real-world clinical practice, and frequently omit rigorous comparisons against both single-LLM-based and established conventional methods. To address this critical gap, we introduce MedAgentBoard, a comprehensive benchmark for the systematic evaluation of multi-agent collaboration, single-LLM, and conventional approaches. MedAgentBoard encompasses four diverse medical task categories: (1) medical (visual) question answering, (2) lay summary generation, (3) structured Electronic Health Record (EHR) predictive modeling, and (4) clinical workflow automation, across text, medical images, and structured EHR data. Our extensive experiments reveal a nuanced landscape: while multi-agent collaboration demonstrates benefits in specific scenarios, such as enhancing task completeness in clinical workflow automation, it does not consistently outperform advanced single LLMs (e.g., in textual medical QA) or, critically, specialized conventional methods that generally maintain better performance in tasks like medical VQA and EHR-based prediction. MedAgentBoard offers a vital resource and actionable insights, emphasizing the necessity of a task-specific, evidence-based approach to selecting and developing AI solutions in medicine. It underscores that the inherent complexity and overhead of multi-agent collaboration must be carefully weighed against tangible performance gains. All code, datasets, detailed prompts, and experimental results are open-sourced at https://medagentboard.netlify.app/.

  • 9 authors
·
May 18, 2025

MDAgents: An Adaptive Collaboration of LLMs for Medical Decision-Making

Foundation models are becoming valuable tools in medicine. Yet despite their promise, the best way to leverage Large Language Models (LLMs) in complex medical tasks remains an open question. We introduce a novel multi-agent framework, named Medical Decision-making Agents (MDAgents) that helps address this gap by automatically assigning a collaboration structure to a team of LLMs. The assigned solo or group collaboration structure is tailored to the medical task at hand, emulating real-world medical decision-making processes adapted to tasks of varying complexities. We evaluate our framework and baseline methods using state-of-the-art LLMs across a suite of real-world medical knowledge and medical diagnosis benchmarks, including a comparison of LLMs' medical complexity classification against human physicians. MDAgents achieved the best performance in seven out of ten benchmarks on tasks requiring an understanding of medical knowledge and multi-modal reasoning, showing a significant improvement of up to 4.2% (p < 0.05) compared to previous methods' best performances. Ablation studies reveal that MDAgents effectively determines medical complexity to optimize for efficiency and accuracy across diverse medical tasks. Notably, the combination of moderator review and external medical knowledge in group collaboration resulted in an average accuracy improvement of 11.8%. Our code can be found at https://github.com/mitmedialab/MDAgents.

  • 10 authors
·
Apr 22, 2024

MedReseacher-R1: Expert-Level Medical Deep Researcher via A Knowledge-Informed Trajectory Synthesis Framework

Recent developments in Large Language Model (LLM)-based agents have shown impressive capabilities spanning multiple domains, exemplified by deep research systems that demonstrate superior performance on complex information-seeking and synthesis tasks. While general-purpose deep research agents have shown impressive capabilities, they struggle significantly with medical domain challenges, as evidenced by leading proprietary systems achieving limited accuracy on complex medical benchmarks. The key limitations are: (1) the model lacks sufficient dense medical knowledge for clinical reasoning, and (2) the framework is constrained by the absence of specialized retrieval tools tailored for medical contexts.We present a medical deep research agent that addresses these challenges through two core innovations. First, we develop a novel data synthesis framework using medical knowledge graphs, extracting the longest chains from subgraphs around rare medical entities to generate complex multi-hop question-answer pairs. Second, we integrate a custom-built private medical retrieval engine alongside general-purpose tools, enabling accurate medical information synthesis. Our approach generates 2100+ diverse trajectories across 12 medical specialties, each averaging 4.2 tool interactions.Through a two-stage training paradigm combining supervised fine-tuning and online reinforcement learning with composite rewards, our MedResearcher-R1-32B model demonstrates exceptional performance, establishing new state-of-the-art results on medical benchmarks while maintaining competitive performance on general deep research tasks. Our work demonstrates that strategic domain-specific innovations in architecture, tool design, and training data construction can enable smaller open-source models to outperform much larger proprietary systems in specialized domains.

  • 15 authors
·
Aug 20, 2025 2

ClinSeekAgent: Automating Multimodal Evidence Seeking for Agentic Clinical Reasoning

Large language models (LLMs) and agentic systems have shown promise for clinical decision support, but existing works largely assume that evidence has already been curated and handed to the model. Real-world clinical workflows instead require agents to actively seek, iteratively plan, and synthesize multimodal evidence from heterogeneous sources. In this paper, we introduce ClinSeekAgent, an automated agentic framework for dynamic multimodal evidence seeking that shifts the paradigm from passive evidence consumption to active evidence acquisition. Given only a clinical query and access to raw data sources, ClinSeekAgent gathers evidence by querying medical knowledge bases, navigating raw EHRs, and invoking medical imaging tools; refines its hypotheses as new information emerges; and integrates the collected evidence into grounded clinical decisions. ClinSeekAgent serves both as an inference-time agent for frontier LLMs and as a training-time pipeline for distilling high-quality agent trajectories into compact open-source models. To validate its inference-time effectiveness, we construct ClinSeek-Bench, which pairs Curated Input reasoning from fixed pre-selected evidence with Automated Evidence-Seeking over raw clinical data. On text-only EHR tasks, ClinSeekAgent improves Claude Opus 4.6 from 60.0 to 63.2 overall F1 and MiniMax M2.5 from 43.1 to 47.3, with positive risk-prediction gains in 7 out of 9 evaluated host models. On multimodal tasks, ClinSeekAgent improves Claude Opus 4.6 from 47.5 to 62.6 (+15.1); all evaluated models improve across the three CXR-related task groups. We further validate ClinSeekAgent as a training pipeline by distilling agentic evidence-seeking trajectories into ClinSeek-35B-A3B, which achieves 34.0 average F1 on existing AgentEHR-Bench, improving over its Qwen3.5-35B-A3B baseline by +11.9 points and approaching Claude Opus 4.6.

UCSC-VLAA UCSC-VLAA
·
May 18 2

Automated Rubrics for Reliable Evaluation of Medical Dialogue Systems

Large Language Models (LLMs) are increasingly used for clinical decision support, where hallucinations and unsafe suggestions may pose direct risks to patient safety. These risks are particularly challenging as they often manifest as subtle clinical errors that evade detection by generic metrics, while expert-authored fine-grained rubrics remain costly to construct and difficult to scale. In this paper, we propose a retrieval-augmented multi-agent framework designed to automate the generation of instance-specific evaluation rubrics. Our approach grounds evaluation in authoritative medical evidence by decomposing retrieved content into atomic facts and synthesizing them with user interaction constraints to form verifiable, fine-grained evaluation criteria. Evaluated on HealthBench, our framework achieves a Clinical Intent Alignment (CIA) score of 60.12%, a statistically significant improvement over the GPT-4o baseline (55.16%). In discriminative tests, our rubrics yield a mean score delta (μ_Δ = 8.658) and an AUROC of 0.977, nearly doubling the quality separation achieved by GPT-4o baseline (4.972). Beyond evaluation, our rubrics effectively guide response refinement, improving quality by 9.2% (from 59.0% to 68.2%). This provides a scalable and transparent foundation for both evaluating and improving medical LLMs. The code is available at https://anonymous.4open.science/r/Automated-Rubric-Generation-AF3C/.

  • 4 authors
·
Jan 21

MMedAgent-RL: Optimizing Multi-Agent Collaboration for Multimodal Medical Reasoning

Medical Large Vision-Language Models (Med-LVLMs) have shown strong potential in multimodal diagnostic tasks. However, existing single-agent models struggle to generalize across diverse medical specialties, limiting their performance. Recent efforts introduce multi-agent collaboration frameworks inspired by clinical workflows, where general practitioners (GPs) and specialists interact in a fixed sequence. Despite improvements, these static pipelines lack flexibility and adaptability in reasoning. To address this, we propose MMedAgent-RL, a reinforcement learning (RL)-based multi-agent framework that enables dynamic, optimized collaboration among medical agents. Specifically, we train two GP agents based on Qwen2.5-VL via RL: the triage doctor learns to assign patients to appropriate specialties, while the attending physician integrates the judgments from multi-specialists and its own knowledge to make final decisions. To address the inconsistency in specialist outputs, we introduce a curriculum learning (CL)-guided RL strategy that progressively teaches the attending physician to balance between imitating specialists and correcting their mistakes. Experiments on five medical VQA benchmarks demonstrate that MMedAgent-RL not only outperforms both open-source and proprietary Med-LVLMs, but also exhibits human-like reasoning patterns. Notably, it achieves an average performance gain of 20.7% over supervised fine-tuning baselines.

  • 11 authors
·
May 31, 2025

MedDialogRubrics: A Comprehensive Benchmark and Evaluation Framework for Multi-turn Medical Consultations in Large Language Models

Medical conversational AI (AI) plays a pivotal role in the development of safer and more effective medical dialogue systems. However, existing benchmarks and evaluation frameworks for assessing the information-gathering and diagnostic reasoning abilities of medical large language models (LLMs) have not been rigorously evaluated. To address these gaps, we present MedDialogRubrics, a novel benchmark comprising 5,200 synthetically constructed patient cases and over 60,000 fine-grained evaluation rubrics generated by LLMs and subsequently refined by clinical experts, specifically designed to assess the multi-turn diagnostic capabilities of LLM. Our framework employs a multi-agent system to synthesize realistic patient records and chief complaints from underlying disease knowledge without accessing real-world electronic health records, thereby mitigating privacy and data-governance concerns. We design a robust Patient Agent that is limited to a set of atomic medical facts and augmented with a dynamic guidance mechanism that continuously detects and corrects hallucinations throughout the dialogue, ensuring internal coherence and clinical plausibility of the simulated cases. Furthermore, we propose a structured LLM-based and expert-annotated rubric-generation pipeline that retrieves Evidence-Based Medicine (EBM) guidelines and utilizes the reject sampling to derive a prioritized set of rubric items ("must-ask" items) for each case. We perform a comprehensive evaluation of state-of-the-art models and demonstrate that, across multiple assessment dimensions, current models face substantial challenges. Our results indicate that improving medical dialogue will require advances in dialogue management architectures, not just incremental tuning of the base-model.

  • 12 authors
·
Jan 6

AgentMD: Empowering Language Agents for Risk Prediction with Large-Scale Clinical Tool Learning

Clinical calculators play a vital role in healthcare by offering accurate evidence-based predictions for various purposes such as prognosis. Nevertheless, their widespread utilization is frequently hindered by usability challenges, poor dissemination, and restricted functionality. Augmenting large language models with extensive collections of clinical calculators presents an opportunity to overcome these obstacles and improve workflow efficiency, but the scalability of the manual curation process poses a significant challenge. In response, we introduce AgentMD, a novel language agent capable of curating and applying clinical calculators across various clinical contexts. Using the published literature, AgentMD has automatically curated a collection of 2,164 diverse clinical calculators with executable functions and structured documentation, collectively named RiskCalcs. Manual evaluations show that RiskCalcs tools achieve an accuracy of over 80% on three quality metrics. At inference time, AgentMD can automatically select and apply the relevant RiskCalcs tools given any patient description. On the newly established RiskQA benchmark, AgentMD significantly outperforms chain-of-thought prompting with GPT-4 (87.7% vs. 40.9% in accuracy). Additionally, we also applied AgentMD to real-world clinical notes for analyzing both population-level and risk-level patient characteristics. In summary, our study illustrates the utility of language agents augmented with clinical calculators for healthcare analytics and patient care.

