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May 15

Evolving Diagnostic Agents in a Virtual Clinical Environment

In this paper, we present a framework for training large language models (LLMs) as diagnostic agents with reinforcement learning, enabling them to manage multi-turn diagnostic processes, adaptively select examinations, and commit to final diagnoses. Unlike instruction-tuned models trained on static case summaries, our method acquires diagnostic strategies through interactive exploration and outcome-based feedback. Our contributions are fourfold: (i) We present DiagGym, a diagnostics world model trained with electronic health records that emits examination outcomes conditioned on patient history and recommended examination, serving as a virtual clinical environment for realistic diagnosis training and evaluation; (ii) We train DiagAgent via end-to-end, multi-turn reinforcement learning to learn diagnostic policies that optimize both information yield and diagnostic accuracy; (iii) We introduce DiagBench, a diagnostic benchmark comprising 750 cases with physician-validated examination recommendations and 99 cases annotated with 973 physician-written rubrics on diagnosis process; (iv) we demonstrate superior performance across diverse diagnostic settings. DiagAgent significantly outperforms 10 state-of-the-art LLMs, including DeepSeek-v3 and GPT-4o, as well as two prompt-engineered agents. In single-turn settings, DiagAgent achieves 9.34% higher diagnostic accuracy and 44.03% improvement in examination recommendation hit ratio. In end-to-end settings, it delivers 15.12% increase in diagnostic accuracy and 23.09% boost in examination recommendation F1 score. In rubric-based evaluation, it surpasses the next-best model, Claude-sonnet-4, by 7.1% in weighted rubric score. These findings indicate that learning policies in interactive clinical environments confers dynamic and clinically meaningful diagnostic management abilities unattainable through passive training alone.

Beyond Pixels: Visual Metaphor Transfer via Schema-Driven Agentic Reasoning

A visual metaphor constitutes a high-order form of human creativity, employing cross-domain semantic fusion to transform abstract concepts into impactful visual rhetoric. Despite the remarkable progress of generative AI, existing models remain largely confined to pixel-level instruction alignment and surface-level appearance preservation, failing to capture the underlying abstract logic necessary for genuine metaphorical generation. To bridge this gap, we introduce the task of Visual Metaphor Transfer (VMT), which challenges models to autonomously decouple the "creative essence" from a reference image and re-materialize that abstract logic onto a user-specified target subject. We propose a cognitive-inspired, multi-agent framework that operationalizes Conceptual Blending Theory (CBT) through a novel Schema Grammar ("G"). This structured representation decouples relational invariants from specific visual entities, providing a rigorous foundation for cross-domain logic re-instantiation. Our pipeline executes VMT through a collaborative system of specialized agents: a perception agent that distills the reference into a schema, a transfer agent that maintains generic space invariance to discover apt carriers, a generation agent for high-fidelity synthesis and a hierarchical diagnostic agent that mimics a professional critic, performing closed-loop backtracking to identify and rectify errors across abstract logic, component selection, and prompt encoding. Extensive experiments and human evaluations demonstrate that our method significantly outperforms SOTA baselines in metaphor consistency, analogy appropriateness, and visual creativity, paving the way for automated high-impact creative applications in advertising and media. Source code will be made publicly available.

tencent Tencent
·
Feb 1 2

Thinking Like a Botanist: Challenging Multimodal Language Models with Intent-Driven Chain-of-Inquiry

Vision evaluations are typically done through multi-step processes. In most contemporary fields, experts analyze images using structured, evidence-based adaptive questioning. In plant pathology, botanists inspect leaf images, identify visual cues, infer diagnostic intent, and probe further with targeted questions that adapt to species, symptoms, and severity. This structured probing is crucial for accurate disease diagnosis and treatment formulation. Yet current vision-language models are evaluated on single-turn question answering. To address this gap, we introduce PlantInquiryVQA, a benchmark for studying multi-step, intent-driven visual reasoning in botanical diagnosis. We formalize a Chain of Inquiry framework modeling diagnostic trajectories as ordered question-answer sequences conditioned on grounded visual cues and explicit epistemic intent. We release a dataset of 24,950 expert-curated plant images and 138,068 question-answer pairs annotated with visual grounding, severity labels, and domain-specific reasoning templates. Evaluations on top-tier Multimodal Large Language Models reveal that while they describe visual symptoms adequately, they struggle with safe clinical reasoning and accurate diagnosis. Importantly, structured question-guided inquiry significantly improves diagnostic correctness, reduces hallucination, and increases reasoning efficiency. We hope PlantInquiryVQA serves as a foundational benchmark in advancing research to train diagnostic agents to reason like expert botanists rather than static classifiers.

  • 7 authors
·
Apr 21

RoboPhD: Evolving Diverse Complex Agents Under Tight Evaluation Budgets

2026 has brought an explosion of interest in LLM-guided evolution of agentic artifacts, with systems like GEPA and Autoresearch demonstrating that LLMs can iteratively improve prompts, code, and agent architectures across diverse domains. As adoption accelerates, a central question emerges: given the same information, the same seed agent, and the same objective, which optimization algorithm yields the best results under the same evaluation budget? This question becomes critical when evaluations are expensive, such as when they require human judgment or multiple LLM calls. We present the first systematic comparison of three optimization paradigms -- Elo tournament selection (RoboPhD), Pareto-based selection (GEPA), and greedy hill-climbing (Autoresearch) -- across four benchmarks spanning abstract reasoning, cloud scheduling, SQL generation, and financial QA, all under a fixed budget of 1,500 evaluations. RoboPhD introduces validation-free evolution: instead of splitting the budget between training and validation, it uses Elo competition on training data to simultaneously evaluate agents and drive evolution. All three systems receive seed agents with diagnostic print() statements that evolution can grow, enabling self-instrumenting agents that develop increasingly informative diagnostics for the benefit of their evolutionary successors. Using a single default configuration, RoboPhD outperforms both GEPA and Autoresearch on three of four benchmarks, losing only on the simplest task, where the winning solution (from our Autoresearch adaptation) required under 90 lines of code. On ARC-AGI, RoboPhD evolves a 22-line seed agent into a 1,013-line multi-strategy system, improving accuracy from 27.8% to 65.8% using Gemini 3.1 Flash Lite as the solver. We release RoboPhD as a versatile toolkit under the MIT license with a simple optimize_anything() API for evolving diverse complex agents.

  • 3 authors
·
Apr 5

When Agents Fail to Act: A Diagnostic Framework for Tool Invocation Reliability in Multi-Agent LLM Systems

Multi-agent systems powered by large language models (LLMs) are transforming enterprise automation, yet systematic evaluation methodologies for assessing tool-use reliability remain underdeveloped. We introduce a comprehensive diagnostic framework that leverages big data analytics to evaluate procedural reliability in intelligent agent systems, addressing critical needs for SME-centric deployment in privacy-sensitive environments. Our approach features a 12-category error taxonomy capturing failure modes across tool initialization, parameter handling, execution, and result interpretation. Through systematic evaluation of 1,980 deterministic test instances spanning both open-weight models (Qwen2.5 series, Functionary) and proprietary alternatives (GPT-4, Claude 3.5/3.7) across diverse edge hardware configurations, we identify actionable reliability thresholds for production deployment. Our analysis reveals that procedural reliability, particularly tool initialization failures, constitutes the primary bottleneck for smaller models, while qwen2.5:32b achieves flawless performance matching GPT-4.1. The framework demonstrates that mid-sized models (qwen2.5:14b) offer practical accuracy-efficiency trade-offs on commodity hardware (96.6\% success rate, 7.3 s latency), enabling cost-effective intelligent agent deployment for resource-constrained organizations. This work establishes foundational infrastructure for systematic reliability evaluation of tool-augmented multi-agent AI systems.

  • 3 authors
·
Jan 21

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
·
Aug 21, 2025 2

An Agentic System for Rare Disease Diagnosis with Traceable Reasoning

Rare diseases collectively affect over 300 million individuals worldwide, yet timely and accurate diagnosis remains a pervasive challenge. This is largely due to their clinical heterogeneity, low individual prevalence, and the limited familiarity most clinicians have with rare conditions. Here, we introduce DeepRare, the first rare disease diagnosis agentic system powered by a large language model (LLM), capable of processing heterogeneous clinical inputs. The system generates ranked diagnostic hypotheses for rare diseases, each accompanied by a transparent chain of reasoning that links intermediate analytic steps to verifiable medical evidence. DeepRare comprises three key components: a central host with a long-term memory module; specialized agent servers responsible for domain-specific analytical tasks integrating over 40 specialized tools and web-scale, up-to-date medical knowledge sources, ensuring access to the most current clinical information. This modular and scalable design enables complex diagnostic reasoning while maintaining traceability and adaptability. We evaluate DeepRare on eight datasets. The system demonstrates exceptional diagnostic performance among 2,919 diseases, achieving 100% accuracy for 1013 diseases. In HPO-based evaluations, DeepRare significantly outperforms other 15 methods, like traditional bioinformatics diagnostic tools, LLMs, and other agentic systems, achieving an average Recall@1 score of 57.18% and surpassing the second-best method (Reasoning LLM) by a substantial margin of 23.79 percentage points. For multi-modal input scenarios, DeepRare achieves 70.60% at Recall@1 compared to Exomiser's 53.20% in 109 cases. Manual verification of reasoning chains by clinical experts achieves 95.40% agreements. Furthermore, the DeepRare system has been implemented as a user-friendly web application http://raredx.cn/doctor.

  • 12 authors
·
Jun 25, 2025 1

AViLA: Asynchronous Vision-Language Agent for Streaming Multimodal Data Interaction

An ideal vision-language agent serves as a bridge between the human users and their surrounding physical world in real-world applications like autonomous driving and embodied agents, and proactively provides accurate and timely responses given user intents. An intriguing challenge arises when agents interact with the world as a dynamic data stream and ad-hoc queries from users: supporting knowledge for queries, namely evidence, usually appears asynchronously with the arrival time of queries, and agents need to ground their responses in historical data, present observations, and even future streams. We frame this challenge as Query-Evidence Asynchrony, where user queries and their supporting evidence typically arrive asynchronously in the streaming setting. This setting requires not only strong reasoning capabilities but also the ability to retain past observations and respond to queries with temporal awareness. In this paper, we introduce a diagnostic benchmark that evaluates Multimodal Large Language Models (MLLMs) on their ability to handle interaction with streaming data. Further, we present AViLA, Asynchronous Video-Language Agent for streaming data interaction that can handle ad-hoc queries and give time-aware responses. For this purpose, AViLA consists of three key modules: comprehensive memory retention, evidence identification, and evidence-grounded trigger, that are designed to maintain a general-purpose memory and respond readily and timely to queries. Our experiments show that existing models often fail to respond at appropriate times, while AViLA significantly improves both accuracy and temporal awareness. Our code and dataset will be publicly available.

