Better with Experience: Self-Evolving LLM Agents for Evidence-Grounded Health Community Notes

Community Notes, a bridging-based crowd-sourced fact-checking system, has emerged as a new mechanism for moderating misleading information on social media and has been adopted by major platforms including X, Facebook, Instagram, Threads, and TikTok. Since its introduction, there has been an open question about what role AI could play in scaling and optimizing the system. Recently, X extended its Community Notes system by introducing Collaborative Notes: notes initially drafted by an LLM and iteratively refined based on feedback from human contributors. In this work, we systematically analyze the complete corpus of 19,146 collaborative notes and 211,850 instances of human feedback. First, we develop a taxonomy of human suggestions for improving AI-generated note drafts and find that suggestions involving factual corrections and additional context are most likely to be incorporated, while subjective policy judgments rarely are. Second, we examine changes in helpfulness across versions of collaborative notes and find that human feedback leads to more helpful notes, with the greatest impact coming from suggestions that challenge the main claim in the previous draft, particularly when submitted by more active contributors. Finally, we find that although collaborative notes improve through human feedback, they reach helpful status and are shown on the platform at lower rates than human-only or AI-only notes, with limited human participation emerging as a key bottleneck. Nevertheless, rather than serving as a weaker substitute, collaborative notes tend to play a complementary role, predominantly targeting posts that do not attract human-only or AI-only notes. Our analysis provides an initial description of efforts to use AI to improve crowdsourced content moderation in a real-world moderation system and outlines pathways for future improvements to such features.

As Large Language Models (LLMs) are increasingly deployed in healthcare settings, accurate error detection and correction in generated or existing text becomes critical, as even minor mistakes can pose risks to patient safety. Existing methods for error detection and correction, including automated checks and heuristic-based approaches, do not generalize well across unseen datasets. In this paper, we propose MedGuards as a medical safety guardrail, which is a new framework that treats medical error detection and correction as a multi-agent in-context learning task. Specialized agents separately detect, localize, and correct errors, while a confidence-guided arbitration mechanism resolves disagreements using reasoning traces and confidence scores. This design enhances interpretability, robustness, and adaptability, without requiring additional training of the base LLMs. Additionally, we introduce the Keyword-Prioritized Correction Score (KPCS), a new evaluation metric that considers whether critical keywords within the reference text are generated correctly, providing a more comprehensive assessment than conventional metrics. Experiments across four multilingual medical datasets consisting of clinical notes demonstrate significant improvements by the proposed framework across several metrics and models. Our aim is to enable safer deployment of LLMs in real-world healthcare applications. For reproducibility, we make our code publicly available at https://github.com/congboma/MedGuards.

Medical knowledge evolves continuously, whereas the parametric knowledge encoded in large language models (LLMs) is fixed at training time. External retrieval, including retrieval-augmented generation (RAG), can provide access to newly available evidence, but retrieved information may be irrelevant, incomplete, or conflicting. As a result, external retrieval can in turn degrade the factual accuracy and evidence grounding of LLM outputs. To address this challenge, we propose \textbf{CLEAR}, an agentic framework for cross-source evidence adjudication in LLMs in medicine. CLEAR independently generates candidate answers from three complementary pathways---parametric knowledge, locally curated corpora, and dynamically retrieved evidence---reflecting three common sources of information available to LLMs. An aggregation verifier jointly evaluates the candidates, supporting evidence, provenance, and source-quality information to identify agreement and conflict across sources. An adjudication module then determines whether the current conclusion should be preserved or revised through complementary override-guard and challenge-audit mechanisms, while unresolved conflicts trigger targeted follow-up search and re-adjudication.