  • 11 authors
·
Feb 20, 2024

PublicAgent: Multi-Agent Design Principles From an LLM-Based Open Data Analysis Framework

Open data repositories hold potential for evidence-based decision-making, yet are inaccessible to non-experts lacking expertise in dataset discovery, schema mapping, and statistical analysis. Large language models show promise for individual tasks, but end-to-end analytical workflows expose fundamental limitations: attention dilutes across growing contexts, specialized reasoning patterns interfere, and errors propagate undetected. We present PublicAgent, a multi-agent framework that addresses these limitations through decomposition into specialized agents for intent clarification, dataset discovery, analysis, and reporting. This architecture maintains focused attention within agent contexts and enables validation at each stage. Evaluation across five models and 50 queries derives five design principles for multi-agent LLM systems. First, specialization provides value independent of model strength--even the strongest model shows 97.5% agent win rates, with benefits orthogonal to model scale. Second, agents divide into universal (discovery, analysis) and conditional (report, intent) categories. Universal agents show consistent effectiveness (std dev 12.4%) while conditional agents vary by model (std dev 20.5%). Third, agents mitigate distinct failure modes--removing discovery or analysis causes catastrophic failures (243-280 instances), while removing report or intent causes quality degradation. Fourth, architectural benefits persist across task complexity with stable win rates (86-92% analysis, 84-94% discovery), indicating workflow management value rather than reasoning enhancement. Fifth, wide variance in agent effectiveness across models (42-96% for analysis) requires model-aware architecture design. These principles guide when and why specialization is necessary for complex analytical workflows while enabling broader access to public data through natural language interfaces.

  • 3 authors
·
Nov 4, 2025

Deep Research Agents: A Systematic Examination And Roadmap

The rapid progress of Large Language Models (LLMs) has given rise to a new category of autonomous AI systems, referred to as Deep Research (DR) agents. These agents are designed to tackle complex, multi-turn informational research tasks by leveraging a combination of dynamic reasoning, adaptive long-horizon planning, multi-hop information retrieval, iterative tool use, and the generation of structured analytical reports. In this paper, we conduct a detailed analysis of the foundational technologies and architectural components that constitute Deep Research agents. We begin by reviewing information acquisition strategies, contrasting API-based retrieval methods with browser-based exploration. We then examine modular tool-use frameworks, including code execution, multimodal input processing, and the integration of Model Context Protocols (MCPs) to support extensibility and ecosystem development. To systematize existing approaches, we propose a taxonomy that differentiates between static and dynamic workflows, and we classify agent architectures based on planning strategies and agent composition, including single-agent and multi-agent configurations. We also provide a critical evaluation of current benchmarks, highlighting key limitations such as restricted access to external knowledge, sequential execution inefficiencies, and misalignment between evaluation metrics and the practical objectives of DR agents. Finally, we outline open challenges and promising directions for future research. A curated and continuously updated repository of DR agent research is available at: {https://github.com/ai-agents-2030/awesome-deep-research-agent}.

  • 12 authors
·
Jun 22, 2025 1

The Path to Self-Evolving Clinical Systems: Scaling Medical Agents from Assistance to Autonomy

The growing ability of large language models and vision language models to jointly interpret and reason over images and text is reshaping medical agents, moving them from task specific predictors toward autonomous systems that perceive, reason, plan, remember, and act in clinical environments. This work departs from the capability first perspective of existing literature and instead begins from clinical deployment, asking what tasks, contamination resistant benchmarks, and interactive training environments are required before medical agents can be trusted in practice. Medical agents are formalized as sequential decision making systems under partial observability, together with a three level autonomy taxonomy spanning assisted, cooperative, and fully autonomous operation. The field is organized along a unified scaling spine consisting of framework scaling, capability scaling, and environment scaling. Within this framework, clinical environment scaling, the integration of tools, data, and clinical gyms, is identified as the most actionable yet underexplored direction for agents operating in PACS, EHR, and FHIR ecosystems. Clinical self evolution, where agents improve through interaction with their environments rather than parameter scaling alone, is further positioned as a key research frontier, drawing insights from self improving agents, agent gyms, and test time compute scaling. Applications across radiology, pathology, ophthalmology, and hospital workflows are examined together with deployment challenges including hallucination, cascading failures, and fairness. By consolidating more than 300 references, with particular emphasis on advances from 2025 to 2026, this work provides a roadmap toward trustworthy, self improving medical imaging systems for real clinical practice.

  • 18 authors
·
Jul 12

When OpenClaw Meets Hospital: Toward an Agentic Operating System for Dynamic Clinical Workflows

Large language model (LLM) agents extend generative models with reasoning, tool use, and persistent memory, thereby enabling the automation of complex tasks. In healthcare, such systems could support documentation, care coordination, and clinical decision making. Their reliable deployment in hospitals, however, remains constrained by safety risks, limited transparency, and inadequate mechanisms for handling longitudinal clinical context. Here we propose an architecture that adapts LLM agents to hospital environments. The design comprises four components: a restricted execution environment inspired by multi-user operating systems, a document-centric interaction model linking patient and clinician agents, a page-indexed memory architecture for longitudinal context management, and a curated library of composable medical skills. Implemented on top of OpenClaw, an open-source agent orchestration framework, this design provides the basis for an Agentic Operating System for Hospitals: a computing layer for coordinating clinical workflows while preserving safety, transparency, and auditability. To evaluate the memory component, we introduce manifest-guided retrieval for hierarchical navigation of longitudinal patient records. In a benchmark derived from the MIMIC-IV dataset (v2.2) comprising 100 de-identified patient records and 300 clinical queries stratified across three difficulty tiers (100 per tier), manifest-guided retrieval matched a metadata-filtered RAG baseline on overall recall (0.877 versus 0.876) while achieving 2.2x higher precision (0.779 versus 0.352) and retrieving fewer documents; on tier-3 longitudinal queries, manifest recall was 21% higher (0.846 versus 0.701), confirming that LLM-guided hierarchical navigation is most valuable when queries span multiple care episodes. These results outline a practical path toward hospital-scale agentic infrastructure.

  • 8 authors
·
Mar 20

SearchOS-V1: Towards Robust Open-Domain Information-Seeking Agent Collaboration

Recent advances in Tool-Integrated Large Language Models have made web search a core capability of information-seeking agents. However, as interaction histories grow, agents increasingly struggle to track task progress. When search attempts fail to yield useful evidence, current single- and multi-agent systems can become trapped in repetitive loops, wasting search budgets and ultimately compromising the quality and completeness of the final output. We introduce SearchOS, a system-level multi-agent framework that turns fragile, implicit search progress into explicit, persistent, and shared state. First, we formulate open-domain information seeking as relational schema completion with grounded citations, where agents discover entities, populate attributes across linked tables, and anchor each value to source evidence. Then we design Search-Oriented Context Management (SOCM), which externalizes the evolving state into Frontier Task, an Evidence Graph, a Coverage Map, and Failure Memory. Built on SOCM, SearchOS applies a pipeline-parallel scheduling mechanism that overlaps the execution of sub-agents and continuously refills freed slots with tasks targeting unresolved coverage gaps to improve utilization and throughput. To schedule and control the execution of search agents, SearchOS introduces a Search Tool Middleware Harness that intercepts model and tool interactions to record grounded evidence and react to stalls or budget exhaustion, and provides a reusable hierarchical skill system comprising strategy and access skills to augment the agents' search process and avoid repeating failed search patterns across runs. On WideSearch and GISA, SearchOS leads all metrics among the evaluated single- and multi-agent baselines, paving the way toward robust information-seeking collaboration.

antgroup Ant Group
·
Jul 15 1

HealthAgentBench: A Unified Benchmark Suite of Realistic Agentic Healthcare Environments for Challenging Frontier AI Agents

As AI agents become increasingly capable of complex, long-horizon reasoning, rigorous and holistic evaluation is essential for measuring progress toward real-world healthcare applications. We introduce HealthAgentBench, a suite of 54 agentic healthcare tasks across 7 categories each with its unique environment. The benchmark suite spans diverse workflows throughout the patient journey and a broad range of modalities. Each task is designed to replicate an end-to-end clinical workflow: given minimal instructions, an agent must explore raw healthcare data, operate within a complex environment, and execute multi-step solutions that go beyond naive prompting. A final task success rate is reported to provide a single, interpretable metric for HealthAgentBench overall performance for each agent. Evaluating frontier agents on HealthAgentBench, we find that overall task success rate remains low, underscoring the difficulty of the suite. The strongest and the most cost effective agent, Codex GPT-5.5, achieves only approximately 42% success rate. Beyond aggregate performance, HealthAgentBench reveals nuanced strengths and weaknesses across task categories. Frontier agents show promise in automatically developing research modeling pipelines over EHR data, but medical imaging remains especially challenging, particularly for Claude Code models, while Codex GPT-5.5 shows emerging capability. Tasks that combine large search spaces with compositional reasoning requirements remain difficult for all current agents. Together, these results suggest that HealthAgentBench provides a challenging and realistic benchmark with substantial room for future progress. We release our benchmark at https://github.com/microsoft/HealthAgentBench.

microsoft Microsoft
·
Jun 29 2

MedAgentBench: A Realistic Virtual EHR Environment to Benchmark Medical LLM Agents

Recent large language models (LLMs) have demonstrated significant advancements, particularly in their ability to serve as agents thereby surpassing their traditional role as chatbots. These agents can leverage their planning and tool utilization capabilities to address tasks specified at a high level. However, a standardized dataset to benchmark the agent capabilities of LLMs in medical applications is currently lacking, making the evaluation of LLMs on complex tasks in interactive healthcare environments challenging. To address this gap, we introduce MedAgentBench, a broad evaluation suite designed to assess the agent capabilities of large language models within medical records contexts. MedAgentBench encompasses 300 patient-specific clinically-derived tasks from 10 categories written by human physicians, realistic profiles of 100 patients with over 700,000 data elements, a FHIR-compliant interactive environment, and an accompanying codebase. The environment uses the standard APIs and communication infrastructure used in modern EMR systems, so it can be easily migrated into live EMR systems. MedAgentBench presents an unsaturated agent-oriented benchmark that current state-of-the-art LLMs exhibit some ability to succeed at. The best model (Claude 3.5 Sonnet v2) achieves a success rate of 69.67%. However, there is still substantial space for improvement which gives the community a next direction to optimize. Furthermore, there is significant variation in performance across task categories. MedAgentBench establishes this and is publicly available at https://github.com/stanfordmlgroup/MedAgentBench , offering a valuable framework for model developers to track progress and drive continuous improvements in the agent capabilities of large language models within the medical domain.

  • 7 authors
·
Jan 24, 2025

An Agentic AI System for Multi-Framework Communication Coding

Clinical communication is central to patient outcomes, yet large-scale human annotation of patient-provider conversation remains labor-intensive, inconsistent, and difficult to scale. Existing approaches based on large language models typically rely on single-task models that lack adaptability, interpretability, and reliability, especially when applied across various communication frameworks and clinical domains. In this study, we developed a Multi-framework Structured Agentic AI system for Clinical Communication (MOSAIC), built on a LangGraph-based architecture that orchestrates four core agents, including a Plan Agent for codebook selection and workflow planning, an Update Agent for maintaining up-to-date retrieval databases, a set of Annotation Agents that applies codebook-guided retrieval-augmented generation (RAG) with dynamic few-shot prompting, and a Verification Agent that provides consistency checks and feedback. To evaluate performance, we compared MOSAIC outputs against gold-standard annotations created by trained human coders. We developed and evaluated MOSAIC using 26 gold standard annotated transcripts for training and 50 transcripts for testing, spanning rheumatology and OB/GYN domains. On the test set, MOSAIC achieved an overall F1 score of 0.928. Performance was highest in the Rheumatology subset (F1 = 0.962) and strongest for Patient Behavior (e.g., patients asking questions, expressing preferences, or showing assertiveness). Ablations revealed that MOSAIC outperforms baseline benchmarking.

  • 17 authors
·
Dec 8, 2025

Doctor-R1: Mastering Clinical Inquiry with Experiential Agentic Reinforcement Learning

The professionalism of a human doctor in outpatient service depends on two core abilities: the ability to make accurate medical decisions and the medical consultation skill to conduct strategic, empathetic patient inquiry. Existing Large Language Models (LLMs) have achieved remarkable accuracy on medical decision-making benchmarks. However, they often lack the ability to conduct the strategic and empathetic consultation, which is essential for real-world clinical scenarios. To address this gap, we propose Doctor-R1, an AI doctor agent trained to master both of the capabilities by ask high-yield questions and conduct strategic multi-turn inquiry to guide decision-making. Our framework introduces three key components: a multi-agent interactive environment, a two-tiered reward architecture that separately optimizes clinical decision-making and communicative inquiry skills, and an experience repository to ground policy learning in high-quality prior trajectories. We evaluate Doctor-R1 on OpenAI's HealthBench and MAQuE, assessed across multi-facet metrics, such as communication quality, user experience, and task accuracy. Remarkably, Doctor-R1 surpasses state-of-the-art open-source specialized LLMs by a substantial margin with higher parameter efficiency and outperforms powerful proprietary models. Furthermore, the human evaluations show a strong preference for Doctor-R1 to generate human-preferred clinical dialogue, demonstrating the effectiveness of the framework.