  • 9 authors
·
Jun 23, 2025

SymptomAI: Towards a Conversational AI Agent for Everyday Symptom Assessment

Language models excel at diagnostic assessments on currated medical case-studies and vignettes, performing on par with, or better than, clinical professionals. However, existing studies focus on complex scenarios with rich context making it difficult to draw conclusions about how these systems perform for patients reporting symptoms in everyday life. We deployed SymptomAI, a set of conversational AI agents for end-to-end patient interviewing and differential diagnosis (DDx), via the Fitbit app in a study that randomized participants (N=13,917) to interact with five AI agents. This corpus captures diverse communication and a realistic distribution of illnesses from a real world population. A subset of 1,228 participants reported a clinician-provided diagnosis, and 517 of these were further evaluated by a panel of clinicians during over 250 hours of annotation. SymptomAI DDx were significantly more accurate (OR = 2.47, p < 0.001) than those from independent clinicians given the same dialogue in a blinded randomized comparison. Moreover, agentic strategies which conduct a dedicated symptom interview that elicit additional symptom information before providing a diagnosis, perform substantially better than baseline, user-guided conversations (p < 0.001). An auxiliary analysis on 1,509 conversations from a general US population panel validated that these results generalize beyond wearable device users. We used SymptomAI diagnoses as labels for all 13,917 participants to analyze over 500,000 days of wearable metrics across nearly 400 unique conditions. We identified strong associations between acute infections and physiological shifts (e.g., OR > 7 for influenza). While limited by self-reported ground truth, these results demonstrate the benefits of a dedicated and complete symptom interview compared to a user-guided symptom discussion, which is the default of most consumer LLMs.

  • 33 authors
·
May 4 1

BAAI Cardiac Agent: An intelligent multimodal agent for automated reasoning and diagnosis of cardiovascular diseases from cardiac magnetic resonance imaging

Cardiac magnetic resonance (CMR) is a cornerstone for diagnosing cardiovascular disease. However, it remains underutilized due to complex, time-consuming interpretation across multi-sequences, phases, quantitative measures that heavily reliant on specialized expertise. Here, we present BAAI Cardiac Agent, a multimodal intelligent system designed for end-to-end CMR interpretation. The agent integrates specialized cardiac expert models to perform automated segmentation of cardiac structures, functional quantification, tissue characterization and disease diagnosis, and generates structured clinical reports within a unified workflow. Evaluated on CMR datasets from two hospitals (2413 patients) spanning 7-types of major cardiovascular diseases, the agent achieved an area under the receiver-operating-characteristic curve exceeding 0.93 internally and 0.81 externally. In the task of estimating left ventricular function indices, the results generated by this system for core parameters such as ejection fraction, stroke volume, and left ventricular mass are highly consistent with clinical reports, with Pearson correlation coefficients all exceeding 0.90. The agent outperformed state-of-the-art models in segmentation and diagnostic tasks, and generated clinical reports showing high concordance with expert radiologists (six readers across three experience levels). By dynamically orchestrating expert models for coordinated multimodal analysis, this agent framework enables accurate, efficient CMR interpretation and highlights its potentials for complex clinical imaging workflows. Code is available at https://github.com/plantain-herb/Cardiac-Agent.

  • 21 authors
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Apr 4

3MDBench: Medical Multimodal Multi-agent Dialogue Benchmark

Large Vision-Language Models (LVLMs) are increasingly being explored for applications in telemedicine, yet their ability to engage with diverse patient behaviors remains underexplored. We introduce 3MDBench (Medical Multimodal Multi-agent Dialogue Benchmark), an open-source evaluation framework designed to assess LLM-driven medical consultations. Unlike existing benchmarks, 3MDBench simulates real-world patient variability by incorporating four temperament-driven Patient Agents and an Assessor Agent that evaluates diagnostic accuracy and dialogue quality. The benchmark integrates textual and image-based patient data across 34 common diagnoses, mirroring real-world telemedicine interactions. Under different diagnostic strategies, we evaluate state-of-the-art LVLMs. Our findings demonstrate that incorporating dialogue improves the F1 score from 50.4 to 54.2 compared to non-dialogue settings, underscoring the value of context-driven, information-seeking questioning. Additionally, we demonstrate that multimodal inputs enhance diagnostic efficiency. Image-supported models outperform text-only counterparts by raising the diagnostic F1 score from 52.8 to 54.2 in a similar dialogue setting. Finally, we suggest an approach that improves the diagnostic F1-score to 70.3 by training the CNN model on the diagnosis prediction task and incorporating its top-3 predictions into the LVLM context. 3MDBench provides a reproducible and extendable evaluation framework for AI-driven medical assistants. It offers insights into how patient temperament, dialogue strategies, and multimodal reasoning influence diagnosis quality. By addressing real-world complexities in telemedicine, our benchmark paves the way for more empathetic, reliable, and context-aware AI-driven healthcare solutions. The source code of our benchmark is publicly available: https://github.com/univanxx/3mdbench

  • 6 authors
·
Mar 26, 2025

TRAJEVAL: Decomposing Code Agent Trajectories for Fine-Grained Diagnosis

Code agents can autonomously resolve GitHub issues, yet when they fail, current evaluation provides no visibility into where or why. Metrics such as Pass@1 collapse an entire execution into a single binary outcome, making it difficult to identify where and why the agent went wrong. To address this limitation, we introduce TRAJEVAL, a diagnostic framework that decomposes agent trajectories into three interpretable stages: search (file localization), read (function comprehension), and edit (modification targeting). For each stage, we compute precision and recall by comparing against reference patches. Analyzing 16,758 trajectories across three agent architectures and seven models, we find universal inefficiencies (all agents examine approximately 22x more functions than necessary) yet distinct failure modes: GPT-5 locates relevant code but targets edits incorrectly, while Qwen-32B fails at file discovery entirely. We validate that these diagnostics are predictive, achieving model-level Pass@1 prediction within 0.87-2.1% MAE, and actionable: real-time feedback based on trajectory signals improves two state-of-the-art models by 2.2-4.6 percentage points while reducing costs by 20-31%. These results demonstrate that our framework not only provides a more fine-grained analysis of agent behavior, but also translates diagnostic signals into tangible performance gains. More broadly, TRAJEVAL transforms agent evaluation beyond outcome-based benchmarking toward mechanism-driven diagnosis of agent success and failure.

  • 9 authors
·
Mar 24

MEDDxAgent: A Unified Modular Agent Framework for Explainable Automatic Differential Diagnosis

Differential Diagnosis (DDx) is a fundamental yet complex aspect of clinical decision-making, in which physicians iteratively refine a ranked list of possible diseases based on symptoms, antecedents, and medical knowledge. While recent advances in large language models (LLMs) have shown promise in supporting DDx, existing approaches face key limitations, including single-dataset evaluations, isolated optimization of components, unrealistic assumptions about complete patient profiles, and single-attempt diagnosis. We introduce a Modular Explainable DDx Agent (MEDDxAgent) framework designed for interactive DDx, where diagnostic reasoning evolves through iterative learning, rather than assuming a complete patient profile is accessible. MEDDxAgent integrates three modular components: (1) an orchestrator (DDxDriver), (2) a history taking simulator, and (3) two specialized agents for knowledge retrieval and diagnosis strategy. To ensure robust evaluation, we introduce a comprehensive DDx benchmark covering respiratory, skin, and rare diseases. We analyze single-turn diagnostic approaches and demonstrate the importance of iterative refinement when patient profiles are not available at the outset. Our broad evaluation demonstrates that MEDDxAgent achieves over 10% accuracy improvements in interactive DDx across both large and small LLMs, while offering critical explainability into its diagnostic reasoning process.

  • 6 authors
·
Feb 26, 2025

MiroEval: Benchmarking Multimodal Deep Research Agents in Process and Outcome

Recent progress in deep research systems has been impressive, but evaluation still lags behind real user needs. Existing benchmarks predominantly assess final reports using fixed rubrics, failing to evaluate the underlying research process. Most also offer limited multimodal coverage, rely on synthetic tasks that do not reflect real-world query complexity, and cannot be refreshed as knowledge evolves. To address these gaps, we introduce MiroEval, a benchmark and evaluation framework for deep research systems. The benchmark comprises 100 tasks (70 text-only, 30 multimodal), all grounded in real user needs and constructed via a dual-path pipeline that supports periodic updates, enabling a live and evolving setting. The proposed evaluation suite assesses deep research systems along three complementary dimensions: adaptive synthesis quality evaluation with task-specific rubrics, agentic factuality verification via active retrieval and reasoning over both web sources and multimodal attachments, and process-centric evaluation audits how the system searches, reasons, and refines throughout its investigation. Evaluation across 13 systems yields three principal findings: the three evaluation dimensions capture complementary aspects of system capability, with each revealing distinct strengths and weaknesses across systems; process quality serves as a reliable predictor of overall outcome while revealing weaknesses invisible to output-level metrics; and multimodal tasks pose substantially greater challenges, with most systems declining by 3 to 10 points. The MiroThinker series achieves the most balanced performance, with MiroThinker-H1 ranking the highest overall in both settings. Human verification and robustness results confirm the reliability of the benchmark and evaluation framework. MiroEval provides a holistic diagnostic tool for the next generation of deep research agents.

miromind-ai MiroMind AI
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Mar 30 5

A Benchmark and Agentic Framework for Omni-Modal Reasoning and Tool Use in Long Videos

Long-form multimodal video understanding requires integrating vision, speech, and ambient audio with coherent long-range reasoning. Existing benchmarks emphasize either temporal length or multimodal richness, but rarely both and while some incorporate open-ended questions and advanced metrics, they mostly rely on single-score accuracy, obscuring failure modes. We introduce LongShOTBench, a diagnostic benchmark with open-ended, intent-driven questions; single- and multi-turn dialogues; and tasks requiring multimodal reasoning and agentic tool use across video, audio, and speech. Each item includes a reference answer and graded rubric for interpretable, and traceable evaluation. LongShOTBench is produced via a scalable, human-validated pipeline to ensure coverage and reproducibility. All samples in our LongShOTBench are human-verified and corrected. Furthermore, we present LongShOTAgent, an agentic system that analyzes long videos via preprocessing, search, and iterative refinement. On LongShOTBench, state-of-the-art MLLMs show large gaps: Gemini-2.5-Flash achieves 52.95%, open-source models remain below 30%, and LongShOTAgent attains 44.66%. These results underscore the difficulty of real-world long-form video understanding. LongShOTBench provides a practical, reproducible foundation for evaluating and improving MLLMs. All resources are available on GitHub: https://github.com/mbzuai-oryx/longshot.

