Toward Vibe Medicine: A Self-Evolving Multi-Agent Framework for Clinical Decision Support
Organizations: Medical AI Lab, The First Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China · Hebei Provincial Medical Artificial Intelligence Research Institute, Shijiazhuang, 050000, Hebei, China · Hebei Provincial Engineering Research Center for AI-Based Cancer Treatment Decision-Making, The First Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China · State Key Laboratory of Neurology and Oncology Drug Development, Nanjing, China · School of Computing, University of Georgia, 415 Boyd Research and Education Center, Athens, 30602, GA, USA · Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China · College of Mathematics and Physics, China Three Gorges University, Yichang, Hubei, China · Department of Radiation Oncology, Mayo Clinic, 5881 E. Mayo Blvd., Phoenix, 85054, AZ, USA · Gastrointestinal Disease Diagnosis and Treatment Center, The First Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China · Department of General Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China
Abstract
In recent years, the advances of large language models and autonomous agents have revolutionized the healthcare field, facilitating diagnosis and improving treatment results. However, most existing AI systems rely on pre-trained knowledge and predefined pipelines, which struggle to learn dynamically from the interactive chat session history that contains patient outcomes and past failures. To address this limitation, we propose VIBEMed, a multi-agent framework with a built-in self-evolution mechanism and architecture-level safety sandbox for robust clinical decision support. The system integrates three specialized agents, including a Clinical Diagnostic Agent (CDA) for hypothesis generation, a Therapeutic Execution Agent (TEA) for treatment planning, and a Clinical Evolution Manager Agent (CEMA) that distills longitudinal clinical feedback into reusable knowledge, transforming multimodal patient information into personalized medical decisions. Through self-evolution mechanism, the framework enables iterative updates across memory, model behavior, and decision strategies, allowing the system to improve over time. Experimental results show that VIBEMed demonstrates superior performance through its evolving mechanism in complex clinical cases, particularly in tasks that require integrated decision-making and longitudinal planning. The framework also supports reliable end-to-end decisions in challenging scenarios such as oncology treatment planning, highlighting its feasibility in real-world clinical contexts. Overall, VIBEMed provides a practical path beyond static AI systems toward adaptive, experience-driven clinical decision support, demonstrating the value of combining multi-agent collaboration with continuous evolution for advancing precision medicine.
Figures & tables
| Experiments | Avg | SD | Min | Max |
| Pipeline A: Direct LLM | 35.13 | 3.92 | 24 | 40 |
| Pipeline B: CDA only | 36.97 | 1.61 | 32 | 40 |
| Pipeline C: TEA only | 31.53 | 4.75 | 24 | 39 |
| Pipeline D: CDA + TEA | 39.20 | 1.42 | 35 | 40 |
| Base Model | Evolved Model | |
| CMB-Clin-extended | 22.5 | 23.4 |
| MedTreat | 21.6 | 25.5 |
| MedOutcome | 18.0 | 18.7 |
| MedAnalysis | 38.8 | 35.8 |
| MedDiag | 26.7 | 24.7 |
| MedDiffer | 9.3 | 13.0 |