  • 5 authors
·
Oct 5, 2025

AgentClinic: a multimodal agent benchmark to evaluate AI in simulated clinical environments

Diagnosing and managing a patient is a complex, sequential decision making process that requires physicians to obtain information -- such as which tests to perform -- and to act upon it. Recent advances in artificial intelligence (AI) and large language models (LLMs) promise to profoundly impact clinical care. However, current evaluation schemes overrely on static medical question-answering benchmarks, falling short on interactive decision-making that is required in real-life clinical work. Here, we present AgentClinic: a multimodal benchmark to evaluate LLMs in their ability to operate as agents in simulated clinical environments. In our benchmark, the doctor agent must uncover the patient's diagnosis through dialogue and active data collection. We present two open medical agent benchmarks: a multimodal image and dialogue environment, AgentClinic-NEJM, and a dialogue-only environment, AgentClinic-MedQA. We embed cognitive and implicit biases both in patient and doctor agents to emulate realistic interactions between biased agents. We find that introducing bias leads to large reductions in diagnostic accuracy of the doctor agents, as well as reduced compliance, confidence, and follow-up consultation willingness in patient agents. Evaluating a suite of state-of-the-art LLMs, we find that several models that excel in benchmarks like MedQA are performing poorly in AgentClinic-MedQA. We find that the LLM used in the patient agent is an important factor for performance in the AgentClinic benchmark. We show that both having limited interactions as well as too many interaction reduces diagnostic accuracy in doctor agents. The code and data for this work is publicly available at https://AgentClinic.github.io.

  • 6 authors
·
May 13, 2024

CARE: Towards Clinical Accountability in Multi-Modal Medical Reasoning with an Evidence-Grounded Agentic Framework

Large visual language models (VLMs) have shown strong multi-modal medical reasoning ability, but most operate as end-to-end black boxes, diverging from clinicians' evidence-based, staged workflows and hindering clinical accountability. Complementarily, expert visual grounding models can accurately localize regions of interest (ROIs), providing explicit, reliable evidence that improves both reasoning accuracy and trust. In this paper, we introduce CARE, advancing Clinical Accountability in multi-modal medical Reasoning with an Evidence-grounded agentic framework. Unlike existing approaches that couple grounding and reasoning within a single generalist model, CARE decomposes the task into coordinated sub-modules to reduce shortcut learning and hallucination: a compact VLM proposes relevant medical entities; an expert entity-referring segmentation model produces pixel-level ROI evidence; and a grounded VLM reasons over the full image augmented by ROI hints. The VLMs are optimized with reinforcement learning with verifiable rewards to align answers with supporting evidence. Furthermore, a VLM coordinator plans tool invocation and reviews evidence-answer consistency, providing agentic control and final verification. Evaluated on standard medical VQA benchmarks, our CARE-Flow (coordinator-free) improves average accuracy by 10.9% over the same size (10B) state-of-the-art (SOTA). With dynamic planning and answer review, our CARE-Coord yields a further gain, outperforming the heavily pre-trained SOTA by 5.2%. Our experiments demonstrate that an agentic framework that emulates clinical workflows, incorporating decoupled specialized models and explicit evidence, yields more accurate and accountable medical AI. Project page: https://xypb.github.io/CARE-Project-Page/

  • 5 authors
·
Mar 10

AgentRxiv: Towards Collaborative Autonomous Research

Progress in scientific discovery is rarely the result of a single "Eureka" moment, but is rather the product of hundreds of scientists incrementally working together toward a common goal. While existing agent workflows are capable of producing research autonomously, they do so in isolation, without the ability to continuously improve upon prior research results. To address these challenges, we introduce AgentRxiv-a framework that lets LLM agent laboratories upload and retrieve reports from a shared preprint server in order to collaborate, share insights, and iteratively build on each other's research. We task agent laboratories to develop new reasoning and prompting techniques and find that agents with access to their prior research achieve higher performance improvements compared to agents operating in isolation (11.4% relative improvement over baseline on MATH-500). We find that the best performing strategy generalizes to benchmarks in other domains (improving on average by 3.3%). Multiple agent laboratories sharing research through AgentRxiv are able to work together towards a common goal, progressing more rapidly than isolated laboratories, achieving higher overall accuracy (13.7% relative improvement over baseline on MATH-500). These findings suggest that autonomous agents may play a role in designing future AI systems alongside humans. We hope that AgentRxiv allows agents to collaborate toward research goals and enables researchers to accelerate discovery.

  • 2 authors
·
Mar 23, 2025 2

MedMMV: A Controllable Multimodal Multi-Agent Framework for Reliable and Verifiable Clinical Reasoning

Recent progress in multimodal large language models (MLLMs) has demonstrated promising performance on medical benchmarks and in preliminary trials as clinical assistants. Yet, our pilot audit of diagnostic cases uncovers a critical failure mode: instability in early evidence interpretation precedes hallucination, creating branching reasoning trajectories that cascade into globally inconsistent conclusions. This highlights the need for clinical reasoning agents that constrain stochasticity and hallucination while producing auditable decision flows. We introduce MedMMV, a controllable multimodal multi-agent framework for reliable and verifiable clinical reasoning. MedMMV stabilizes reasoning through diversified short rollouts, grounds intermediate steps in a structured evidence graph under the supervision of a Hallucination Detector, and aggregates candidate paths with a Combined Uncertainty scorer. On six medical benchmarks, MedMMV improves accuracy by up to 12.7% and, more critically, demonstrates superior reliability. Blind physician evaluations confirm that MedMMV substantially increases reasoning truthfulness without sacrificing informational content. By controlling instability through a verifiable, multi-agent process, our framework provides a robust path toward deploying trustworthy AI systems in high-stakes domains like clinical decision support.

  • 7 authors
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Sep 29, 2025

MedAgents: Large Language Models as Collaborators for Zero-shot Medical Reasoning

Large Language Models (LLMs), despite their remarkable progress across various general domains, encounter significant barriers in medicine and healthcare. This field faces unique challenges such as domain-specific terminologies and the reasoning over specialized knowledge. To address these obstinate issues, we propose a novel Multi-disciplinary Collaboration (MC) framework for the medical domain that leverages role-playing LLM-based agents who participate in a collaborative multi-round discussion, thereby enhancing LLM proficiency and reasoning capabilities. This training-free and interpretable framework encompasses five critical steps: gathering domain experts, proposing individual analyses, summarising these analyses into a report, iterating over discussions until a consensus is reached, and ultimately making a decision. Our work particularly focuses on the zero-shot scenario, our results on nine data sets (MedQA, MedMCQA, PubMedQA, and six subtasks from MMLU) establish that our proposed MC framework excels at mining and harnessing the medical expertise in LLMs, as well as extending its reasoning abilities. Based on these outcomes, we further conduct a human evaluation to pinpoint and categorize common errors within our method, as well as ablation studies aimed at understanding the impact of various factors on overall performance. Our code can be found at https://github.com/gersteinlab/MedAgents.

  • 7 authors
·
Nov 16, 2023

MedInsightBench: Evaluating Medical Analytics Agents Through Multi-Step Insight Discovery in Multimodal Medical Data

In medical data analysis, extracting deep insights from complex, multi-modal datasets is essential for improving patient care, increasing diagnostic accuracy, and optimizing healthcare operations. However, there is currently a lack of high-quality datasets specifically designed to evaluate the ability of large multi-modal models (LMMs) to discover medical insights. In this paper, we introduce MedInsightBench, the first benchmark that comprises 332 carefully curated medical cases, each annotated with thoughtfully designed insights. This benchmark is intended to evaluate the ability of LMMs and agent frameworks to analyze multi-modal medical image data, including posing relevant questions, interpreting complex findings, and synthesizing actionable insights and recommendations. Our analysis indicates that existing LMMs exhibit limited performance on MedInsightBench, which is primarily attributed to their challenges in extracting multi-step, deep insights and the absence of medical expertise. Therefore, we propose MedInsightAgent, an automated agent framework for medical data analysis, composed of three modules: Visual Root Finder, Analytical Insight Agent, and Follow-up Question Composer. Experiments on MedInsightBench highlight pervasive challenges and demonstrate that MedInsightAgent can improve the performance of general LMMs in medical data insight discovery.

  • 7 authors
·
Dec 15, 2025

From LLM Reasoning to Autonomous AI Agents: A Comprehensive Review

Large language models and autonomous AI agents have evolved rapidly, resulting in a diverse array of evaluation benchmarks, frameworks, and collaboration protocols. However, the landscape remains fragmented and lacks a unified taxonomy or comprehensive survey. Therefore, we present a side-by-side comparison of benchmarks developed between 2019 and 2025 that evaluate these models and agents across multiple domains. In addition, we propose a taxonomy of approximately 60 benchmarks that cover general and academic knowledge reasoning, mathematical problem-solving, code generation and software engineering, factual grounding and retrieval, domain-specific evaluations, multimodal and embodied tasks, task orchestration, and interactive assessments. Furthermore, we review AI-agent frameworks introduced between 2023 and 2025 that integrate large language models with modular toolkits to enable autonomous decision-making and multi-step reasoning. Moreover, we present real-world applications of autonomous AI agents in materials science, biomedical research, academic ideation, software engineering, synthetic data generation, chemical reasoning, mathematical problem-solving, geographic information systems, multimedia, healthcare, and finance. We then survey key agent-to-agent collaboration protocols, namely the Agent Communication Protocol (ACP), the Model Context Protocol (MCP), and the Agent-to-Agent Protocol (A2A). Finally, we discuss recommendations for future research, focusing on advanced reasoning strategies, failure modes in multi-agent LLM systems, automated scientific discovery, dynamic tool integration via reinforcement learning, integrated search capabilities, and security vulnerabilities in agent protocols.

  • 3 authors
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Apr 28, 2025

MedMemoryBench: Benchmarking Agent Memory in Personalized Healthcare

The large-scale deployment of personalized healthcare agents demands memory mechanisms that are exceptionally precise, safe, and capable of long-term clinical tracking. However, existing benchmarks primarily focus on daily open-domain conversations, failing to capture the high-stakes complexity of real-world medical applications. Motivated by the stringent production requirements of an industry-leading health management agent serving tens of millions of active users, we introduce MedMemoryBench. We develop a human-agent collaborative pipeline to synthesize highly realistic, long-horizon medical trajectories based on clinically grounded, synthetic patient archetypes. This process yields a massive, expertly validated dataset comprising approximately 2,000 sessions and 16,000 interaction turns. Crucially, MedMemoryBench departs from traditional static evaluations by pioneering an "evaluate-while-constructing" streaming assessment protocol, which precisely mirrors dynamic memory accumulation in production environments. Furthermore, we formalize and systematically investigate the critical phenomenon of memory saturation, where sustained information influx actively degrades retrieval and reasoning robustness. Comprehensive benchmarking reveals severe bottlenecks in mainstream architectures, particularly concerning complex medical reasoning and noise resilience. By exposing these fundamental flaws, MedMemoryBench establishes a vital foundation for developing robust, production-ready medical agents.

  • 13 authors
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May 11

Evolving Medical Imaging Agents via Experience-driven Self-skill Discovery

Clinical image interpretation is inherently multi-step and tool-centric: clinicians iteratively combine visual evidence with patient context, quantify findings, and refine their decisions through a sequence of specialized procedures. While LLM-based agents promise to orchestrate such heterogeneous medical tools, existing systems treat tool sets and invocation strategies as static after deployment. This design is brittle under real-world domain shifts, across tasks, and evolving diagnostic requirements, where predefined tool chains frequently degrade and demand costly manual re-design. We propose MACRO, a self-evolving, experience-augmented medical agent that shifts from static tool composition to experience-driven tool discovery. From verified execution trajectories, the agent autonomously identifies recurring effective multi-step tool sequences, synthesizes them into reusable composite tools, and registers these as new high-level primitives that continuously expand its behavioral repertoire. A lightweight image-feature memory grounds tool selection in a visual-clinical context, while a GRPO-like training loop reinforces reliable invocation of discovered composites, enabling closed-loop self-improvement with minimal supervision. Extensive experiments across diverse medical imaging datasets and tasks demonstrate that autonomous composite tool discovery consistently improves multi-step orchestration accuracy and cross-domain generalization over strong baselines and recent state-of-the-art agentic methods, bridging the gap between brittle static tool use and adaptive, context-aware clinical AI assistance. Code will be available upon acceptance.