VenusBench-Mobile: A Challenging and User-Centric Benchmark for Mobile GUI Agents with Capability Diagnostics

Existing online benchmarks for mobile GUI agents remain largely app-centric and task-homogeneous, failing to reflect the diversity and instability of real-world mobile usage. To this end, we introduce VenusBench-Mobile, a challenging online benchmark for evaluating general-purpose mobile GUI agents under realistic, user-centric conditions. VenusBench-Mobile builds two core evaluation pillars: defining what to evaluate via user-intent-driven task design that reflects real mobile usage, and how to evaluate through a capability-oriented annotation scheme for fine-grained agent behavior analysis. Extensive evaluation of state-of-the-art mobile GUI agents reveals large performance gaps relative to prior benchmarks, indicating that VenusBench-Mobile poses substantially more challenging and realistic tasks and that current agents remain far from reliable real-world deployment. Diagnostic analysis further shows that failures are dominated by deficiencies in perception and memory, which are largely obscured by coarse-grained evaluations. Moreover, even the strongest agents exhibit near-zero success under environment variations, highlighting their brittleness in realistic settings. Based on these insights, we believe VenusBench-Mobile provides an important stepping stone toward robust real-world deployment of mobile GUI agents. Code and data are available at https://github.com/inclusionAI/UI-Venus/tree/VenusBench-Mobile.

  • 7 authors
·
Feb 5 2

Can Current Agents Close the Discovery-to-Application Gap? A Case Study in Minecraft

Discovering causal regularities and applying them to build functional systems--the discovery-to-application loop--is a hallmark of general intelligence, yet evaluating this capacity has been hindered by the vast complexity gap between scientific discovery and real-world engineering. We introduce SciCrafter, a Minecraft-based benchmark that operationalizes this loop through parameterized redstone circuit tasks. Agents must ignite lamps in specified patterns (e.g., simultaneously or in timed sequences); scaling target parameters substantially increases construction complexity and required knowledge, forcing genuine discovery rather than reliance on memorized solutions. Evaluating frontier models including GPT-5.2, Gemini-3-Pro, and Claude-Opus-4.5 under a general-purpose code agent scaffold, we find that all plateau at approximately 26% success rate. To diagnose these failures, we decompose the loop into four capacities--knowledge gap identification, experimental discovery, knowledge consolidation, and knowledge application--and design targeted interventions whose marginal contributions serve as proxies for corresponding gaps. Our analysis reveals that although the general knowledge application capability still remains as the biggest gap across all models, for frontier models the knowledge gap identification starts to become a major hurdle--indicating the bottleneck is shifting from solving problems right to raising the right problems for current AI. We release SciCrafter as a diagnostic probe for future research on AI systems that navigate the full discovery-to-application loop.

  • 12 authors
·
Apr 26

Aligning Agents via Planning: A Benchmark for Trajectory-Level Reward Modeling

In classical Reinforcement Learning from Human Feedback (RLHF), Reward Models (RMs) serve as the fundamental signal provider for model alignment. As Large Language Models evolve into agentic systems capable of autonomous tool invocation and complex reasoning, the paradigm of reward modeling faces unprecedented challenges--most notably, the lack of benchmarks specifically designed to assess RM capabilities within tool-integrated environments. To address this gap, we present Plan-RewardBench, a trajectory-level preference benchmark designed to evaluate how well judges distinguish preferred versus distractor agent trajectories in complex tool-using scenarios. Plan-RewardBench covers four representative task families -- (i) Safety Refusal, (ii) Tool-Irrelevance / Unavailability, (iii) Complex Planning, and (iv) Robust Error Recovery -- comprising validated positive trajectories and confusable hard negatives constructed via multi-model natural rollouts, rule-based perturbations, and minimal-edit LLM perturbations. We benchmark representative RMs (generative, discriminative, and LLM-as-Judge) under a unified pairwise protocol, reporting accuracy trends across varying trajectory lengths and task categories. Furthermore, we provide diagnostic analyses of prevalent failure modes. Our results reveal that all three evaluator families face substantial challenges, with performance degrading sharply on long-horizon trajectories, underscoring the necessity for specialized training in agentic, trajectory-level reward modeling. Ultimately, Plan-RewardBench aims to serve as both a practical evaluation suite and a reusable blueprint for constructing agentic planning preference data.

  • 6 authors
·
Apr 8

FIRE-Bench: Evaluating Agents on the Rediscovery of Scientific Insights

Autonomous agents powered by large language models (LLMs) promise to accelerate scientific discovery end-to-end, but rigorously evaluating their capacity for verifiable discovery remains a central challenge. Existing benchmarks face a trade-off: they either heavily rely on LLM-as-judge evaluations of automatically generated research outputs or optimize convenient yet isolated performance metrics that provide coarse proxies for scientific insight. To address this gap, we introduce FIRE-Bench (Full-cycle Insight Rediscovery Evaluation), a benchmark that evaluates agents through the rediscovery of established findings from recent, high-impact machine learning research. Agents are given only a high-level research question extracted from a published, verified study and must autonomously explore ideas, design experiments, implement code, execute their plans, and derive conclusions supported by empirical evidence. We evaluate a range of state-of-the-art agents with frontier LLMs backbones like gpt-5 on FIRE-Bench. Our results show that full-cycle scientific research remains challenging for current agent systems: even the strongest agents achieve limited rediscovery success (<50 F1), exhibit high variance across runs, and display recurring failure modes in experimental design, execution, and evidence-based reasoning. FIRE-Bench provides a rigorous and diagnostic framework for measuring progress toward reliable agent-driven scientific discovery.

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

TraceCoder: A Trace-Driven Multi-Agent Framework for Automated Debugging of LLM-Generated Code

Large Language Models (LLMs) often generate code with subtle but critical bugs, especially for complex tasks. Existing automated repair methods typically rely on superficial pass/fail signals, offering limited visibility into program behavior and hindering precise error localization. In addition, without a way to learn from prior failures, repair processes often fall into repetitive and inefficient cycles. To overcome these challenges, we present TraceCoder, a collaborative multi-agent framework that emulates the observe-analyze-repair process of human experts. The framework first instruments the code with diagnostic probes to capture fine-grained runtime traces, enabling deep insight into its internal execution. It then conducts causal analysis on these traces to accurately identify the root cause of the failure. This process is further enhanced by a novel Historical Lesson Learning Mechanism (HLLM), which distills insights from prior failed repair attempts to inform subsequent correction strategies and prevent recurrence of similar mistakes. To ensure stable convergence, a Rollback Mechanism enforces that each repair iteration constitutes a strict improvement toward the correct solution. Comprehensive experiments across multiple benchmarks show that TraceCoder achieves up to a 34.43\% relative improvement in Pass@1 accuracy over existing advanced baselines. Ablation studies verify the significance of each system component, with the iterative repair process alone contributing a 65.61\% relative gain in accuracy. Furthermore, TraceCoder significantly outperforms leading iterative methods in terms of both accuracy and cost-efficiency.

  • 6 authors
·
Feb 6

Automatic Failure Attribution and Critical Step Prediction Method for Multi-Agent Systems Based on Causal Inference

Multi-agent systems (MAS) are critical for automating complex tasks, yet their practical deployment is severely hampered by the challenge of failure attribution. Current diagnostic tools, which rely on statistical correlations, are fundamentally inadequate; on challenging benchmarks like Who\&When, state-of-the-art methods achieve less than 15\% accuracy in locating the root-cause step of a failure. To address this critical gap, we introduce the first failure attribution framework for MAS grounded in multi-granularity causal inference. Our approach makes two key technical contributions: (1) a performance causal inversion principle, which correctly models performance dependencies by reversing the data flow in execution logs, combined with Shapley values to accurately assign agent-level blame; (2) a novel causal discovery algorithm, CDC-MAS, that robustly identifies critical failure steps by tackling the non-stationary nature of MAS interaction data. The framework's attribution results directly fuel an automated optimization loop, generating targeted suggestions whose efficacy is validated via counterfactual simulations. Evaluations on the Who\&When and TRAIL benchmarks demonstrate a significant leap in performance. Our method achieves up to 36.2\% step-level accuracy. Crucially, the generated optimizations boost overall task success rates by an average of 22.4\%. This work provides a principled and effective solution for debugging complex agent interactions, paving the way for more reliable and interpretable multi-agent systems.

  • 7 authors
·
Sep 10, 2025

Agentic Confidence Calibration

AI agents are rapidly advancing from passive language models to autonomous systems executing complex, multi-step tasks. Yet their overconfidence in failure remains a fundamental barrier to deployment in high-stakes settings. Existing calibration methods, built for static single-turn outputs, cannot address the unique challenges of agentic systems, such as compounding errors along trajectories, uncertainty from external tools, and opaque failure modes. To address these challenges, we introduce, for the first time, the problem of Agentic Confidence Calibration and propose Holistic Trajectory Calibration (HTC), a novel diagnostic framework that extracts rich process-level features ranging from macro dynamics to micro stability across an agent's entire trajectory. Powered by a simple, interpretable model, HTC consistently surpasses strong baselines in both calibration and discrimination, across eight benchmarks, multiple LLMs, and diverse agent frameworks. Beyond performance, HTC delivers three essential advances: it provides interpretability by revealing the signals behind failure, enables transferability by applying across domains without retraining, and achieves generalization through a General Agent Calibrator (GAC) that achieves the best calibration (lowest ECE) on the out-of-domain GAIA benchmark. Together, these contributions establish a new process-centric paradigm for confidence calibration, providing a framework for diagnosing and enhancing the reliability of AI agents.

UI-CUBE: Enterprise-Grade Computer Use Agent Benchmarking Beyond Task Accuracy to Operational Reliability

While current Computer Use Agent (CUA) benchmarks measure task completion effectively, they provide limited assessment of enterprise deployment readiness, emphasizing functional correctness over the operational reliability required for production systems. We present UI-CUBE (UiPath Computer Use BEnchmark), a systematic benchmark comprising 226 tasks across two difficulty tiers designed to expose fundamental architectural limitations in current CUAs. Our evaluation covers simple UI interactions (136 tasks) and complex workflows including copy-paste tasks (50 tasks) and enterprise application scenarios (40 tasks), with systematic interface variation coverage, multi-resolution testing and automated validation of task success through the application state. Evaluation of five state-of-the-art models reveals a sharp capability cliff rather than gradual performance degradation. Simple UI interactions achieve 67-85% success rates (compared to 97.9% human performance), but complex workflows drop precipitously to 9-19%. Human evaluators with no prior application experience achieve only 61.2% on complex tasks despite near-perfect performance on simple tasks, establishing realistic performance ceilings. This discontinuous performance pattern -- where agents achieve 68-87% of human performance on simple tasks but only 15-32% on complex workflows -- indicates fundamental architectural limitations in memory management, hierarchical planning, and state coordination rather than incremental capability gaps addressable through better training or prompting. UI-CUBE functions as an enterprise-readiness diagnostic, revealing that while current CUAs can manipulate individual interface elements, they cannot yet function as reliable workflow automation tools. These findings provide architectural insights essential for developing production-ready CUAs capable of managing complex, multi-step enterprise processes.

