MARC v1: An Open-Source Multi-Agent Framework for Clinical AI Reasoning and Coordination

Care plan coordination demands synthesizing heterogeneous clinical, functional, and psychosocial information across multiple professional disciplines, where monolithic LLM pipelines cannot perform in a transparent or safe manner. We present CANOE (Contestable Argumentative Network-of-Experts), a multi-agent neuro-symbolic framework that addresses these limitations through five modules: complexity assessment, adaptive team recruitment, role-based argumentative computation via an Arena-based Quantitative Bipolar Argumentation Framework (A-QBAF), human-in-the-loop contestation, and care-plan synthesis. Role-specialized agents generate supporting and attacking arguments for candidate interventions; conflicts are resolved through arena-based clash resolution before acceptability scores propagate across the argumentation graph. Care planners may accept, reject, edit, or add arguments, and the framework will deterministically recompute the final plan. Evaluation on Discharge Me! and MedicalRAG using ROUGE-L, AlignScore, MEDCON F1, FKGL, and LLM-as-a-judge shows that medically fine-tuned models achieve the strongest clinical correctness and safety, while CANOE's argumentative structure provides faithful explanation and human contestability.

High-stakes reasoning tasks necessitate transparent and verifiable workflows, yet conventional single-model large language models (LLMs) often struggle with hallucination and low interpretability under zero-shot paradigms. To address this general AI challenge, we propose a Multi-Agent Audit Framework that simulates a collaborative, multi-step verification process. We empirically validate this architecture in the sensitive domain of clinical mental health screening using a modular LangChain workflow. Our framework decomposes the reasoning process into a Perception Agent, Knowledge Retrieval-Augmented Generation (RAG), Chain-of-Thought (CoT) clinical inference, and a critical Audit verification stage. We evaluated this framework on the DAIC-WOZ dataset using locally deployed open-source models. Experimental results demonstrate that our multi-agent pipeline significantly outperforms single-agent baselines, reducing the Mean Absolute Error (MAE) for PHQ-8 depression severity prediction from 5.35 to 5.02. By exposing cross-agent validation traces, the framework mitigates reasoning drift and provides highly interpretable diagnostic rationales, offering a generalizable paradigm for reliable AI-assisted decision support beyond isolated model scaling. We make data and code open access on GitHub for replicability.

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 $6.5\times$ compared with communication-heavy baselines.