  • 7 authors
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Mar 5

Reinventing Clinical Dialogue: Agentic Paradigms for LLM Enabled Healthcare Communication

Clinical dialogue represents a complex duality requiring both the empathetic fluency of natural conversation and the rigorous precision of evidence-based medicine. While Large Language Models possess unprecedented linguistic capabilities, their architectural reliance on reactive and stateless processing often favors probabilistic plausibility over factual veracity. This structural limitation has catalyzed a paradigm shift in medical AI from generative text prediction to agentic autonomy, where the model functions as a central reasoning engine capable of deliberate planning and persistent memory. Moving beyond existing reviews that primarily catalog downstream applications, this survey provides a first-principles analysis of the cognitive architecture underpinning this shift. We introduce a novel taxonomy structured along the orthogonal axes of knowledge source and agency objective to delineate the provenance of clinical knowledge against the system's operational scope. This framework facilitates a systematic analysis of the intrinsic trade-offs between creativity and reliability by categorizing methods into four archetypes: Latent Space Clinicians, Emergent Planners, Grounded Synthesizers, and Verifiable Workflow Automators. For each paradigm, we deconstruct the technical realization across the entire cognitive pipeline, encompassing strategic planning, memory management, action execution, collaboration, and evolution to reveal how distinct architectural choices balance the tension between autonomy and safety.

  • 5 authors
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Dec 1, 2025 2

Automated Composition of Agents: A Knapsack Approach for Agentic Component Selection

Designing effective agentic systems requires the seamless composition and integration of agents, tools, and models within dynamic and uncertain environments. Most existing methods rely on static, semantic retrieval approaches for tool or agent discovery. However, effective reuse and composition of existing components remain challenging due to incomplete capability descriptions and the limitations of retrieval methods. Component selection suffers because the decisions are not based on capability, cost, and real-time utility. To address these challenges, we introduce a structured, automated framework for agentic system composition that is inspired by the knapsack problem. Our framework enables a composer agent to systematically identify, select, and assemble an optimal set of agentic components by jointly considering performance, budget constraints, and compatibility. By dynamically testing candidate components and modeling their utility in real-time, our approach streamlines the assembly of agentic systems and facilitates scalable reuse of resources. Empirical evaluation with Claude 3.5 Sonnet across five benchmarking datasets shows that our online-knapsack-based composer consistently lies on the Pareto frontier, achieving higher success rates at significantly lower component costs compared to our baselines. In the single-agent setup, the online knapsack composer shows a success rate improvement of up to 31.6% in comparison to the retrieval baselines. In multi-agent systems, the online knapsack composer increases success rate from 37% to 87% when agents are selected from an agent inventory of 100+ agents. The substantial performance gap confirms the robust adaptability of our method across diverse domains and budget constraints.

  • 8 authors
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Oct 18, 2025 2

Agents-K1: Towards Agent-native Knowledge Orchestration

Current LLM-based research agents have advanced through agent orchestration, yet largely overlook scientific knowledge orchestration. Existing works often reduce papers to abstracts, surface mentions, and flat cites edges, omitting key entities, claims, evidence, mechanisms, and method lineages essential for scientific reasoning. To this end, we introduce Agents-K1, an end-to-end knowledge orchestration pipeline that converts raw documents into agent-native scientific knowledge graphs. Agents-K1 integrates three components under a unifying theoretical foundation: a multimodal parser whose five-module schema captures entities, multimodal evidence, citations, and typed inter-entity relations across the full paper rather than abstracts alone; a 4B information-extraction backbone trained with GRPO under a rule-based reward; and a graphanything CLI, a tri-source agent interface that unifies web search, multimodal graph retrieval, and cross-document traversal. On top of this, we process 2.46 million scientific papers across six subjects to produce Scholar-KG, of which we release a one-million-paper subset, and the full Scholar-KG is accessible via the SCP link below. The same pipeline can be extended to general-domain corpora and to schema-conformant data synthesis. Extensive experiments demonstrate that Agents-K1 achieves superior performance in scientific information extraction, knowledge graph construction, and multi-hop scientific reasoning.

  • 25 authors
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Jun 10

Multi-Agent Transactive Memory

The decentralized deployment of LLM agents with diverse capabilities across diverse tasks motivates infrastructure for knowledge sharing across heterogeneous agent populations. Just as search engines index human-generated artifacts to support human problem solving, retrieval systems can organize agent-generated artifacts for reuse across agent populations. We extend retrieval-augmented generation - which demonstrates the value of human-authored artifacts to individual agents - to retrieval of agent-generated artifacts supporting a population of agents. In particular, agent trajectories encode reusable procedural knowledge, yet these artifacts are typically discarded after a single use or retained only by the producing agent, forcing newly instantiated agents to repeatedly rediscover existing solutions. We propose Multi-Agent Transactive Memory (MATM), a framework for population-level storage and retrieval of agent-generated trajectories, where producer agents contribute trajectories to a shared repository and consumer agents retrieve them to improve task execution. We focus on interactive environments (ALFWorld and WebArena), where trajectories are long and encode especially rich procedural structure. Our experiments demonstrate that retrieving trajectories from MATM improves downstream task performance and reduces interaction steps without coordination or joint training. These results position MATM as a design pattern for population-level experience sharing in open agent ecosystems.

  • 6 authors
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Jun 17

Paper Circle: An Open-source Multi-agent Research Discovery and Analysis Framework

The rapid growth of scientific literature has made it increasingly difficult for researchers to efficiently discover, evaluate, and synthesize relevant work. Recent advances in multi-agent large language models (LLMs) have demonstrated strong potential for understanding user intent and are being trained to utilize various tools. In this paper, we introduce Paper Circle, a multi-agent research discovery and analysis system designed to reduce the effort required to find, assess, organize, and understand academic literature. The system comprises two complementary pipelines: (1) a Discovery Pipeline that integrates offline and online retrieval from multiple sources, multi-criteria scoring, diversity-aware ranking, and structured outputs; and (2) an Analysis Pipeline that transforms individual papers into structured knowledge graphs with typed nodes such as concepts, methods, experiments, and figures, enabling graph-aware question answering and coverage verification. Both pipelines are implemented within a coder LLM-based multi-agent orchestration framework and produce fully reproducible, synchronized outputs including JSON, CSV, BibTeX, Markdown, and HTML at each agent step. This paper describes the system architecture, agent roles, retrieval and scoring methods, knowledge graph schema, and evaluation interfaces that together form the Paper Circle research workflow. We benchmark Paper Circle on both paper retrieval and paper review generation, reporting hit rate, MRR, and Recall at K. Results show consistent improvements with stronger agent models. We have publicly released the website at https://papercircle.vercel.app/ and the code at https://github.com/MAXNORM8650/papercircle.

Build Your Personalized Research Group: A Multiagent Framework for Continual and Interactive Science Automation

The automation of scientific discovery represents a critical milestone in Artificial Intelligence (AI) research. However, existing agentic systems for science suffer from two fundamental limitations: rigid, pre-programmed workflows that cannot adapt to intermediate findings, and inadequate context management that hinders long-horizon research. We present freephdlabor, an open-source multiagent framework featuring fully dynamic workflows determined by real-time agent reasoning and a \textit{modular architecture} enabling seamless customization -- users can modify, add, or remove agents to address domain-specific requirements. The framework provides comprehensive infrastructure including automatic context compaction, workspace-based communication to prevent information degradation, memory persistence across sessions, and non-blocking human intervention mechanisms. These features collectively transform automated research from isolated, single-run attempts into continual research programs that build systematically on prior explorations and incorporate human feedback. By providing both the architectural principles and practical implementation for building customizable co-scientist systems, this work aims to facilitate broader adoption of automated research across scientific domains, enabling practitioners to deploy interactive multiagent systems that autonomously conduct end-to-end research -- from ideation through experimentation to publication-ready manuscripts.

  • 7 authors
·
Oct 17, 2025 5

WideSearch: Benchmarking Agentic Broad Info-Seeking

From professional research to everyday planning, many tasks are bottlenecked by wide-scale information seeking, which is more repetitive than cognitively complex. With the rapid development of Large Language Models (LLMs), automated search agents powered by LLMs offer a promising solution to liberate humans from this tedious work. However, the capability of these agents to perform such "wide-context" collection reliably and completely remains largely unevaluated due to a lack of suitable benchmarks. To bridge this gap, we introduce WideSearch, a new benchmark engineered to evaluate agent reliability on these large-scale collection tasks. The benchmark features 200 manually curated questions (100 in English, 100 in Chinese) from over 15 diverse domains, grounded in real user queries. Each task requires agents to collect large-scale atomic information, which could be verified one by one objectively, and arrange it into a well-organized output. A rigorous five-stage quality control pipeline ensures the difficulty, completeness, and verifiability of the dataset. We benchmark over 10 state-of-the-art agentic search systems, including single-agent, multi-agent frameworks, and end-to-end commercial systems. Most systems achieve overall success rates near 0\%, with the best performer reaching just 5\%. However, given sufficient time, cross-validation by multiple human testers can achieve a near 100\% success rate. These results demonstrate that present search agents have critical deficiencies in large-scale information seeking, underscoring urgent areas for future research and development in agentic search. Our dataset, evaluation pipeline, and benchmark results have been publicly released at https://widesearch-seed.github.io/

  • 13 authors
·
Aug 11, 2025 3

MedBench v4: A Robust and Scalable Benchmark for Evaluating Chinese Medical Language Models, Multimodal Models, and Intelligent Agents

Recent advances in medical large language models (LLMs), multimodal models, and agents demand evaluation frameworks that reflect real clinical workflows and safety constraints. We present MedBench v4, a nationwide, cloud-based benchmarking infrastructure comprising over 700,000 expert-curated tasks spanning 24 primary and 91 secondary specialties, with dedicated tracks for LLMs, multimodal models, and agents. Items undergo multi-stage refinement and multi-round review by clinicians from more than 500 institutions, and open-ended responses are scored by an LLM-as-a-judge calibrated to human ratings. We evaluate 15 frontier models. Base LLMs reach a mean overall score of 54.1/100 (best: Claude Sonnet 4.5, 62.5/100), but safety and ethics remain low (18.4/100). Multimodal models perform worse overall (mean 47.5/100; best: GPT-5, 54.9/100), with solid perception yet weaker cross-modal reasoning. Agents built on the same backbones substantially improve end-to-end performance (mean 79.8/100), with Claude Sonnet 4.5-based agents achieving up to 85.3/100 overall and 88.9/100 on safety tasks. MedBench v4 thus reveals persisting gaps in multimodal reasoning and safety for base models, while showing that governance-aware agentic orchestration can markedly enhance benchmarked clinical readiness without sacrificing capability. By aligning tasks with Chinese clinical guidelines and regulatory priorities, the platform offers a practical reference for hospitals, developers, and policymakers auditing medical AI.

  • 18 authors
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Nov 18, 2025

ArgMed-Agents: Explainable Clinical Decision Reasoning with LLM Disscusion via Argumentation Schemes

There are two main barriers to using large language models (LLMs) in clinical reasoning. Firstly, while LLMs exhibit significant promise in Natural Language Processing (NLP) tasks, their performance in complex reasoning and planning falls short of expectations. Secondly, LLMs use uninterpretable methods to make clinical decisions that are fundamentally different from the clinician's cognitive processes. This leads to user distrust. In this paper, we present a multi-agent framework called ArgMed-Agents, which aims to enable LLM-based agents to make explainable clinical decision reasoning through interaction. ArgMed-Agents performs self-argumentation iterations via Argumentation Scheme for Clinical Discussion (a reasoning mechanism for modeling cognitive processes in clinical reasoning), and then constructs the argumentation process as a directed graph representing conflicting relationships. Ultimately, use symbolic solver to identify a series of rational and coherent arguments to support decision. We construct a formal model of ArgMed-Agents and present conjectures for theoretical guarantees. ArgMed-Agents enables LLMs to mimic the process of clinical argumentative reasoning by generating explanations of reasoning in a self-directed manner. The setup experiments show that ArgMed-Agents not only improves accuracy in complex clinical decision reasoning problems compared to other prompt methods, but more importantly, it provides users with decision explanations that increase their confidence.