  • 6 authors
·
Nov 21, 2025

Does Socialization Emerge in AI Agent Society? A Case Study of Moltbook

As large language model agents increasingly populate networked environments, a fundamental question arises: do artificial intelligence (AI) agent societies undergo convergence dynamics similar to human social systems? Lately, Moltbook approximates a plausible future scenario in which autonomous agents participate in an open-ended, continuously evolving online society. We present the first large-scale systemic diagnosis of this AI agent society. Beyond static observation, we introduce a quantitative diagnostic framework for dynamic evolution in AI agent societies, measuring semantic stabilization, lexical turnover, individual inertia, influence persistence, and collective consensus. Our analysis reveals a system in dynamic balance in Moltbook: while global semantic averages stabilize rapidly, individual agents retain high diversity and persistent lexical turnover, defying homogenization. However, agents exhibit strong individual inertia and minimal adaptive response to interaction partners, preventing mutual influence and consensus. Consequently, influence remains transient with no persistent supernodes, and the society fails to develop stable collective influence anchors due to the absence of shared social memory. These findings demonstrate that scale and interaction density alone are insufficient to induce socialization, providing actionable design and analysis principles for upcoming next-generation AI agent societies.

umd-zhou-lab Tianyi Lab
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Feb 15 4

Towards Efficient and Robust Linguistic Emotion Diagnosis for Mental Health via Multi-Agent Instruction Refinement

Linguistic expressions of emotions such as depression, anxiety, and trauma-related states are pervasive in clinical notes, counseling dialogues, and online mental health communities, and accurate recognition of these emotions is essential for clinical triage, risk assessment, and timely intervention. Although large language models (LLMs) have demonstrated strong generalization ability in emotion analysis tasks, their diagnostic reliability in high-stakes, context-intensive medical settings remains highly sensitive to prompt design. Moreover, existing methods face two key challenges: emotional comorbidity, in which multiple intertwined emotional states complicate prediction, and inefficient exploration of clinically relevant cues. To address these challenges, we propose APOLO (Automated Prompt Optimization for Linguistic Emotion Diagnosis), a framework that systematically explores a broader and finer-grained prompt space to improve diagnostic efficiency and robustness. APOLO formulates instruction refinement as a Partially Observable Markov Decision Process and adopts a multi-agent collaboration mechanism involving Planner, Teacher, Critic, Student, and Target roles. Within this closed-loop framework, the Planner defines an optimization trajectory, while the Teacher-Critic-Student agents iteratively refine prompts to enhance reasoning stability and effectiveness, and the Target agent determines whether to continue optimization based on performance evaluation. Experimental results show that APOLO consistently improves diagnostic accuracy and robustness across domain-specific and stratified benchmarks, demonstrating a scalable and generalizable paradigm for trustworthy LLM applications in mental healthcare.

  • 8 authors
·
Jan 19 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
·
Sep 29, 2025

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

Synthesizing Multi-Agent Harnesses for Vulnerability Discovery

LLM agents have begun to find real security vulnerabilities that human auditors and automated fuzzers missed for decades, in source-available targets where the analyst can build and instrument the code. In practice the work is split among several agents, wired together by a harness: the program that fixes which roles exist, how they pass information, which tools each may call, and how retries are coordinated. When the language model is held fixed, changing only the harness can still change success rates by several-fold on public agent benchmarks, yet most harnesses are written by hand; recent harness optimizers each search only a narrow slice of the design space and rely on coarse pass/fail feedback that gives no diagnostic signal about why a trial failed. AgentFlow addresses both limitations with a typed graph DSL whose search space jointly covers agent roles, prompts, tools, communication topology, and coordination protocol, paired with a feedback-driven outer loop that reads runtime signals from the target program itself to diagnose which part of the harness caused the failure and rewrite it accordingly. We evaluate AgentFlow on TerminalBench-2 with Claude Opus 4.6 and on Google Chrome with Kimi K2.5. AgentFlow reaches 84.3% on TerminalBench-2, the highest score in the public leaderboard snapshot we evaluate against, and discovers ten previously unknown zero-day vulnerabilities in Google Chrome, including two Critical sandbox-escape vulnerabilities (CVE-2026-5280 and CVE-2026-6297).

  • 7 authors
·
Apr 21

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
·
Aug 4, 2025

PAPERMIND: Benchmarking Agentic Reasoning and Critique over Scientific Papers in Multimodal LLMs

Understanding scientific papers requires more than answering isolated questions or summarizing content. It involves an integrated reasoning process that grounds textual and visual information, interprets experimental evidence, synthesizes information across sources, and critically evaluates scientific claims. However, existing benchmarks typically assess these abilities in isolation, making it difficult to evaluate scientific paper understanding as a unified set of interacting cognitive abilities. In this work, we introduce PAPERMIND, a benchmark designed to evaluate integrated and agent-oriented scientific reasoning over research papers. PAPERMIND is constructed from real scientific papers across seven domains, including agriculture, biology, chemistry, computer science, medicine, physics, and economics. It comprises four complementary task families that collectively operationalize distinct cognitive facets of scientific paper reasoning, including multimodal grounding, experimental interpretation, cross-source evidence reasoning, and critical assessment. By analyzing model behavior across multiple tasks, PAPERMIND enables a diagnostic evaluation of integrated scientific reasoning behaviors that are difficult to assess through isolated task evaluations. Extensive experiments on both opensource and closed-source multimodal LLMs reveal consistent performance gaps across tasks, highlighting persistent challenges in integrated scientific reasoning and critique. Our benchmark and dataset are available at https:// github.com/Yanjun-Zhao/PaperMind.

  • 10 authors
·
Apr 22

Embeddings to Diagnosis: Latent Fragility under Agentic Perturbations in Clinical LLMs

LLMs for clinical decision support often fail under small but clinically meaningful input shifts such as masking a symptom or negating a finding, despite high performance on static benchmarks. These reasoning failures frequently go undetected by standard NLP metrics, which are insensitive to latent representation shifts that drive diagnosis instability. We propose a geometry-aware evaluation framework, LAPD (Latent Agentic Perturbation Diagnostics), which systematically probes the latent robustness of clinical LLMs under structured adversarial edits. Within this framework, we introduce Latent Diagnosis Flip Rate (LDFR), a model-agnostic diagnostic signal that captures representational instability when embeddings cross decision boundaries in PCA-reduced latent space. Clinical notes are generated using a structured prompting pipeline grounded in diagnostic reasoning, then perturbed along four axes: masking, negation, synonym replacement, and numeric variation to simulate common ambiguities and omissions. We compute LDFR across both foundation and clinical LLMs, finding that latent fragility emerges even under minimal surface-level changes. Finally, we validate our findings on 90 real clinical notes from the DiReCT benchmark (MIMIC-IV), confirming the generalizability of LDFR beyond synthetic settings. Our results reveal a persistent gap between surface robustness and semantic stability, underscoring the importance of geometry-aware auditing in safety-critical clinical AI.

  • 1 authors
·
Jul 27, 2025

FileGram: Grounding Agent Personalization in File-System Behavioral Traces

Coworking AI agents operating within local file systems are rapidly emerging as a paradigm in human-AI interaction; however, effective personalization remains limited by severe data constraints, as strict privacy barriers and the difficulty of jointly collecting multimodal real-world traces prevent scalable training and evaluation, and existing methods remain interaction-centric while overlooking dense behavioral traces in file-system operations; to address this gap, we propose FileGram, a comprehensive framework that grounds agent memory and personalization in file-system behavioral traces, comprising three core components: (1) FileGramEngine, a scalable persona-driven data engine that simulates realistic workflows and generates fine-grained multimodal action sequences at scale; (2) FileGramBench, a diagnostic benchmark grounded in file-system behavioral traces for evaluating memory systems on profile reconstruction, trace disentanglement, persona drift detection, and multimodal grounding; and (3) FileGramOS, a bottom-up memory architecture that builds user profiles directly from atomic actions and content deltas rather than dialogue summaries, encoding these traces into procedural, semantic, and episodic channels with query-time abstraction; extensive experiments show that FileGramBench remains challenging for state-of-the-art memory systems and that FileGramEngine and FileGramOS are effective, and by open-sourcing the framework, we hope to support future research on personalized memory-centric file-system agents.

  • 9 authors
·
Apr 5 1

CodeTracer: Towards Traceable Agent States

Code agents are advancing rapidly, but debugging them is becoming increasingly difficult. As frameworks orchestrate parallel tool calls and multi-stage workflows over complex tasks, making the agent's state transitions and error propagation hard to observe. In these runs, an early misstep can trap the agent in unproductive loops or even cascade into fundamental errors, forming hidden error chains that make it hard to tell when the agent goes off track and why. Existing agent tracing analyses either focus on simple interaction or rely on small-scale manual inspection, which limits their scalability and usefulness for real coding workflows. We present CodeTracer, a tracing architecture that parses heterogeneous run artifacts through evolving extractors, reconstructs the full state transition history as a hierarchical trace tree with persistent memory, and performs failure onset localization to pinpoint the failure origin and its downstream chain. To enable systematic evaluation, we construct CodeTraceBench from a large collection of executed trajectories generated by four widely used code agent frameworks on diverse code tasks (e.g., bug fixing, refactoring, and terminal interaction), with supervision at both the stage and step levels for failure localization. Experiments show that CodeTracer substantially outperforms direct prompting and lightweight baselines, and that replaying its diagnostic signals consistently recovers originally failed runs under matched budgets. Our code and data are publicly available.

NJU-LINK NJU-LINK Lab
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Apr 12 2

DeepSearchQA: Bridging the Comprehensiveness Gap for Deep Research Agents

We introduce DeepSearchQA, a 900-prompt benchmark for evaluating agents on difficult multi-step information-seeking tasks across 17 different fields. Unlike traditional benchmarks that target single answer retrieval or broad-spectrum factuality, DeepSearchQA features a dataset of challenging, handcrafted tasks designed to evaluate an agent's ability to execute complex search plans to generate exhaustive answer lists. This shift in design explicitly tests three critical, yet under-evaluated capabilities: 1) systematic collation of fragmented information from disparate sources, 2) de-duplication and entity resolution to ensure precision, and 3) the ability to reason about stopping criteria within an open-ended search space. Each task is structured as a causal chain, where discovering information for one step is dependent on the successful completion of the previous one, stressing long-horizon planning and context retention. All tasks are grounded in the open web with objectively verifiable answer sets. Our comprehensive evaluation of state-of-the-art agent architectures reveals significant performance limitations: even the most advanced models struggle to balance high recall with precision. We observe distinct failure modes ranging from premature stopping (under-retrieval) to hedging behaviors, where agents cast an overly wide net of low-confidence answers to artificially boost recall. These findings highlight critical headroom in current agent designs and position DeepSearchQA as an essential diagnostic tool for driving future research toward more robust, deep-research capabilities.

google Google
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Jan 28 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
·
May 26, 2025 2

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

AndroTMem: From Interaction Trajectories to Anchored Memory in Long-Horizon GUI Agents

Long-horizon GUI agents are a key step toward real-world deployment, yet effective interaction memory under prevailing paradigms remains under-explored. Replaying full interaction sequences is redundant and amplifies noise, while summaries often erase dependency-critical information and traceability. We present AndroTMem, a diagnostic framework for anchored memory in long-horizon Android GUI agents. Its core benchmark, AndroTMem-Bench, comprises 1,069 tasks with 34,473 interaction steps (avg. 32.1 per task, max. 65). We evaluate agents with TCR (Task Complete Rate), focusing on tasks whose completion requires carrying forward critical intermediate state; AndroTMem-Bench is designed to enforce strong step-to-step causal dependencies, making sparse yet essential intermediate states decisive for downstream actions and centering interaction memory in evaluation. Across open- and closed-source GUI agents, we observe a consistent pattern: as interaction sequences grow longer, performance drops are driven mainly by within-task memory failures, not isolated perception errors or local action mistakes. Guided by this diagnosis, we propose Anchored State Memory (ASM), which represents interaction sequences as a compact set of causally linked intermediate-state anchors to enable subgoal-targeted retrieval and attribution-aware decision making. Across multiple settings and 12 evaluated GUI agents, ASM consistently outperforms full-sequence replay and summary-based baselines, improving TCR by 5%-30.16% and AMS by 4.93%-24.66%, indicating that anchored, structured memory effectively mitigates the interaction-memory bottleneck in long-horizon GUI tasks. The code, benchmark, and related resources are publicly available at [https://github.com/CVC2233/AndroTMem](https://github.com/CVC2233/AndroTMem).

