Agents Catching Agents: Shortcut Cascades and Benchmark Gaming in Clinical Multi-Agent Systems
Authors: Sebastián Andrés Cajas Ordóñez, Agastya Munnangi, Aldo Marzullo, Felipe Ocampo Osorio, Quang Bui, Mohammad Shahin, Armaan Grewal, Emmanuel Paul Kwesiga, +8 more
Organizations: MIT Critical Data, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States · Georgia State University, Atlanta, Georgia, United States · Politecnico di Milano, Milan, Italy · American International School Vienna, Vienna, Austria · School of Public Health, Boston University, Boston, Massachusetts, United States · Northwestern University, Evanston, Illinois, United States · Technische Hochschule Lübeck, Lübeck, Germany · Substrate Labs · School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada · Dartmouth College, Hanover, New Hampshire, United States · Department of Computer Science, University of Maryland, College Park, Maryland, United States · McGill University, Montreal, Quebec, Canada · Department of Molecular Biosciences, University of Texas at Austin, Austin, Texas, United States · King’s College London, London, United Kingdom · Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
Abstract
Clinical decision support is moving toward committees of language-model agents deliberating on a shared workspace. We ask whether such committees can be gamed by shortcuts, cues a benchmark rewards but a clinician would ignore. Across seven cohorts on six public datasets spanning text (MedQA-USMLE, MedMCQA, MIMIC-CXR reports), imaging (NIH ChestX-ray14, MIMIC-CXR-JPG, CheXpert) and tabular ICU records (SUPPORT2), Gemini committees resist these cues in isolation (flip 5-16%), yet a socially plausible shortcut spreads: when two peers assert the same wrong answer, the holdout under test adopts it in 38% of cases, as does a false "pre-screen" system flag, on both capability tiers. Of three oversight agents, a gate cannot separate adoption from honest agreement (false-positive rate 100%); a same-lineage judge reading only the transcript flags adoption on text (precision 100%, recall 93%) but collapses onto the gate in imaging; a referee that privately re-queries the holdout transfers to imaging (77-88% precision, 13-21% false-positive rate). Tripling a cue's visual salience does not move contagion, whereas a second peer voice raises it by half again. Gaming a hidden rubric is near-silent: only 1/10 text and 1/134 imaging drifters name the rubric they moved toward. What games a committee is social plausibility, and only a referee independent of self-report catches it. Code: https://github.com/criticaldata/benchmaxxing
Agent systems often decompose a task across multiple roles, but these roles are typically specified by prompts rather than enforced by access controls. Without enforcement, a team pass rate can mask whether agents actually coordinated or whether one role effectively did another role's work. We present TeamBench, a benchmark with 851 task templates and 931 seeded instances for evaluating agent coordination under operating system-enforced role separation. TeamBench separates specification access, workspace editing, and final certification across Planner, Executor, and Verifier roles, so that no role can read the full requirements, modify the workspace, and certify the final answer. Prompt-only and sandbox-enforced teams reach statistically indistinguishable pass rates, but prompt-only runs produce 3.6 times more cases where the verifier attempts to edit the executor's code. Verifiers approve 49% of submissions that fail the deterministic grader, and removing the verifier improves mean partial score in the ablation. Team value is also conditional. Teams benefit when single agents struggle, but hurt when single agents already perform well. A 40-session human study under the same role separation shows that our benchmark exposes interaction patterns that pass rate misses. Solo participants work through the task directly, human participants paired with agents often collapse into quick approval, and human teams spend more effort coordinating missing information across roles.
Multi-agent LLM systems improve reasoning by combining outputs from multiple agents, but interaction-heavy methods can introduce error propagation and high communication overhead. When agents exchange raw responses or reasoning traces, incorrect intermediate reasoning may be adopted and amplified, leading to confident but wrong consensus; multi-round communication also increases token consumption, latency, and inference cost. In this paper, we propose a controlled-communication coordination framework named DarkForest. DarkForest first keeps agents independent, so each agent produces an answer without seeing the others' outputs. It then parses the raw responses into structured candidate records, groups semantically equivalent candidates into clusters, and estimates a calibrated belief distribution over these clusters using agent reliability, confidence, parse quality, support-pattern reliability, and independence corrections. A coordinator receives only policy-permitted evidence from this belief state with controlled communication. Experiments on six reasoning benchmarks show that DarkForest achieves leading overall quality, improves the strongest baseline by up to 30.7% on benchmark metrics, and reduces token consumption by up to 6.5× compared with communication-heavy baselines.
Clinical protocol-execution tasks -- checking a lab value, applying a threshold, placing a correctly structured FHIR order -- are natural candidates for RL from world feedback: once clinical SMEs encode decision logic into a verifier, that verifier grades unlimited rollouts without per-episode annotation. But applying RL requires a sound feedback channel and sufficient base capability. We audit MedAgentBench v1/v2, find a 41.7% silent-finish ceiling that makes inaction the RL dominant strategy, and construct \textbf{MedAgentBench-v3 (MAB-v3)} (508 tasks, 8.9% ceiling). Training Qwen3-8B exposes two structural barriers: a \emph{capability ceiling} (10/20 task types have 0% base performance, zero gradient) and a \emph{format-knowledge barrier} (3/20 types require exact clinical codes undiscoverable by exploration). Pure RL reaches 18.2% pass@1 vs.\ 34.1% for rule-based SFT; the 15.9~pp gap is attributable entirely to these barriers. A decision/format-knowledge/lookup taxonomy predicts RL learnability and prescribes the fix: SFT to inject codes, RL to learn conditionals.