  • 4 authors
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Mar 10, 2024

LLM-based Multi-Agent Blackboard System for Information Discovery in Data Science

The rapid advancement of Large Language Models (LLMs) has opened new opportunities in data science, yet their practical deployment is often constrained by the challenge of discovering relevant data within large heterogeneous data lakes. Existing methods struggle with this: single-agent systems are quickly overwhelmed by large, heterogeneous files in the large data lakes, while multi-agent systems designed based on a master-slave paradigm depend on a rigid central controller for task allocation that requires precise knowledge of each sub-agent's capabilities. To address these limitations, we propose a novel multi-agent communication paradigm inspired by the blackboard architecture for traditional AI models. In this framework, a central agent posts requests to a shared blackboard, and autonomous subordinate agents -- either responsible for a partition of the data lake or general information retrieval -- volunteer to respond based on their capabilities. This design improves scalability and flexibility by eliminating the need for a central coordinator to have prior knowledge of all sub-agents' expertise. We evaluate our method on three benchmarks that require explicit data discovery: KramaBench and modified versions of DS-Bench and DA-Code to incorporate data discovery. Experimental results demonstrate that the blackboard architecture substantially outperforms baselines, including RAG and the master-slave multi-agent paradigm, achieving between 13% to 57% relative improvement in end-to-end task success and up to a 9% relative gain in F1 score for data discovery over the best-performing baselines across both proprietary and open-source LLMs. Our findings establish the blackboard paradigm as a scalable and generalizable communication framework for multi-agent systems.

  • 8 authors
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Sep 30, 2025

OralAgent: Integrating Reasoning, Tools, and Knowledge for Interactive Dental Image Analysis

Dental image analysis plays a pivotal role in supporting accurate diagnosis and treatment planning in oral healthcare. Although recent advances have produced dental AI models for specific tasks and individual imaging modalities, their isolated designs limit practical use in real-world clinical workflows. In this paper, we present OralAgent, the first dental-specialized AI agent that unifies multimodal reasoning, tool-based decision-making, and knowledge-grounded retrieval within an end-to-end automated framework. It integrates 22 visual analysis tools and 368 widely-used classical dental textbooks, enabling autonomous reasoning, planning, tool use, knowledge retrieval, and multi-step workflow execution. Furthermore, we introduce OralCorpus, a large-scale, high-quality bilingual textual resource containing 134.8M tokens curated for dental retrieval-augmented generation (RAG). To evaluate models' multidisciplinary dental knowledge, we construct OralQA-ZH, a Chinese multiple-choice question benchmark consisting of 798 items across eleven oral subspecialties. Extensive experiments demonstrate that OralAgent achieves state-of-the-art performance on the MMOral-Uni, MMOral-OPG, and OralQA-ZH benchmarks, highlighting its effectiveness, interpretability, and adaptability in real-world clinical settings. The code and models are publicly available at https://github.com/isjinghao/OralAgent.

  • 16 authors
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Apr 8

Federation of Agents: A Semantics-Aware Communication Fabric for Large-Scale Agentic AI

We present Federation of Agents (FoA), a distributed orchestration framework that transforms static multi-agent coordination into dynamic, capability-driven collaboration. FoA introduces Versioned Capability Vectors (VCVs): machine-readable profiles that make agent capabilities searchable through semantic embeddings, enabling agents to advertise their capabilities, cost, and limitations. Our aarchitecturecombines three key innovations: (1) semantic routing that matches tasks to agents over sharded HNSW indices while enforcing operational constraints through cost-biased optimization, (2) dynamic task decomposition where compatible agents collaboratively break down complex tasks into DAGs of subtasks through consensus-based merging, and (3) smart clustering that groups agents working on similar subtasks into collaborative channels for k-round refinement before synthesis. Built on top of MQTT,s publish-subscribe semantics for scalable message passing, FoA achieves sub-linear complexity through hierarchical capability matching and efficient index maintenance. Evaluation on HealthBench shows 13x improvements over single-model baselines, with clustering-enhanced laboration particularly effective for complex reasoning tasks requiring multiple perspectives. The system scales horizontally while maintaining consistent performance, demonstrating that semantic orchestration with structured collaboration can unlock the collective intelligence of heterogeneous federations of AI agents.

  • 11 authors
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Sep 24, 2025

End-to-End Agentic RAG System Training for Traceable Diagnostic Reasoning

Accurate diagnosis with medical large language models is hindered by knowledge gaps and hallucinations. Retrieval and tool-augmented methods help, but their impact is limited by weak use of external knowledge and poor feedback-reasoning traceability. To address these challenges, We introduce Deep-DxSearch, an agentic RAG system trained end-to-end with reinforcement learning (RL) that enables steer tracebale retrieval-augmented reasoning for medical diagnosis. In Deep-DxSearch, we first construct a large-scale medical retrieval corpus comprising patient records and reliable medical knowledge sources to support retrieval-aware reasoning across diagnostic scenarios. More crutially, we frame the LLM as the core agent and the retrieval corpus as its environment, using tailored rewards on format, retrieval, reasoning structure, and diagnostic accuracy, thereby evolving the agentic RAG policy from large-scale data through RL. Experiments demonstrate that our end-to-end agentic RL training framework consistently outperforms prompt-engineering and training-free RAG approaches across multiple data centers. After training, Deep-DxSearch achieves substantial gains in diagnostic accuracy, surpassing strong diagnostic baselines such as GPT-4o, DeepSeek-R1, and other medical-specific frameworks for both common and rare disease diagnosis under in-distribution and out-of-distribution settings. Moreover, ablation studies on reward design and retrieval corpus components confirm their critical roles, underscoring the uniqueness and effectiveness of our approach compared with traditional implementations. Finally, case studies and interpretability analyses highlight improvements in Deep-DxSearch's diagnostic policy, providing deeper insight into its performance gains and supporting clinicians in delivering more reliable and precise preliminary diagnoses. See https://github.com/MAGIC-AI4Med/Deep-DxSearch.

  • 10 authors
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Aug 21, 2025 2

MedAgentsBench: Benchmarking Thinking Models and Agent Frameworks for Complex Medical Reasoning

Large Language Models (LLMs) have shown impressive performance on existing medical question-answering benchmarks. This high performance makes it increasingly difficult to meaningfully evaluate and differentiate advanced methods. We present MedAgentsBench, a benchmark that focuses on challenging medical questions requiring multi-step clinical reasoning, diagnosis formulation, and treatment planning-scenarios where current models still struggle despite their strong performance on standard tests. Drawing from seven established medical datasets, our benchmark addresses three key limitations in existing evaluations: (1) the prevalence of straightforward questions where even base models achieve high performance, (2) inconsistent sampling and evaluation protocols across studies, and (3) lack of systematic analysis of the interplay between performance, cost, and inference time. Through experiments with various base models and reasoning methods, we demonstrate that the latest thinking models, DeepSeek R1 and OpenAI o3, exhibit exceptional performance in complex medical reasoning tasks. Additionally, advanced search-based agent methods offer promising performance-to-cost ratios compared to traditional approaches. Our analysis reveals substantial performance gaps between model families on complex questions and identifies optimal model selections for different computational constraints. Our benchmark and evaluation framework are publicly available at https://github.com/gersteinlab/medagents-benchmark.

  • 12 authors
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Mar 10, 2025 3

DoctorAgent-RL: A Multi-Agent Collaborative Reinforcement Learning System for Multi-Turn Clinical Dialogue

Large language models (LLMs) have demonstrated excellent capabilities in the field of biomedical question answering, but their application in real-world clinical consultations still faces core challenges. Existing systems rely on a one-way information transmission mode where patients must fully describe their symptoms in a single round, leading to nonspecific diagnostic recommendations when complaints are vague. Traditional multi-turn dialogue methods based on supervised learning are constrained by static data-driven paradigms, lacking generalizability and struggling to intelligently extract key clinical information. To address these limitations, we propose DoctorAgent-RL, a reinforcement learning (RL)-based multi-agent collaborative framework that models medical consultations as a dynamic decision-making process under uncertainty. The doctor agent continuously optimizes its questioning strategy within the RL framework through multi-turn interactions with the patient agent, dynamically adjusting its information-gathering path based on comprehensive rewards from the Consultation Evaluator. This RL fine-tuning mechanism enables LLMs to autonomously develop interaction strategies aligned with clinical reasoning logic, rather than superficially imitating patterns in existing dialogue data. Notably, we constructed MTMedDialog, the first English multi-turn medical consultation dataset capable of simulating patient interactions. Experiments demonstrate that DoctorAgent-RL outperforms existing models in both multi-turn reasoning capability and final diagnostic performance, demonstrating practical value in assisting clinical consultations. https://github.com/JarvisUSTC/DoctorAgent-RL

  • 4 authors
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May 26, 2025 2

OpenCUA: Open Foundations for Computer-Use Agents

Vision-language models have demonstrated impressive capabilities as computer-use agents (CUAs) capable of automating diverse computer tasks. As their commercial potential grows, critical details of the most capable CUA systems remain closed. As these agents will increasingly mediate digital interactions and execute consequential decisions on our behalf, the research community needs access to open CUA frameworks to study their capabilities, limitations, and risks. To bridge this gap, we propose OpenCUA, a comprehensive open-source framework for scaling CUA data and foundation models. Our framework consists of: (1) an annotation infrastructure that seamlessly captures human computer-use demonstrations; (2) AgentNet, the first large-scale computer-use task dataset spanning 3 operating systems and 200+ applications and websites; (3) a scalable pipeline that transforms demonstrations into state-action pairs with reflective long Chain-of-Thought reasoning that sustain robust performance gains as data scales. Our end-to-end agent models demonstrate strong performance across CUA benchmarks. In particular, OpenCUA-32B achieves an average success rate of 34.8% on OSWorld-Verified, establishing a new state-of-the-art (SOTA) among open-source models and surpassing OpenAI CUA (GPT-4o). Further analysis confirms that our approach generalizes well across domains and benefits significantly from increased test-time computation. We release our annotation tool, datasets, code, and models to build open foundations for further CUA research.

  • 39 authors
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Aug 12, 2025 2

A multimodal and temporal foundation model for virtual patient representations at healthcare system scale

Modern medicine generates vast multimodal data across siloed systems, yet no existing model integrates the full breadth and temporal depth of the clinical record into a unified patient representation. We introduce Apollo, a multimodal temporal foundation model trained and evaluated on over three decades of longitudinal hospital records from a major US hospital system, composed of 25 billion records from 7.2 million patients, representing 28 distinct medical modalities and 12 major medical specialties. Apollo learns a unified representation space integrating over 100 thousand unique medical events in our clinical vocabulary as well as images and clinical text. This "atlas of medical concepts" forms a computational substrate for modeling entire patient care journeys comprised of sequences of structured and unstructured events, which are compressed by Apollo into virtual patient representations. To assess the potential of these whole-patient representations, we created 322 prognosis and retrieval tasks from a held-out test set of 1.4 million patients. We demonstrate the generalized clinical forecasting potential of Apollo embeddings, including predicting new disease onset risk up to five years in advance (95 tasks), disease progression (78 tasks), treatment response (59 tasks), risk of treatment-related adverse events (17 tasks), and hospital operations endpoints (12 tasks). Using feature attribution techniques, we show that model predictions align with clinically-interpretable multimodal biomarkers. We evaluate semantic similarity search on 61 retrieval tasks, and moreover demonstrate the potential of Apollo as a multimodal medical search engine using text and image queries. Together, these modeling capabilities establish the foundation for computable medicine, where the full context of patient care becomes accessible to computational reasoning.