  • 28 authors
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Mar 18 2

AgentDevel: Reframing Self-Evolving LLM Agents as Release Engineering

Recent progress in large language model (LLM) agents has largely focused on embedding self-improvement mechanisms inside the agent or searching over many concurrent variants. While these approaches can raise aggregate scores, they often yield unstable and hard-to-audit improvement trajectories, making it difficult to guarantee non-regression or to reason about failures across versions. We reframe agent improvement as release engineering: agents are treated as shippable artifacts, and improvement is externalized into a regression-aware release pipeline. We introduce AgentDevel, a release engineering pipeline that iteratively runs the current agent, produces implementation-blind, symptom-level quality signals from execution traces, synthesizes a single release candidate (RC) via executable diagnosis, and promotes it under flip-centered gating. AgentDevel features three core designs: (i) an implementation-blind LLM critic that characterizes failure appearances without accessing agent internals, (ii) script-based executable diagnosis that aggregates dominant symptom patterns and produces auditable engineering specifications, and (iii) flip-centered gating that prioritizes pass to fail regressions and fail to pass fixes as first-class evidence. Unlike population-based search or in-agent self-refinement, AgentDevel maintains a single canonical version line and emphasizes non-regression as a primary objective. Experiments on execution-heavy benchmarks demonstrate that AgentDevel yields stable improvements with significantly fewer regressions while producing reproducible, auditable artifacts. Overall, AgentDevel provides a practical development discipline for building, debugging, and releasing LLM agents as software development.

  • 1 authors
·
Jan 8 2

AgenticRAGTracer: A Hop-Aware Benchmark for Diagnosing Multi-Step Retrieval Reasoning in Agentic RAG

With the rapid advancement of agent-based methods in recent years, Agentic RAG has undoubtedly become an important research direction. Multi-hop reasoning, which requires models to engage in deliberate thinking and multi-step interaction, serves as a critical testbed for assessing such capabilities. However, existing benchmarks typically provide only final questions and answers, while lacking the intermediate hop-level questions that gradually connect atomic questions to the final multi-hop query. This limitation prevents researchers from analyzing at which step an agent fails and restricts more fine-grained evaluation of model capabilities. Moreover, most current benchmarks are manually constructed, which is both time-consuming and labor-intensive, while also limiting scalability and generalization. To address these challenges, we introduce AgenticRAGTracer, the first Agentic RAG benchmark that is primarily constructed automatically by large language models and designed to support step-by-step validation. Our benchmark spans multiple domains, contains 1,305 data points, and has no overlap with existing mainstream benchmarks. Extensive experiments demonstrate that even the best large language models perform poorly on our dataset. For instance, GPT-5 attains merely 22.6\% EM accuracy on the hardest portion of our dataset. Hop-aware diagnosis reveals that failures are primarily driven by distorted reasoning chains -- either collapsing prematurely or wandering into over-extension. This highlights a critical inability to allocate steps consistent with the task's logical structure, providing a diagnostic dimension missing in traditional evaluations. We believe our work will facilitate research in Agentic RAG and inspire further meaningful progress in this area. Our code and data are available at https://github.com/YqjMartin/AgenticRAGTracer.

  • 3 authors
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Feb 22

MedExAgent: Training LLM Agents to Ask, Examine, and Diagnose in Noisy Clinical Environments

Real-world clinical diagnosis is a complex process in which the doctor is required to obtain information from both interaction with the patient and conducting medical exams. Additionally, the doctor needs to adapt to different patient personas, as well as noisy and incomplete information that can happen at any time during the process. However, existing benchmarks for medical LLMs and methods for automatic diagnosis largely simplify this process by reducing it to single-turn question answering, noise-free conversations, or sequential exam making, etc., ignoring the interactive and uncertain nature of clinical diagnosis. In this paper, we aim to address this gap by formalizing clinical diagnosis as a Partially Observable Markov Decision Process (POMDP) with three action types: questioning the patient, ordering medical exams as tool calls, and issuing a diagnosis. We also introduce a systematic noise model comprising seven patient noise types and three exam noise types. Using our proposed environment, we train an effective diagnosis agent, MedExAgent, through a two-stage pipeline that first performs supervised finetuning on synthetic conversations structured after the Calgary-Cambridge model for clinical interviews, and then applies DAPO to optimize a composite reward capturing diagnostic accuracy, tool call quality, and exam cost including financial cost and patient discomfort. Through extensive experiments and ablation studies, we demonstrate that MedExAgent achieves diagnostic performance comparable to larger models while maintaining cost-efficient examination strategies.

  • 5 authors
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May 7

PrefixGuard: From LLM-Agent Traces to Online Failure-Warning Monitors

Large language model (LLM) agents now execute long, tool-using tasks where final outcome checks can arrive too late for intervention. Online warning requires lightweight prefix monitors over heterogeneous traces, but hand-authored event schemas are brittle and deployment-time LLM judging is costly. We introduce PrefixGuard, a trace-to-monitor framework with an offline StepView induction step followed by supervised monitor training. StepView induces deterministic typed-step adapters from raw trace samples, and the monitor learns an event abstraction and prefix-risk scorer from terminal outcomes. Across WebArena, τ^2-Bench, SkillsBench, and TerminalBench, the strongest PrefixGuard monitors reach 0.900/0.710/0.533/0.557 AUPRC. Using the strongest backend within each representation, they improve over raw-text controls by an average of +0.137 AUPRC. LLM judges remain substantially weaker under the same prefix-warning protocol. We also derive an observability ceiling on score-based area under the precision-recall curve (AUPRC) that separates monitor error from failures lacking evidence in the observed prefix. For finite-state audit, post-hoc deterministic finite automaton (DFA) extraction remains compact on WebArena and τ^2-Bench (29 and 20 states) but expands to 151 and 187 states on SkillsBench and TerminalBench. Finally, first-alert diagnostics show that strong ranking does not imply deployment utility: WebArena ranks well yet fails to support low-false-alarm alerts, whereas τ^2-Bench and TerminalBench retain more actionable early alerts. Together, these results position PrefixGuard as a practical monitor-synthesis recipe with explicit diagnostics for when prefix warnings translate into actionable interventions.

LAMMI-Pathology: A Tool-Centric Bottom-Up LVLM-Agent Framework for Molecularly Informed Medical Intelligence in Pathology

The emergence of tool-calling-based agent systems introduces a more evidence-driven paradigm for pathology image analysis in contrast to the coarse-grained text-image diagnostic approaches. With the recent large-scale experimental adoption of spatial transcriptomics technologies, molecularly validated pathological diagnosis is becoming increasingly open and accessible. In this work, we propose LAMMI-Pathology (LVLM-Agent System for Molecularly Informed Medical Intelligence in Pathology), a scalable agent framework for domain-specific agent tool-calling. LAMMI-Pathology adopts a tool-centric, bottom-up architecture in which customized domain-adaptive tools serve as the foundation. These tools are clustered by domain style to form component agents, which are then coordinated through a top-level planner hierarchically, avoiding excessively long context lengths that could induce task drift. Based on that, we introduce a novel trajectory construction mechanism based on Atomic Execution Nodes (AENs), which serve as reliable and composable units for building semi-simulated reasoning trajectories that capture credible agent-tool interactions. Building on this foundation, we develop a trajectory-aware fine-tuning strategy that aligns the planner's decision-making process with these multi-step reasoning trajectories, thereby enhancing inference robustness in pathology understanding and its adaptive use of the customized toolset.

  • 3 authors
·
Feb 21

EvolveMem:Self-Evolving Memory Architecture via AutoResearch for LLM Agents

Long-term memory is essential for LLM agents that operate across multiple sessions, yet existing memory systems treat retrieval infrastructure as fixed: stored content evolves while scoring functions, fusion strategies, and answer-generation policies remain frozen at deployment. We argue that truly adaptive memory requires co-evolution at two levels: the stored knowledge and the retrieval mechanism that queries it. We present EvolveMem, a self-evolving memory architecture that exposes its full retrieval configuration as a structured action space optimized by an LLM-powered diagnosis module. In each evolution round, the module reads per-question failure logs, identifies root causes, and proposes targeted configuration adjustments; a guarded meta-analyzer applies them with automatic revert-on-regression and explore-on-stagnation safeguards. This closed-loop self-evolution realizes an AutoResearch process: the system autonomously conducts iterative research cycles on its own architecture, replacing manual configuration tuning. Starting from a minimal baseline, the process converges autonomously, discovering effective retrieval strategies including entirely new configuration dimensions not present in the original action space. On LoCoMo, EvolveMem outperforms the strongest baseline by 25.7% relative and achieves a 78.0% relative improvement over the minimal baseline. On MemBench, EvolveMem exceeds the strongest baseline by 18.9% relative. Evolved configurations transfer across benchmarks with positive rather than catastrophic transfer, indicating that the self-evolution process captures universal retrieval principles rather than benchmark-specific heuristics. Code is available at https://github.com/aiming-lab/SimpleMem.