  • 11 authors
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Apr 20

Autonomous Agents Coordinating Distributed Discovery Through Emergent Artifact Exchange

We present ScienceClaw + Infinite, a framework for autonomous scientific investigation in which independent agents conduct research without central coordination, and any contributor can deploy new agents into a shared ecosystem. The system is built around three components: an extensible registry of over 300 interoperable scientific skills, an artifact layer that preserves full computational lineage as a directed acyclic graph (DAG), and a structured platform for agent-based scientific discourse with provenance-aware governance. Agents select and chain tools based on their scientific profiles, produce immutable artifacts with typed metadata and parent lineage, and broadcast unsatisfied information needs to a shared global index. The ArtifactReactor enables plannerless coordination: peer agents discover and fulfill open needs through pressure-based scoring, while schema-overlap matching triggers multi-parent synthesis across independent analyses. An autonomous mutation layer actively prunes the expanding artifact DAG to resolve conflicting or redundant workflows, while persistent memory allows agents to continuously build upon complex epistemic states across multiple cycles. Infinite converts these outputs into auditable scientific records through structured posts, provenance views, and machine-readable discourse relations, with community feedback steering subsequent investigation cycles. Across four autonomous investigations, peptide design for the somatostatin receptor SSTR2, lightweight impact-resistant ceramic screening, cross-domain resonance bridging biology, materials, and music, and formal analogy construction between urban morphology and grain-boundary evolution, the framework demonstrates heterogeneous tool chaining, emergent convergence among independently operating agents, and traceable reasoning from raw computation to published finding.

CarePilot: A Multi-Agent Framework for Long-Horizon Computer Task Automation in Healthcare

Multimodal agentic pipelines are transforming human-computer interaction by enabling efficient and accessible automation of complex, real-world tasks. However, recent efforts have focused on short-horizon or general-purpose applications (e.g., mobile or desktop interfaces), leaving long-horizon automation for domain-specific systems, particularly in healthcare, largely unexplored. To address this, we introduce CareFlow, a high-quality human-annotated benchmark comprising complex, long-horizon software workflows across medical annotation tools, DICOM viewers, EHR systems, and laboratory information systems. On this benchmark, existing vision-language models (VLMs) perform poorly, struggling with long-horizon reasoning and multi-step interactions in medical contexts. To overcome this, we propose CarePilot, a multi-agent framework based on the actor-critic paradigm. The Actor integrates tool grounding with dual-memory mechanisms (long-term and short-term experience) to predict the next semantic action from the visual interface and system state. The Critic evaluates each action, updates memory based on observed effects, and either executes or provides corrective feedback to refine the workflow. Through iterative agentic simulation, the Actor learns to perform more robust and reasoning-aware predictions during inference. Our experiments show that CarePilot achieves state-of-the-art performance, outperforming strong closed-source and open-source multimodal baselines by approximately 15.26% and 3.38%, respectively, on our benchmark and out-of-distribution dataset.

Towards a Medical AI Scientist

Autonomous systems that generate scientific hypotheses, conduct experiments, and draft manuscripts have recently emerged as a promising paradigm for accelerating discovery. However, existing AI Scientists remain largely domain-agnostic, limiting their applicability to clinical medicine, where research is required to be grounded in medical evidence with specialized data modalities. In this work, we introduce Medical AI Scientist, the first autonomous research framework tailored to clinical autonomous research. It enables clinically grounded ideation by transforming extensively surveyed literature into actionable evidence through clinician-engineer co-reasoning mechanism, which improves the traceability of generated research ideas. It further facilitates evidence-grounded manuscript drafting guided by structured medical compositional conventions and ethical policies. The framework operates under 3 research modes, namely paper-based reproduction, literature-inspired innovation, and task-driven exploration, each corresponding to a distinct level of automated scientific inquiry with progressively increasing autonomy. Comprehensive evaluations by both large language models and human experts demonstrate that the ideas generated by the Medical AI Scientist are of substantially higher quality than those produced by commercial LLMs across 171 cases, 19 clinical tasks, and 6 data modalities. Meanwhile, our system achieves strong alignment between the proposed method and its implementation, while also demonstrating significantly higher success rates in executable experiments. Double-blind evaluations by human experts and the Stanford Agentic Reviewer suggest that the generated manuscripts approach MICCAI-level quality, while consistently surpassing those from ISBI and BIBM. The proposed Medical AI Scientist highlights the potential of leveraging AI for autonomous scientific discovery in healthcare.

  • 8 authors
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Mar 30 4

Learning to Recommend Multi-Agent Subgraphs from Calling Trees

Multi-agent systems (MAS) increasingly solve complex tasks by orchestrating agents and tools selected from rapidly growing marketplaces. As these marketplaces expand, many candidates become functionally overlapping, making selection not just a retrieval problem: beyond filtering relevant agents, an orchestrator must choose options that are reliable, compatible with the current execution context, and able to cooperate with other selected agents. Existing recommender systems -- largely built for item-level ranking from flat user-item logs -- do not directly address the structured, sequential, and interaction-dependent nature of agent orchestration. We address this gap by formulating agent recommendation in MAS as a constrained decision problem and introducing a generic constrained recommendation framework that first uses retrieval to build a compact candidate set conditioned on the current subtask and context, and then performs utility optimization within this feasible set using a learned scorer that accounts for relevance, reliability, and interaction effects. We ground both the formulation and learning signals in historical calling trees, which capture the execution structure of MAS (parent-child calls, branching dependencies, and local cooperation patterns) beyond what flat logs provide. The framework supports two complementary settings: agent-level recommendation (select the next agent/tool) and system-level recommendation (select a small, connected agent team/subgraph for coordinated execution). To enable systematic evaluation, we construct a unified calling-tree benchmark by normalizing invocation logs from eight heterogeneous multi-agent corpora into a shared structured representation.

  • 2 authors
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Jan 28

ResearchCodeAgent: An LLM Multi-Agent System for Automated Codification of Research Methodologies

In this paper we introduce ResearchCodeAgent, a novel multi-agent system leveraging large language models (LLMs) agents to automate the codification of research methodologies described in machine learning literature. The system bridges the gap between high-level research concepts and their practical implementation, allowing researchers auto-generating code of existing research papers for benchmarking or building on top-of existing methods specified in the literature with availability of partial or complete starter code. ResearchCodeAgent employs a flexible agent architecture with a comprehensive action suite, enabling context-aware interactions with the research environment. The system incorporates a dynamic planning mechanism, utilizing both short and long-term memory to adapt its approach iteratively. We evaluate ResearchCodeAgent on three distinct machine learning tasks with distinct task complexity and representing different parts of the ML pipeline: data augmentation, optimization, and data batching. Our results demonstrate the system's effectiveness and generalizability, with 46.9% of generated code being high-quality and error-free, and 25% showing performance improvements over baseline implementations. Empirical analysis shows an average reduction of 57.9% in coding time compared to manual implementation. We observe higher gains for more complex tasks. ResearchCodeAgent represents a significant step towards automating the research implementation process, potentially accelerating the pace of machine learning research.

  • 5 authors
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Apr 28, 2025

AstaBench: Rigorous Benchmarking of AI Agents with a Scientific Research Suite

AI agents hold the potential to revolutionize scientific productivity by automating literature reviews, replicating experiments, analyzing data, and even proposing new directions of inquiry; indeed, there are now many such agents, ranging from general-purpose "deep research" systems to specialized science-specific agents, such as AI Scientist and AIGS. Rigorous evaluation of these agents is critical for progress. Yet existing benchmarks fall short on several fronts: they (1) fail to provide holistic, product-informed measures of real-world use cases such as science research; (2) lack reproducible agent tools necessary for a controlled comparison of core agentic capabilities; (3) do not account for confounding variables such as model cost and tool access; (4) do not provide standardized interfaces for quick agent prototyping and evaluation; and (5) lack comprehensive baseline agents necessary to identify true advances. In response, we define principles and tooling for more rigorously benchmarking agents. Using these, we present AstaBench, a suite that provides the first holistic measure of agentic ability to perform scientific research, comprising 2400+ problems spanning the entire scientific discovery process and multiple scientific domains, and including many problems inspired by actual user requests to deployed Asta agents. Our suite comes with the first scientific research environment with production-grade search tools that enable controlled, reproducible evaluation, better accounting for confounders. Alongside, we provide a comprehensive suite of nine science-optimized classes of Asta agents and numerous baselines. Our extensive evaluation of 57 agents across 22 agent classes reveals several interesting findings, most importantly that despite meaningful progress on certain individual aspects, AI remains far from solving the challenge of science research assistance.

  • 39 authors
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Oct 24, 2025 1

Agentic Systems in Radiology: Design, Applications, Evaluation, and Challenges

Building agents, systems that perceive and act upon their environment with a degree of autonomy, has long been a focus of AI research. This pursuit has recently become vastly more practical with the emergence of large language models (LLMs) capable of using natural language to integrate information, follow instructions, and perform forms of "reasoning" and planning across a wide range of tasks. With its multimodal data streams and orchestrated workflows spanning multiple systems, radiology is uniquely suited to benefit from agents that can adapt to context and automate repetitive yet complex tasks. In radiology, LLMs and their multimodal variants have already demonstrated promising performance for individual tasks such as information extraction and report summarization. However, using LLMs in isolation underutilizes their potential to support complex, multi-step workflows where decisions depend on evolving context from multiple information sources. Equipping LLMs with external tools and feedback mechanisms enables them to drive systems that exhibit a spectrum of autonomy, ranging from semi-automated workflows to more adaptive agents capable of managing complex processes. This review examines the design of such LLM-driven agentic systems, highlights key applications, discusses evaluation methods for planning and tool use, and outlines challenges such as error cascades, tool-use efficiency, and health IT integration.

  • 11 authors
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Oct 10, 2025

TURA: Tool-Augmented Unified Retrieval Agent for AI Search

The advent of Large Language Models (LLMs) is transforming search engines into conversational AI search products, primarily using Retrieval-Augmented Generation (RAG) on web corpora. However, this paradigm has significant industrial limitations. Traditional RAG approaches struggle with real-time needs and structured queries that require accessing dynamically generated content like ticket availability or inventory. Limited to indexing static pages, search engines cannot perform the interactive queries needed for such time-sensitive data. Academic research has focused on optimizing RAG for static content, overlooking complex intents and the need for dynamic sources like databases and real-time APIs. To bridge this gap, we introduce TURA (Tool-Augmented Unified Retrieval Agent for AI Search), a novel three-stage framework that combines RAG with agentic tool-use to access both static content and dynamic, real-time information. TURA has three key components: an Intent-Aware Retrieval module to decompose queries and retrieve information sources encapsulated as Model Context Protocol (MCP) Servers, a DAG-based Task Planner that models task dependencies as a Directed Acyclic Graph (DAG) for optimal parallel execution, and a lightweight Distilled Agent Executor for efficient tool calling. TURA is the first architecture to systematically bridge the gap between static RAG and dynamic information sources for a world-class AI search product. Serving tens of millions of users, it leverages an agentic framework to deliver robust, real-time answers while meeting the low-latency demands of a large-scale industrial system.

  • 9 authors
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Aug 6, 2025

DeepResearch Arena: The First Exam of LLMs' Research Abilities via Seminar-Grounded Tasks

Deep research agents have attracted growing attention for their potential to orchestrate multi-stage research workflows, spanning literature synthesis, methodological design, and empirical verification. Despite these strides, evaluating their research capability faithfully is rather challenging due to the difficulty of collecting frontier research questions that genuinely capture researchers' attention and intellectual curiosity. To address this gap, we introduce DeepResearch Arena, a benchmark grounded in academic seminars that capture rich expert discourse and interaction, better reflecting real-world research environments and reducing the risk of data leakage. To automatically construct DeepResearch Arena, we propose a Multi-Agent Hierarchical Task Generation (MAHTG) system that extracts research-worthy inspirations from seminar transcripts. The MAHTG system further translates research-worthy inspirations into high-quality research tasks, ensuring the traceability of research task formulation while filtering noise. With the MAHTG system, we curate DeepResearch Arena with over 10,000 high-quality research tasks from over 200 academic seminars, spanning 12 disciplines, such as literature, history, and science. Our extensive evaluation shows that DeepResearch Arena presents substantial challenges for current state-of-the-art agents, with clear performance gaps observed across different models.

  • 13 authors
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Sep 1, 2025 6

Knowledge-Aware Iterative Retrieval for Multi-Agent Systems

We introduce a novel large language model (LLM)-driven agent framework, which iteratively refines queries and filters contextual evidence by leveraging dynamically evolving knowledge. A defining feature of the system is its decoupling of external sources from an internal knowledge cache that is progressively updated to guide both query generation and evidence selection. This design mitigates bias-reinforcement loops and enables dynamic, trackable search exploration paths, thereby optimizing the trade-off between exploring diverse information and maintaining accuracy through autonomous agent decision-making. Our approach is evaluated on a broad range of open-domain question answering benchmarks, including multi-step tasks that mirror real-world scenarios where integrating information from multiple sources is critical, especially given the vulnerabilities of LLMs that lack explicit reasoning or planning capabilities. The results show that the proposed system not only outperforms single-step baselines regardless of task difficulty but also, compared to conventional iterative retrieval methods, demonstrates pronounced advantages in complex tasks through precise evidence-based reasoning and enhanced efficiency. The proposed system supports both competitive and collaborative sharing of updated context, enabling multi-agent extension. The benefits of multi-agent configurations become especially prominent as task difficulty increases. The number of convergence steps scales with task difficulty, suggesting cost-effective scalability.

  • 1 authors
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Mar 17, 2025

Patho-AgenticRAG: Towards Multimodal Agentic Retrieval-Augmented Generation for Pathology VLMs via Reinforcement Learning

Although Vision Language Models (VLMs) have shown strong generalization in medical imaging, pathology presents unique challenges due to ultra-high resolution, complex tissue structures, and nuanced clinical semantics. These factors make pathology VLMs prone to hallucinations, i.e., generating outputs inconsistent with visual evidence, which undermines clinical trust. Existing RAG approaches in this domain largely depend on text-based knowledge bases, limiting their ability to leverage diagnostic visual cues. To address this, we propose Patho-AgenticRAG, a multimodal RAG framework with a database built on page-level embeddings from authoritative pathology textbooks. Unlike traditional text-only retrieval systems, it supports joint text-image search, enabling direct retrieval of textbook pages that contain both the queried text and relevant visual cues, thus avoiding the loss of critical image-based information. Patho-AgenticRAG also supports reasoning, task decomposition, and multi-turn search interactions, improving accuracy in complex diagnostic scenarios. Experiments show that Patho-AgenticRAG significantly outperforms existing multimodal models in complex pathology tasks like multiple-choice diagnosis and visual question answering. Our project is available at the Patho-AgenticRAG repository: https://github.com/Wenchuan-Zhang/Patho-AgenticRAG.

  • 9 authors
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Aug 4, 2025

MedKGent: A Large Language Model Agent Framework for Constructing Temporally Evolving Medical Knowledge Graph

The rapid expansion of medical literature presents growing challenges for structuring and integrating domain knowledge at scale. Knowledge Graphs (KGs) offer a promising solution by enabling efficient retrieval, automated reasoning, and knowledge discovery. However, current KG construction methods often rely on supervised pipelines with limited generalizability or naively aggregate outputs from Large Language Models (LLMs), treating biomedical corpora as static and ignoring the temporal dynamics and contextual uncertainty of evolving knowledge. To address these limitations, we introduce MedKGent, a LLM agent framework for constructing temporally evolving medical KGs. Leveraging over 10 million PubMed abstracts published between 1975 and 2023, we simulate the emergence of biomedical knowledge via a fine-grained daily time series. MedKGent incrementally builds the KG in a day-by-day manner using two specialized agents powered by the Qwen2.5-32B-Instruct model. The Extractor Agent identifies knowledge triples and assigns confidence scores via sampling-based estimation, which are used to filter low-confidence extractions and inform downstream processing. The Constructor Agent incrementally integrates the retained triples into a temporally evolving graph, guided by confidence scores and timestamps to reinforce recurring knowledge and resolve conflicts. The resulting KG contains 156,275 entities and 2,971,384 relational triples. Quality assessments by two SOTA LLMs and three domain experts demonstrate an accuracy approaching 90%, with strong inter-rater agreement. To evaluate downstream utility, we conduct RAG across seven medical question answering benchmarks using five leading LLMs, consistently observing significant improvements over non-augmented baselines. Case studies further demonstrate the KG's value in literature-based drug repurposing via confidence-aware causal inference.

  • 13 authors
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Aug 17, 2025

Experience Makes Skillful: Enabling Generalizable Medical Agent Reasoning via Self-Evolving Skill Memory

Medical agent systems are increasingly expected to support interactive clinical decision making rather than only static question answering. In such settings, effective agents must reuse prior experience across evolving cases, yet existing memory mechanisms often retain raw historical traces that are redundant, noisy, and difficult to govern. More importantly, they rarely distinguish which memories are truly useful for future reasoning. This limits their ability to accumulate compact and reliable experience for long-horizon clinical reasoning. To close this gap, we propose SkeMex, a post-deployment self-evolution framework that improves medical agents through a skill-based memory without updating model weights. SkeMex distills informative interaction trajectories into structured skills that encode reusable procedural knowledge, and organizes them into a multi-branch repository spanning general, task-specific, and action-level experience. To determine which memories should be reused and retained, SkeMex estimates context-dependent utility from environment feedback and uses it to guide value-aware retrieval and repository governance. A closed-loop ``Read--Write--Assess--Govern" lifecycle further supports continual evolution by writing new skills, updating utilities, promoting useful memories, and removing harmful entries. Experiments across diverse clinical tasks show that SkeMex consistently outperforms representative memory-based agents in both offline and online settings. It also generalizes across model backbones and supports transferable skill memory. All data and code will be released publicly.

  • 11 authors
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Jun 8 2

Project Imaging-X: A Survey of 1000+ Open-Access Medical Imaging Datasets for Foundation Model Development

Foundation models have demonstrated remarkable success across diverse domains and tasks, primarily due to the thrive of large-scale, diverse, and high-quality datasets. However, in the field of medical imaging, the curation and assembling of such medical datasets are highly challenging due to the reliance on clinical expertise and strict ethical and privacy constraints, resulting in a scarcity of large-scale unified medical datasets and hindering the development of powerful medical foundation models. In this work, we present the largest survey to date of medical image datasets, covering over 1,000 open-access datasets with a systematic catalog of their modalities, tasks, anatomies, annotations, limitations, and potential for integration. Our analysis exposes a landscape that is modest in scale, fragmented across narrowly scoped tasks, and unevenly distributed across organs and modalities, which in turn limits the utility of existing medical image datasets for developing versatile and robust medical foundation models. To turn fragmentation into scale, we propose a metadata-driven fusion paradigm (MDFP) that integrates public datasets with shared modalities or tasks, thereby transforming multiple small data silos into larger, more coherent resources. Building on MDFP, we release an interactive discovery portal that enables end-to-end, automated medical image dataset integration, and compile all surveyed datasets into a unified, structured table that clearly summarizes their key characteristics and provides reference links, offering the community an accessible and comprehensive repository. By charting the current terrain and offering a principled path to dataset consolidation, our survey provides a practical roadmap for scaling medical imaging corpora, supporting faster data discovery, more principled dataset creation, and more capable medical foundation models.

Reinforcement Learning for Tool-Calling Agents in Fast Healthcare Interoperability Resources (FHIR)

Fast Healthcare Interoperability Resources (FHIR) is the dominant standard for interoperable exchange of healthcare data. In FHIR, electronic health records form a directed graph of resources. Answering clinically meaningful questions over FHIR requires agents to perform multi-step reasoning, filtering, and aggregation across multiple resource types. Prior work shows that even tool-augmented LLM agents (retrieval, code execution, multi-turn planning) often select the wrong resources or violate traversal constraints. We study this problem in the context of FHIR-AgentBench, a benchmark for realistic question answering over real-world hospital data, and frame reasoning on FHIR as a sequential decision-making problem over a queryable structured graph. We implement a multi-turn CodeAct agent and post-train it with reinforcement learning using a custom harness and tools. A LLM Judge provides execution-grounded rewards. Compared to prompt-based, closed-model baselines, RL post-training improves performance while enforcing data-integrity constraints. Empirically, our approach improves answer correctness from 50% (o4-mini) to 77% on FHIR-AgentBench using a smaller and cheaper Qwen3-8B model. We present an end-to-end post-training pipeline (environment building, harness construction, model training and custom evaluation) that reliably improves multi-turn reasoning over structured clinical graphs.

  • 4 authors
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May 12

Meissa: Multi-modal Medical Agentic Intelligence

Multi-modal large language models (MM-LLMs) have shown strong performance in medical image understanding and clinical reasoning. Recent medical agent systems extend them with tool use and multi-agent collaboration, enabling complex decision-making. However, these systems rely almost entirely on frontier models (e.g., GPT), whose API-based deployment incurs high cost, high latency, and privacy risks that conflict with on-premise clinical requirements. We present Meissa, a lightweight 4B-parameter medical MM-LLM that brings agentic capability offline. Instead of imitating static answers, Meissa learns both when to engage external interaction (strategy selection) and how to execute multi-step interaction (strategy execution) by distilling structured trajectories from frontier models. Specifically, we propose: (1) Unified trajectory modeling: trajectories (reasoning and action traces) are represented within a single state-action-observation formalism, allowing one model to generalize across heterogeneous medical environments. (2) Three-tier stratified supervision: the model's own errors trigger progressive escalation from direct reasoning to tool-augmented and multi-agent interaction, explicitly learning difficulty-aware strategy selection. (3) Prospective-retrospective supervision: pairing exploratory forward traces with hindsight-rationalized execution traces enables stable learning of effective interaction policies. Trained on 40K curated trajectories, Meissa matches or exceeds proprietary frontier agents in 10 of 16 evaluation settings across 13 medical benchmarks spanning radiology, pathology, and clinical reasoning. Using over 25x fewer parameters than typical frontier models like Gemini-3, Meissa operates fully offline with 22x lower end-to-end latency compared to API-based deployment. Data, models, and environments are released at https://github.com/Schuture/Meissa.

Large Language Models Illuminate a Progressive Pathway to Artificial Healthcare Assistant: A Review

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

  • 11 authors
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Nov 3, 2023

A Reference Architecture for Agentic Hybrid Retrieval in Dataset Search

Ad hoc dataset search requires matching underspecified natural-language queries against sparse, heterogeneous metadata records, a task where typical lexical or dense retrieval alone falls short. We reposition dataset search as a software-architecture problem and propose a bounded, auditable reference architecture for agentic hybrid retrieval that combines BM25 lexical search with dense-embedding retrieval via reciprocal rank fusion (RRF), orchestrated by a large language model (LLM) agent that repeatedly plans queries, evaluates the sufficiency of results, and reranks candidates. To reduce the vocabulary mismatch between user intent and provider-authored metadata, we introduce an offline metadata augmentation step in which an LLM generates pseudo-queries for each dataset record, augmenting both retrieval indexes before query time. Two architectural styles are examined: a single ReAct agent and a multi-agent horizontal architecture with Feedback Control. Their quality-attribute tradeoffs are analyzed with respect to modifiability, observability, performance, and governance. An evaluation framework comprising seven system variants is defined to isolate the contribution of each architectural decision. The architecture is presented as an extensible reference design for the software architecture community, incorporating explicit governance tactics to bound and audit nondeterministic LLM components.

  • 4 authors
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Mar 27

Multi-Agent Computer Use

Computer use agents (CUAs) today are primarily deployed as single serial agents. This setup is suboptimal for complex long-horizon tasks that benefit from task decomposition, parallel execution, and consistent re-planning based on new information. In this paper, we argue that we should instead move towards evaluating and building multi-agent computer use (MACU) systems. These systems, which emphasize planning and parallel execution, alleviate many of the shortcomings of single-agent CUAs. We propose a general multi-agent setup in which a manager model decomposes computer use tasks as a directed acyclic graph (DAG), encoding relevant dependencies and goals for subagents. At each iteration, the manager dispatches parallel CUA subagents to carry out nodes on the ready frontier of the DAG, and continuously revises the DAG (adding, canceling, or rewriting nodes) as new findings arrive from subagents. This design treats the partially observable environment of computer use as a first class challenge: information that downstream agents may not be able to re-observe are retained and passed forward through the manager and DAG structure. We demonstrate that MACU consistently improves over strong single-agent baselines by 3.4-25.5% on desktop (OSWorld) and web navigation (Online-Mind2Web, WebTailBench, Odysseys) benchmarks, exhibits more favorable test-time scaling, and solves complex long-horizon tasks where single-agent CUAs get stuck. On Odysseys, a long-horizon web navigation benchmark, MACU improves average task completion wall-clock time by {sim} 1.5 times, demonstrating its efficacy in speeding up traditionally slow CUA pipelines. Our findings highlight that multi-agent coordination is a promising axis for scaling computer use agents to work productively for longer and more effectively. We release all code and interactive visualizations at https://jykoh.com/multi-agent-computer-use.