  • 7 authors
·
May 12 1

DEER: A Benchmark for Evaluating Deep Research Agents on Expert Report Generation

Recent advances in large language models have enabled deep research systems that generate expert-level reports through multi-step reasoning and evidence-based synthesis. However, evaluating such reports remains challenging: report quality is multifaceted, making it difficult to determine what to assess and by what criteria; LLM-based judges may miss errors that require domain expertise to identify; and because deep research relies on retrieved evidence, report-wide claim verification is also necessary. To address these issues, we propose DEER, a benchmark for evaluating expert-level deep research reports. DEER systematizes evaluation criteria with an expert-developed taxonomy (7 dimensions, 25 subdimensions) operationalized as 101 fine-grained rubric items. We also provide task-specific Expert Evaluation Guidance to support LLM-based judging. Alongside rubric-based assessment, we propose a claim verification architecture that verifies both cited and uncited claims and quantifies evidence quality. Experiments show that while current deep research systems can produce structurally plausible reports that cite external evidence, there is room for improvement in fulfilling expert-level user requests and achieving logical completeness. Beyond simple performance comparisons, DEER makes system strengths and limitations interpretable and provides diagnostic signals for improvement.

LG-AI-Research LG AI Research
·
Dec 19, 2025

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

TemporalBench: A Benchmark for Evaluating LLM-Based Agents on Contextual and Event-Informed Time Series Tasks

It is unclear whether strong forecasting performance reflects genuine temporal understanding or the ability to reason under contextual and event-driven conditions. We introduce TemporalBench, a multi-domain benchmark designed to evaluate temporal reasoning behavior under progressively richer informational settings. TemporalBench adopts a four-tier task taxonomy that examines historical structure interpretation, context-free forecasting, contextual temporal reasoning, and event-conditioned prediction across four real-world domains: retail, healthcare, energy, and physical systems. By controlling access to future targets and contextual information, the benchmark enables a diagnostic analysis of whether models can correctly interpret temporal patterns, align them with external context, and adapt predictions when conditions change. Extensive baseline experiments show that strong numerical forecasting accuracy does not reliably translate into robust contextual or event-aware temporal reasoning; instead, existing agent frameworks exhibit fragmented strengths and systematic failure modes that remain largely hidden under forecasting-only benchmarks. The TemporalBench dataset is publicly available at https://huggingface.co/datasets/Melady/TemporalBench, and we additionally provide a public leaderboard at https://huggingface.co/spaces/Melady/TemporalBench_Leaderboard.

  • 5 authors
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Feb 4

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

SWE-WebDevBench: Evaluating Coding Agent Application Platforms as Virtual Software Agencies

The emergence of "vibe coding" platforms, where users describe applications in natural language and AI agents autonomously generate full-stack software, has created a need for rigorous evaluation beyond code-level benchmarks. In order to assess them as virtual software development agencies on understanding business requirements, making architectural decisions, writing production code, handling iterative modifications, and maintaining business readiness, we introduce SWE-WebDev Bench, a 68-metric evaluation framework spanning 25 primary and 43 diagnostic metrics across seven groups, organized along three dimensions: Interaction Mode (App Creation Request (ACR) vs. App Modification Request (AMR)), Agency Angle (Product Manager (PM), Engineering, Ops), and Complexity Tier (T4 multi-role SaaS, T5 AI-native). Our evaluation (six platforms, three domains, 18 evaluation cells) reveals four recurring shortcomings in the current generation of AI app builders: (1) A specification bottleneck, where platforms compress rich business requirements into oversimplified technical plans, (2) A pervasive frontend-backend decoupling, where visually polished UIs mask absent or broken backend infrastructure, (3) A steep production-readiness cliff, where no platform scores above 60% on engineering quality and post-generation human effort varies substantially across platforms and (4) Widespread security and infrastructure failures, with no platform exceeding 65% Security Score against a 90% target and concurrency handling as low as 6%. These observations are descriptive of our sample and require larger-scale replication to establish generality. We release SWE-WebDev Bench as a community benchmark to enable such replication and help platform builders identify and address these gaps. Code and benchmark resources are available at: https://github.com/snowmountainAi/webdevbench and https://webdevbench.com/.

qwikbuild QwikBuild
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May 5 2

Dr.Mi-Bench: A Modular-integrated Benchmark for Scientific Deep Research Agent

The explosive growth in academic literature necessitates automated deep research (DR) agents, yet their evaluation remains a significant challenge. First, existing benchmarks often focus narrowly on retrieval while neglecting high-level planning and reasoning. Second, existing benchmarks favor general domains over the scientific domains that are the core application for DR agents. To address these gaps, we introduce Dr.Mi-Bench, a Modular-integrated benchmark for scientific DR agents. Grounded in academic literature, our benchmark uses a human-annotated dataset of 200 instances across 10 scientific domains, including both research and review papers. Besides, we also propose a Modular-integrated Evaluation Paradigm for DR Agents (Dr.Mi-Eval), a novel modular-integrated evaluation paradigm, which leverages the rich structure of academic papers to assess the core competencies of planning, retrieval, and reasoning through two complementary modes: an end-to-end evaluation for DR agents and an isolated evaluation for foundational LLMs as potential backbones. Experimental results reveal a fragmented performance landscape: agents exhibit specialized strengths but share critical weaknesses, most notably in performing the multi-source retrieval required for review-style tasks and performing consistently across diverse scientific fields. Moreover, improving high-level planning capability is the crucial factor for unlocking the reasoning potential of foundational LLMs as backbones. By exposing these actionable failure modes, Dr.Mi-Bench provides a diagnostic tool to guide the development of more reliable academic research assistants.

  • 10 authors
·
Nov 30, 2025

AcademiClaw: When Students Set Challenges for AI Agents

Benchmarks within the OpenClaw ecosystem have thus far evaluated exclusively assistant-level tasks, leaving the academic-level capabilities of OpenClaw largely unexamined. We introduce AcademiClaw, a bilingual benchmark of 80 complex, long-horizon tasks sourced directly from university students' real academic workflows -- homework, research projects, competitions, and personal projects -- that they found current AI agents unable to solve effectively. Curated from 230 student-submitted candidates through rigorous expert review, the final task set spans 25+ professional domains, ranging from olympiad-level mathematics and linguistics problems to GPU-intensive reinforcement learning and full-stack system debugging, with 16 tasks requiring CUDA GPU execution. Each task executes in an isolated Docker sandbox and is scored on task completion by multi-dimensional rubrics combining six complementary techniques, with an independent five-category safety audit providing additional behavioral analysis. Experiments on six frontier models show that even the best achieves only a 55\% pass rate. Further analysis uncovers sharp capability boundaries across task domains, divergent behavioral strategies among models, and a disconnect between token consumption and output quality, providing fine-grained diagnostic signals beyond what aggregate metrics reveal. We hope that AcademiClaw and its open-sourced data and code can serve as a useful resource for the OpenClaw community, driving progress toward agents that are more capable and versatile across the full breadth of real-world academic demands. All data and code are available at https://github.com/GAIR-NLP/AcademiClaw.

  • 78 authors
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May 3 2

MedAgent-Pro: Towards Multi-modal Evidence-based Medical Diagnosis via Reasoning Agentic Workflow

Developing reliable AI systems to assist human clinicians in multi-modal medical diagnosis has long been a key objective for researchers. Recently, Multi-modal Large Language Models (MLLMs) have gained significant attention and achieved success across various domains. With strong reasoning capabilities and the ability to perform diverse tasks based on user instructions, they hold great potential for enhancing medical diagnosis. However, directly applying MLLMs to the medical domain still presents challenges. They lack detailed perception of visual inputs, limiting their ability to perform quantitative image analysis, which is crucial for medical diagnostics. Additionally, MLLMs often exhibit hallucinations and inconsistencies in reasoning, whereas clinical diagnoses must adhere strictly to established criteria. To address these challenges, we propose MedAgent-Pro, an evidence-based reasoning agentic system designed to achieve reliable, explainable, and precise medical diagnoses. This is accomplished through a hierarchical workflow: at the task level, knowledge-based reasoning generate reliable diagnostic plans for specific diseases following retrieved clinical criteria. While at the case level, multiple tool agents process multi-modal inputs, analyze different indicators according to the plan, and provide a final diagnosis based on both quantitative and qualitative evidence. Comprehensive experiments on both 2D and 3D medical diagnosis tasks demonstrate the superiority and effectiveness of MedAgent-Pro, while case studies further highlight its reliability and interpretability. The code is available at https://github.com/jinlab-imvr/MedAgent-Pro.

  • 4 authors
·
Mar 21, 2025 2

Language Server CLI Empowers Language Agents with Process Rewards

Large language models routinely hallucinate APIs and mislocalize edits, while language servers compute verified, IDE-grade facts about real code. We present Lanser-CLI, a CLI-first orchestration layer that pins and mediates a Language Server Protocol (LSP) server for coding agents and CI, exposing deterministic, replayable workflows. Our position is that language servers provide not only structural information (definitions, references, types, diagnostics) but also an actionable process reward: machine-checked, step-wise signals that align an agent's planning loop with program reality. In this work, Lanser-CLI contributes: (i) a robust addressing scheme beyond brittle "file:line:col" via a Selector DSL (symbolic, AST-path, and content-anchored selectors) with a principled relocation algorithm; (ii) deterministic Analysis Bundles that normalize Language Server responses and capture environment/capability metadata with stable content hashes; (iii) a safety envelope for mutating operations (rename, code actions) with preview, workspace jails, and Git-aware, transactional apply; and (iv) a process-reward functional derived from Language Server facts (diagnostic deltas, disambiguation confidence, and safe-apply checks) that is computable online and replayable offline. We formalize determinism under frozen snapshots and establish a monotonicity property for the process reward, making it suitable for process supervision and counterfactual analysis. Project Page: https://github.com/yifanzhang-pro/lanser-cli

  • 2 authors
·
Oct 26, 2025 1

Springdrift: An Auditable Persistent Runtime for LLM Agents with Case-Based Memory, Normative Safety, and Ambient Self-Perception

We present Springdrift, a persistent runtime for long-lived LLM agents. The system integrates an auditable execution substrate (append-only memory, supervised processes, git-backed recovery), a case-based reasoning memory layer with hybrid retrieval (evaluated against a dense cosine baseline), a deterministic normative calculus for safety gating with auditable axiom trails, and continuous ambient self-perception via a structured self-state representation (the sensorium) injected each cycle without tool calls. These properties support behaviours difficult to achieve in session-bounded systems: cross-session task continuity, cross-channel context maintenance, end-to-end forensic reconstruction of decisions, and self-diagnostic behaviour. We report on a single-instance deployment over 23 days (19 operating days), during which the agent diagnosed its own infrastructure bugs, classified failure modes, identified an architectural vulnerability, and maintained context across email and web channels -- without explicit instruction. We introduce the term Artificial Retainer for this category: a non-human system with persistent memory, defined authority, domain-specific autonomy, and forensic accountability in an ongoing relationship with a specific principal -- distinguished from software assistants and autonomous agents, drawing on professional retainer relationships and the bounded autonomy of trained working animals. This is a technical report on a systems design and deployment case study, not a benchmark-driven evaluation. Evidence is from a single instance with a single operator, presented as illustration of what these architectural properties can support in practice. Implemented in approximately Gleam on Erlang/OTP. Code, artefacts, and redacted operational logs will be available at https://github.com/seamus-brady/springdrift upon publication.