  • 3 authors
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May 31 2

PaperArena: An Evaluation Benchmark for Tool-Augmented Agentic Reasoning on Scientific Literature

Understanding and reasoning on the web-scale scientific literature is a crucial touchstone for large language model (LLM) based agents designed to support complex knowledge-intensive tasks. However, existing works are mainly restricted to tool-free tasks within isolated papers, largely due to the lack of a benchmark for cross-paper reasoning and multi-tool orchestration in real research scenarios. In this work, we propose PaperArena, an evaluation benchmark for agents to address real-world research questions that typically require integrating information across multiple papers with the assistance of external tools. Given a research question, agents should integrate diverse formats across multiple papers through reasoning and interacting with appropriate tools, thereby producing a well-grounded answer. To support standardized evaluation, we provide a modular and extensible platform for agent execution, offering tools such as multimodal parsing, context retrieval, and programmatic computation. Experimental results reveal that even the most advanced LLM powering a well-established agent system achieves merely 38.78% average accuracy. On the hard subset, accuracy drops to only 18.47%, highlighting great potential for improvement. We also present several empirical findings, including that all agents tested exhibit inefficient tool usage, often invoking more tools than necessary to solve a task. We invite the community to adopt PaperArena to develop and evaluate more capable agents for scientific discovery. Our code and data are available https://github.com/Melmaphother/PaperArena.

  • 6 authors
·
Oct 12, 2025

AutoMedBench: Towards Medical AutoResearch with Agentic AI Models

Autonomous agents are increasingly expected to support end-to-end medical-AI research workflows, moving beyond isolated prediction tasks or short-form clinical question answering. However, existing medical agent benchmarks primarily evaluate final outputs, providing limited visibility into agent behavior within the research process. To address this gap, we present AutoMedBench, a workflow-aware benchmark for autonomous medical-AI research across diverse medical imaging and multimodal inference tasks, organizing agent execution into a unified five-stage workflow (S1-S5): Plan, Setup, Validate, Inference, and Submit. It comprises long-horizon tasks with each run averaging 33 agent turns, spanning five research tracks: segmentation, image enhancement, visual question answering (VQA), report generation, and lesion detection. Each task is evaluated under two difficulty tiers, Lite and Standard, which use the same data and metrics but differ in the amount of task-brief scaffolding, and each run is scored using both final task performance and S1-S5 stage scores, enabling stage-level analysis from the initial task brief to the final submitted artifact. Across thousands of recorded runs, stage-level scoring reveals that Validate is the weakest workflow stage on average, whereas Setup is the strongest, suggesting that current agents are better at making pipelines executable than at verifying their reliability. Post-run error analysis further shows that verification and submission failures dominate tagged errors, accounting for 37.7% and 38.1% of fired codes respectively, whereas task-understanding errors are rare at 0.9%, and runs with one fired error code have a 48% lower overall score than runs with no error code on average.

CP-Env: Evaluating Large Language Models on Clinical Pathways in a Controllable Hospital Environment

Medical care follows complex clinical pathways that extend beyond isolated physician-patient encounters, emphasizing decision-making and transitions between different stages. Current benchmarks focusing on static exams or isolated dialogues inadequately evaluate large language models (LLMs) in dynamic clinical scenarios. We introduce CP-Env, a controllable agentic hospital environment designed to evaluate LLMs across end-to-end clinical pathways. CP-Env simulates a hospital ecosystem with patient and physician agents, constructing scenarios ranging from triage and specialist consultation to diagnostic testing and multidisciplinary team meetings for agent interaction. Following real hospital adaptive flow of healthcare, it enables branching, long-horizon task execution. We propose a three-tiered evaluation framework encompassing Clinical Efficacy, Process Competency, and Professional Ethics. Results reveal that most models struggle with pathway complexity, exhibiting hallucinations and losing critical diagnostic details. Interestingly, excessive reasoning steps can sometimes prove counterproductive, while top models tend to exhibit reduced tool dependency through internalized knowledge. CP-Env advances medical AI agents development through comprehensive end-to-end clinical evaluation. We provide the benchmark and evaluation tools for further research and development at https://github.com/SPIRAL-MED/CP_ENV.

  • 8 authors
·
Dec 10, 2025

NeuroClaw Technical Report

Agentic artificial intelligence systems promise to accelerate scientific workflows, but neuroimaging poses unique challenges: heterogeneous modalities (sMRI, fMRI, dMRI, EEG), long multi-stage pipelines, and persistent reproducibility risks. To address this gap, we present NeuroClaw, a domain-specialized multi-agent research assistant for executable and reproducible neuroimaging research. NeuroClaw operates directly on raw neuroimaging data across formats and modalities, grounding decisions in dataset semantics and BIDS metadata so users need not prepare curated inputs or bespoke model code. The platform combines harness engineering with end-to-end environment management, including pinned Python environments, Docker support, automated installers for common neuroimaging tools, and GPU configuration. In practice, this layer emphasizes checkpointing, post-execution verification, structured audit traces, and controlled runtime setup, making toolchains more transparent while improving reproducibility and auditability. A three-tier skill/agent hierarchy separates user-facing interaction, high-level orchestration, and low-level tool skills to decompose complex workflows into safe, reusable units. Alongside the NeuroClaw framework, we introduce NeuroBench, a system-level benchmark for executability, artifact validity, and reproducibility readiness. Across multiple multimodal LLMs, NeuroClaw-enabled runs yield consistent and substantial score improvements compared with direct agent invocation. Project homepage: https://cuhk-aim-group.github.io/NeuroClaw/index.html

  • 8 authors
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Apr 26

MM-DeepResearch: A Simple and Effective Multimodal Agentic Search Baseline

We aim to develop a multimodal research agent capable of explicit reasoning and planning, multi-tool invocation, and cross-modal information synthesis, enabling it to conduct deep research tasks. However, we observe three main challenges in developing such agents: (1) scarcity of search-intensive multimodal QA data, (2) lack of effective search trajectories, and (3) prohibitive cost of training with online search APIs. To tackle them, we first propose Hyper-Search, a hypergraph-based QA generation method that models and connects visual and textual nodes within and across modalities, enabling to generate search-intensive multimodal QA pairs that require invoking various search tools to solve. Second, we introduce DR-TTS, which first decomposes search-involved tasks into several categories according to search tool types, and respectively optimize specialized search tool experts for each tool. It then recomposes tool experts to jointly explore search trajectories via tree search, producing trajectories that successfully solve complex tasks using various search tools. Third, we build an offline search engine supporting multiple search tools, enabling agentic reinforcement learning without using costly online search APIs. With the three designs, we develop MM-DeepResearch, a powerful multimodal deep research agent, and extensive results shows its superiority across benchmarks. Code is available at https://github.com/HJYao00/MM-DeepResearch

  • 8 authors
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Mar 1

SciAgents: Automating scientific discovery through multi-agent intelligent graph reasoning

A key challenge in artificial intelligence is the creation of systems capable of autonomously advancing scientific understanding by exploring novel domains, identifying complex patterns, and uncovering previously unseen connections in vast scientific data. In this work, we present SciAgents, an approach that leverages three core concepts: (1) the use of large-scale ontological knowledge graphs to organize and interconnect diverse scientific concepts, (2) a suite of large language models (LLMs) and data retrieval tools, and (3) multi-agent systems with in-situ learning capabilities. Applied to biologically inspired materials, SciAgents reveals hidden interdisciplinary relationships that were previously considered unrelated, achieving a scale, precision, and exploratory power that surpasses traditional human-driven research methods. The framework autonomously generates and refines research hypotheses, elucidating underlying mechanisms, design principles, and unexpected material properties. By integrating these capabilities in a modular fashion, the intelligent system yields material discoveries, critique and improve existing hypotheses, retrieve up-to-date data about existing research, and highlights their strengths and limitations. Our case studies demonstrate scalable capabilities to combine generative AI, ontological representations, and multi-agent modeling, harnessing a `swarm of intelligence' similar to biological systems. This provides new avenues for materials discovery and accelerates the development of advanced materials by unlocking Nature's design principles.

  • 2 authors
·
Sep 9, 2024

Architecting Agentic Communities using Design Patterns

The rapid evolution of Large Language Models (LLM) and subsequent Agentic AI technologies requires systematic architectural guidance for building sophisticated, production-grade systems. This paper presents an approach for architecting such systems using design patterns derived from enterprise distributed systems standards, formal methods, and industry practice. We classify these patterns into three tiers: LLM Agents (task-specific automation), Agentic AI (adaptive goal-seekers), and Agentic Communities (organizational frameworks where AI agents and human participants coordinate through formal roles, protocols, and governance structures). We focus on Agentic Communities - coordination frameworks encompassing LLM Agents, Agentic AI entities, and humans - most relevant for enterprise and industrial applications. Drawing on established coordination principles from distributed systems, we ground these patterns in a formal framework that specifies collaboration agreements where AI agents and humans fill roles within governed ecosystems. This approach provides both practical guidance and formal verification capabilities, enabling expression of organizational, legal, and ethical rules through accountability mechanisms that ensure operational and verifiable governance of inter-agent communication, negotiation, and intent modeling. We validate this framework through a clinical trial matching case study. Our goal is to provide actionable guidance to practitioners while maintaining the formal rigor essential for enterprise deployment in dynamic, multi-agent ecosystems.

  • 2 authors
·
Jan 7

AgentSwift: Efficient LLM Agent Design via Value-guided Hierarchical Search

Large language model (LLM) agents have demonstrated strong capabilities across diverse domains. However, designing high-performing agentic systems remains challenging. Existing agent search methods suffer from three major limitations: (1) an emphasis on optimizing agentic workflows while under-utilizing proven human-designed components such as memory, planning, and tool use; (2) high evaluation costs, as each newly generated agent must be fully evaluated on benchmarks; and (3) inefficient search in large search space. In this work, we introduce a comprehensive framework to address these challenges. First, We propose a hierarchical search space that jointly models agentic workflow and composable functional components, enabling richer agentic system designs. Building on this structured design space, we introduce a predictive value model that estimates agent performance given agentic system and task description, allowing for efficient, low-cost evaluation during the search process. Finally, we present a hierarchical Monte Carlo Tree Search (MCTS) strategy informed by uncertainty to guide the search. Experiments on seven benchmarks, covering embodied, math, web, tool, and game, show that our method achieves an average performance gain of 8.34\% over state-of-the-art baselines and exhibits faster search progress with steeper improvement trajectories. Code repo is available at https://github.com/Ericccc02/AgentSwift.

  • 8 authors
·
Jun 6, 2025

Evaluating Large Language Models in Dynamic Clinical Decision-Making with Standardized Patient Cases

Large language models (LLMs) are increasingly proposed as clinical agents, yet static, single-turn benchmarks cannot capture how a model dynamically delivers care across an encounter: gathering information, planning treatment, and adapting longitudinal management across successive patient states. Medical education has long addressed an analogous challenge through standardized patients (SPs): trained actors who consistently portray clinical cases, enabling realistic practice and objective, scripted assessment. Here we introduce MedSP1000, an SP-derived interactive benchmark for clinical-agent evaluation, including 1,638 SP cases with 24,602 trajectory-level peer-reviewed rubrics. MedSP1000 converts peer-reviewed SP teaching cases into executable scenarios with defined SP case scripts, clinical environment contexts, and human-validated structured rubric. In each simulation evaluation run, a clinical agent interacts in closed loop with a patient agent and an environment controller, and its behaviour is scored throughout the encounter against expert criteria specified in the original materials. Applying MedSP1000 to a range of general-purpose and medically specialized LLMs, we find that performance on static benchmarks does not reliably translate to such educational scenarios. The best-performing model, GPT-5.5, completes only 60.4% of expert-defined rubric items, whereas the strongest medically specialized model reaches 40.0%; increasing test-time compute produces no measurable gain. These results suggest that current LLMs, including agentic systems tuned for medicine, are not yet reliable enough to be safely integrated into actual clinical practice. More broadly, MedSP1000 shows how process-level, SP-style evaluation can reveal clinically relevant failure modes that single-turn benchmarks miss.

  • 6 authors
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Jun 2 1