  • 1 authors
·
Apr 5

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

SE-Bench: Benchmarking Self-Evolution with Knowledge Internalization

True self-evolution requires agents to act as lifelong learners that internalize novel experiences to solve future problems. However, rigorously measuring this foundational capability is hindered by two obstacles: the entanglement of prior knowledge, where ``new'' knowledge may appear in pre-training data, and the entanglement of reasoning complexity, where failures may stem from problem difficulty rather than an inability to recall learned knowledge. We introduce SE-Bench, a diagnostic environment that obfuscates the NumPy library and its API doc into a pseudo-novel package with randomized identifiers. Agents are trained to internalize this package and evaluated on simple coding tasks without access to documentation, yielding a clean setting where tasks are trivial with the new API doc but impossible for base models without it. Our investigation reveals three insights: (1) the Open-Book Paradox, where training with reference documentation inhibits retention, requiring "Closed-Book Training" to force knowledge compression into weights; (2) the RL Gap, where standard RL fails to internalize new knowledge completely due to PPO clipping and negative gradients; and (3) the viability of Self-Play for internalization, proving models can learn from self-generated, noisy tasks when coupled with SFT, but not RL. Overall, SE-Bench establishes a rigorous diagnostic platform for self-evolution with knowledge internalization. Our code and dataset can be found at https://github.com/thunlp/SE-Bench.

  • 6 authors
·
Feb 4 2

Multi-Spectroscopic Method to Quantify Rapid Decomposition of an Organophosphate Simulant Using Reactive Materials as a Function of Metal Powder Chemistry and Temperature

The development of advanced diagnostic systems to measure and optimize emerging energetic material performance is critical for the defeat of Chemical Warfare Agents (CWA). This study presents an integrated multi-spectroscopic approach to monitor the interaction between a CWA simulant, Diisopropyl Methyl Phosphonate (DIMP), and combusting composite metal particles. A custom benchtop Polygonal Rotating Mirror Infrared Spectrometer (PRiMIRS), equipped with a customizable experimental chamber, is employed to observe DIMP decomposition. Tunable Diode Laser Absorption Spectroscopy (TDLAS) is used to measure path-averaged gas temperature profiles during combustion. In the experiment, the chamber is preheated to evaporate liquid DIMP. Various composite metal powders (Al-8Mg):3Zr, (Al-8Mg):Zr, 2(Al-8Mg):Zr, and 4(Al-8Mg):Zr are placed on a stainless steel mount and ignited using 3Al-2Ni sputter-deposited nanolayered foils. The combusting metal particles mix with the DIMP vapor, initiating chemical and thermal interactions. PRiMIRS captures DIMP spectral evolution, while TDLAS simultaneously monitors gas temperature. A spectral defeat parameter was developed to enable quantitative real-time assessment of the DIMP destruction. It uses infrared light absorption by both from DIMP and its immediate decomposition products Isopropyl Methyl Phosphonate (IMP) and Isopropyl Alcohol (IPA). Fourier Transform Infrared Spectroscopy (FTIR) serves as a secondary verification tool quantifying the decomposition products over extended timeframes, and Transmission Electron Microscopy (TEM) confirms the expected metal oxide dispersion within the reaction space. This study reports variability in DIMP defeat as a function of metal powder stoichiometry, metal powder loading, and path-averaged gas temperature profiles, offering critical insights into optimizing reactive materials for effective CWA neutralization.

  • 6 authors
·
Sep 4, 2025

AOI: Turning Failed Trajectories into Training Signals for Autonomous Cloud Diagnosis

Large language model (LLM) agents offer a promising data-driven approach to automating Site Reliability Engineering (SRE), yet their enterprise deployment is constrained by three challenges: restricted access to proprietary data, unsafe action execution under permission-governed environments, and the inability of closed systems to improve from failures. We present AOI (Autonomous Operations Intelligence), a trainable multi-agent framework formulating automated operations as a structured trajectory learning problem under security constraints. Our approach integrates three key components. First, a trainable diagnostic system applies Group Relative Policy Optimization (GRPO) to distill expert-level knowledge into locally deployed open-source models, enabling preference-based learning without exposing sensitive data. Second, a read-write separated execution architecture decomposes operational trajectories into observation, reasoning, and action phases, allowing safe learning while preventing unauthorized state mutation. Third, a Failure Trajectory Closed-Loop Evolver mines unsuccessful trajectories and converts them into corrective supervision signals, enabling continual data augmentation. Evaluated on the AIOpsLab benchmark, our contributions yield cumulative gains. (1) The AOI runtime alone achieves 66.3% best@5 success on all 86 tasks, outperforming the prior state-of-the-art (41.9%) by 24.4 points. (2) Adding Observer GRPO training, a locally deployed 14B model reaches 42.9% avg@1 on 63 held-out tasks with unseen fault types, surpassing Claude Sonnet 4.5. (3) The Evolver converts 37 failed trajectories into diagnostic guidance, improving end-to-end avg@5 by 4.8 points while reducing variance by 35%.

  • 14 authors
·
Mar 16

Towards Conversational AI for Disease Management

While large language models (LLMs) have shown promise in diagnostic dialogue, their capabilities for effective management reasoning - including disease progression, therapeutic response, and safe medication prescription - remain under-explored. We advance the previously demonstrated diagnostic capabilities of the Articulate Medical Intelligence Explorer (AMIE) through a new LLM-based agentic system optimised for clinical management and dialogue, incorporating reasoning over the evolution of disease and multiple patient visit encounters, response to therapy, and professional competence in medication prescription. To ground its reasoning in authoritative clinical knowledge, AMIE leverages Gemini's long-context capabilities, combining in-context retrieval with structured reasoning to align its output with relevant and up-to-date clinical practice guidelines and drug formularies. In a randomized, blinded virtual Objective Structured Clinical Examination (OSCE) study, AMIE was compared to 21 primary care physicians (PCPs) across 100 multi-visit case scenarios designed to reflect UK NICE Guidance and BMJ Best Practice guidelines. AMIE was non-inferior to PCPs in management reasoning as assessed by specialist physicians and scored better in both preciseness of treatments and investigations, and in its alignment with and grounding of management plans in clinical guidelines. To benchmark medication reasoning, we developed RxQA, a multiple-choice question benchmark derived from two national drug formularies (US, UK) and validated by board-certified pharmacists. While AMIE and PCPs both benefited from the ability to access external drug information, AMIE outperformed PCPs on higher difficulty questions. While further research would be needed before real-world translation, AMIE's strong performance across evaluations marks a significant step towards conversational AI as a tool in disease management.

  • 20 authors
·
Mar 7, 2025

Demystifying deep search: a holistic evaluation with hint-free multi-hop questions and factorised metrics

RAG (Retrieval-Augmented Generation) systems and web agents are increasingly evaluated on multi-hop deep search tasks, yet current practice suffers from two major limitations. First, most benchmarks leak the reasoning path in the question text, allowing models to follow surface cues rather than discover reasoning chains autonomously. Second, evaluation is typically reduced to a single pass rate, which collapses diverse behaviours into one score and obscures whether failures stem from inadequate search, poor knowledge use, or inappropriate refusal. To address these issues, we present WebDetective, a benchmark of hint-free multi-hop questions paired with a controlled Wikipedia sandbox that ensures full traceability of model actions, and a holistic evaluation framework that separates search sufficiency, knowledge utilisation, and refusal behaviour. Our evaluation of 25 state-of-the-art models reveals systematic weaknesses across all architectures: models struggle with knowledge utilisation despite having sufficient evidence and demonstrate near-absent appropriate refusal when evidence is lacking. These patterns expose a fundamental gap: today's systems excel at executing given reasoning paths but fail when required to discover them. We develop an agentic workflow, EvidenceLoop, that explicitly targets the challenges our benchmark identifies, incorporating verification loops and systematic evidence tracking that improve both search and synthesis capabilities. This baseline demonstrates that WebDetective's diagnostic framework can guide concrete architectural improvements, establishing our benchmark as a critical tool for developing genuinely autonomous reasoning systems rather than pattern-following agents.

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

HyperWalker: Dynamic Hypergraph-Based Deep Diagnosis for Multi-Hop Clinical Modeling across EHR and X-Ray in Medical VLMs

Automated clinical diagnosis remains a core challenge in medical AI, which usually requires models to integrate multi-modal data and reason across complex, case-specific contexts. Although recent methods have advanced medical report generation (MRG) and visual question answering (VQA) with medical vision-language models (VLMs), these methods, however, predominantly operate under a sample-isolated inference paradigm, as such processing cases independently without access to longitudinal electronic health records (EHRs) or structurally related patient examples. This paradigm limits reasoning to image-derived information alone, which ignores external complementary medical evidence for potentially more accurate diagnosis. To overcome this limitation, we propose HyperWalker, a Deep Diagnosis framework that reformulates clinical reasoning via dynamic hypergraphs and test-time training. First, we construct a dynamic hypergraph, termed iBrochure, to model the structural heterogeneity of EHR data and implicit high-order associations among multimodal clinical information. Within this hypergraph, a reinforcement learning agent, Walker, navigates to and identifies optimal diagnostic paths. To ensure comprehensive coverage of diverse clinical characteristics in test samples, we incorporate a linger mechanism, a multi-hop orthogonal retrieval strategy that iteratively selects clinically complementary neighborhood cases reflecting distinct clinical attributes. Experiments on MRG with MIMIC and medical VQA on EHRXQA demonstrate that HyperWalker achieves state-of-the-art performance. Code is available at: https://github.com/Bean-Young/HyperWalker

  • 5 authors
·
Jan 19

OmniPlay: Benchmarking Omni-Modal Models on Omni-Modal Game Playing

While generalist foundation models like Gemini and GPT-4o demonstrate impressive multi-modal competence, existing evaluations fail to test their intelligence in dynamic, interactive worlds. Static benchmarks lack agency, while interactive benchmarks suffer from a severe modal bottleneck, typically ignoring crucial auditory and temporal cues. To bridge this evaluation chasm, we introduce OmniPlay, a diagnostic benchmark designed not just to evaluate, but to probe the fusion and reasoning capabilities of agentic models across the full sensory spectrum. Built on a core philosophy of modality interdependence, OmniPlay comprises a suite of five game environments that systematically create scenarios of both synergy and conflict, forcing agents to perform genuine cross-modal reasoning. Our comprehensive evaluation of six leading omni-modal models reveals a critical dichotomy: they exhibit superhuman performance on high-fidelity memory tasks but suffer from systemic failures in challenges requiring robust reasoning and strategic planning. We demonstrate that this fragility stems from brittle fusion mechanisms, which lead to catastrophic performance degradation under modality conflict and uncover a counter-intuitive "less is more" paradox, where removing sensory information can paradoxically improve performance. Our findings suggest that the path toward robust AGI requires a research focus beyond scaling to explicitly address synergistic fusion. Our platform is available for anonymous review at https://github.com/fuqingbie/omni-game-benchmark.

  • 9 authors
·
Aug 6, 2025

Incentivizing Tool-augmented Thinking with Images for Medical Image Analysis

Recent reasoning based medical MLLMs have made progress in generating step by step textual reasoning chains. However, they still struggle with complex tasks that necessitate dynamic and iterative focusing on fine-grained visual regions to achieve precise grounding and diagnosis. We introduce Ophiuchus, a versatile, tool-augmented framework that equips an MLLM to (i) decide when additional visual evidence is needed, (ii) determine where to probe and ground within the medical image, and (iii) seamlessly weave the relevant sub-image content back into an interleaved, multimodal chain of thought. In contrast to prior approaches limited by the performance ceiling of specialized tools, Ophiuchus integrates the model's inherent grounding and perception capabilities with external tools, thereby fostering higher-level reasoning. The core of our method is a three-stage training strategy: cold-start training with tool-integrated reasoning data to achieve basic tool selection and adaptation for inspecting key regions; self-reflection fine-tuning to strengthen reflective reasoning and encourage revisiting tool outputs; and Agentic Tool Reinforcement Learning to directly optimize task-specific rewards and emulate expert-like diagnostic behavior. Extensive experiments show that Ophiuchus consistently outperforms both closed-source and open-source SOTA methods across diverse medical benchmarks, including VQA, detection, and reasoning-based segmentation. Our approach illuminates a path toward medical AI agents that can genuinely "think with images" through tool-integrated reasoning. Datasets, codes, and trained models will be released publicly.

  • 7 authors
·
Dec 16, 2025 1

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

TxAgent: An AI Agent for Therapeutic Reasoning Across a Universe of Tools

Precision therapeutics require multimodal adaptive models that generate personalized treatment recommendations. We introduce TxAgent, an AI agent that leverages multi-step reasoning and real-time biomedical knowledge retrieval across a toolbox of 211 tools to analyze drug interactions, contraindications, and patient-specific treatment strategies. TxAgent evaluates how drugs interact at molecular, pharmacokinetic, and clinical levels, identifies contraindications based on patient comorbidities and concurrent medications, and tailors treatment strategies to individual patient characteristics. It retrieves and synthesizes evidence from multiple biomedical sources, assesses interactions between drugs and patient conditions, and refines treatment recommendations through iterative reasoning. It selects tools based on task objectives and executes structured function calls to solve therapeutic tasks that require clinical reasoning and cross-source validation. The ToolUniverse consolidates 211 tools from trusted sources, including all US FDA-approved drugs since 1939 and validated clinical insights from Open Targets. TxAgent outperforms leading LLMs, tool-use models, and reasoning agents across five new benchmarks: DrugPC, BrandPC, GenericPC, TreatmentPC, and DescriptionPC, covering 3,168 drug reasoning tasks and 456 personalized treatment scenarios. It achieves 92.1% accuracy in open-ended drug reasoning tasks, surpassing GPT-4o and outperforming DeepSeek-R1 (671B) in structured multi-step reasoning. TxAgent generalizes across drug name variants and descriptions. By integrating multi-step inference, real-time knowledge grounding, and tool-assisted decision-making, TxAgent ensures that treatment recommendations align with established clinical guidelines and real-world evidence, reducing the risk of adverse events and improving therapeutic decision-making.

  • 8 authors
·
Mar 13, 2025 3

Pathology-CoT: Learning Visual Chain-of-Thought Agent from Expert Whole Slide Image Diagnosis Behavior

Diagnosing a whole-slide image is an interactive, multi-stage process involving changes in magnification and movement between fields. Although recent pathology foundation models are strong, practical agentic systems that decide what field to examine next, adjust magnification, and deliver explainable diagnoses are still lacking. The blocker is data: scalable, clinically aligned supervision of expert viewing behavior that is tacit and experience-based, not written in textbooks or online, and therefore absent from large language model training. We introduce the AI Session Recorder, which works with standard WSI viewers to unobtrusively record routine navigation and convert the viewer logs into standardized behavioral commands (inspect or peek at discrete magnifications) and bounding boxes. A lightweight human-in-the-loop review turns AI-drafted rationales into the Pathology-CoT dataset, a form of paired "where to look" and "why it matters" supervision produced at roughly six times lower labeling time. Using this behavioral data, we build Pathologist-o3, a two-stage agent that first proposes regions of interest and then performs behavior-guided reasoning. On gastrointestinal lymph-node metastasis detection, it achieved 84.5% precision, 100.0% recall, and 75.4% accuracy, exceeding the state-of-the-art OpenAI o3 model and generalizing across backbones. To our knowledge, this constitutes one of the first behavior-grounded agentic systems in pathology. Turning everyday viewer logs into scalable, expert-validated supervision, our framework makes agentic pathology practical and establishes a path to human-aligned, upgradeable clinical AI.

zhihuanglab Zhi Huang Lab
·
Oct 6, 2025 2

BioDiscoveryAgent: An AI Agent for Designing Genetic Perturbation Experiments

Agents based on large language models have shown great potential in accelerating scientific discovery by leveraging their rich background knowledge and reasoning capabilities. In this paper, we introduce BioDiscoveryAgent, an agent that designs new experiments, reasons about their outcomes, and efficiently navigates the hypothesis space to reach desired solutions. We demonstrate our agent on the problem of designing genetic perturbation experiments, where the aim is to find a small subset out of many possible genes that, when perturbed, result in a specific phenotype (e.g., cell growth). Utilizing its biological knowledge, BioDiscoveryAgent can uniquely design new experiments without the need to train a machine learning model or explicitly design an acquisition function as in Bayesian optimization. Moreover, BioDiscoveryAgent, using Claude 3.5 Sonnet, achieves an average of 21% improvement in predicting relevant genetic perturbations across six datasets, and a 46% improvement in the harder task of non-essential gene perturbation, compared to existing Bayesian optimization baselines specifically trained for this task. Our evaluation includes one dataset that is unpublished, ensuring it is not part of the language model's training data. Additionally, BioDiscoveryAgent predicts gene combinations to perturb more than twice as accurately as a random baseline, a task so far not explored in the context of closed-loop experiment design. The agent also has access to tools for searching the biomedical literature, executing code to analyze biological datasets, and prompting another agent to critically evaluate its predictions. Overall, BioDiscoveryAgent is interpretable at every stage, representing an accessible new paradigm in the computational design of biological experiments with the potential to augment scientists' efficacy.

  • 9 authors
·
May 27, 2024

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

Automatic Differential Diagnosis using Transformer-Based Multi-Label Sequence Classification

As the field of artificial intelligence progresses, assistive technologies are becoming more widely used across all industries. The healthcare industry is no different, with numerous studies being done to develop assistive tools for healthcare professionals. Automatic diagnostic systems are one such beneficial tool that can assist with a variety of tasks, including collecting patient information, analyzing test results, and diagnosing patients. However, the idea of developing systems that can provide a differential diagnosis has been largely overlooked in most of these research studies. In this study, we propose a transformer-based approach for providing differential diagnoses based on a patient's age, sex, medical history, and symptoms. We use the DDXPlus dataset, which provides differential diagnosis information for patients based on 49 disease types. Firstly, we propose a method to process the tabular patient data from the dataset and engineer them into patient reports to make them suitable for our research. In addition, we introduce two data modification modules to diversify the training data and consequently improve the robustness of the models. We approach the task as a multi-label classification problem and conduct extensive experiments using four transformer models. All the models displayed promising results by achieving over 97% F1 score on the held-out test set. Moreover, we design additional behavioral tests to get a broader understanding of the models. In particular, for one of our test cases, we prepared a custom test set of 100 samples with the assistance of a doctor. The results on the custom set showed that our proposed data modification modules improved the model's generalization capabilities. We hope our findings will provide future researchers with valuable insights and inspire them to develop reliable systems for automatic differential diagnosis.

  • 3 authors
·
Aug 28, 2024 1

Sequential Diagnosis with Language Models

Artificial intelligence holds great promise for expanding access to expert medical knowledge and reasoning. However, most evaluations of language models rely on static vignettes and multiple-choice questions that fail to reflect the complexity and nuance of evidence-based medicine in real-world settings. In clinical practice, physicians iteratively formulate and revise diagnostic hypotheses, adapting each subsequent question and test to what they've just learned, and weigh the evolving evidence before committing to a final diagnosis. To emulate this iterative process, we introduce the Sequential Diagnosis Benchmark, which transforms 304 diagnostically challenging New England Journal of Medicine clinicopathological conference (NEJM-CPC) cases into stepwise diagnostic encounters. A physician or AI begins with a short case abstract and must iteratively request additional details from a gatekeeper model that reveals findings only when explicitly queried. Performance is assessed not just by diagnostic accuracy but also by the cost of physician visits and tests performed. We also present the MAI Diagnostic Orchestrator (MAI-DxO), a model-agnostic orchestrator that simulates a panel of physicians, proposes likely differential diagnoses and strategically selects high-value, cost-effective tests. When paired with OpenAI's o3 model, MAI-DxO achieves 80% diagnostic accuracy--four times higher than the 20% average of generalist physicians. MAI-DxO also reduces diagnostic costs by 20% compared to physicians, and 70% compared to off-the-shelf o3. When configured for maximum accuracy, MAI-DxO achieves 85.5% accuracy. These performance gains with MAI-DxO generalize across models from the OpenAI, Gemini, Claude, Grok, DeepSeek, and Llama families. We highlight how AI systems, when guided to think iteratively and act judiciously, can advance diagnostic precision and cost-effectiveness in clinical care.

  • 15 authors
·
Jun 27, 2025

IryoNLP at MEDIQA-CORR 2024: Tackling the Medical Error Detection & Correction Task On the Shoulders of Medical Agents

In natural language processing applied to the clinical domain, utilizing large language models has emerged as a promising avenue for error detection and correction on clinical notes, a knowledge-intensive task for which annotated data is scarce. This paper presents MedReAct'N'MedReFlex, which leverages a suite of four LLM-based medical agents. The MedReAct agent initiates the process by observing, analyzing, and taking action, generating trajectories to guide the search to target a potential error in the clinical notes. Subsequently, the MedEval agent employs five evaluators to assess the targeted error and the proposed correction. In cases where MedReAct's actions prove insufficient, the MedReFlex agent intervenes, engaging in reflective analysis and proposing alternative strategies. Finally, the MedFinalParser agent formats the final output, preserving the original style while ensuring the integrity of the error correction process. One core component of our method is our RAG pipeline based on our ClinicalCorp corpora. Among other well-known sources containing clinical guidelines and information, we preprocess and release the open-source MedWiki dataset for clinical RAG application. Our results demonstrate the central role of our RAG approach with ClinicalCorp leveraged through the MedReAct'N'MedReFlex framework. It achieved the ninth rank on the MEDIQA-CORR 2024 final leaderboard.

  • 1 authors
·
Apr 23, 2024