Medical AI Agents

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39 papers7 papers in the last four weeks, against 2 the four weeks before. 0.0% of all new papers.

Oct 27, 2026

OpenGray: a benchmark for evaluating the decisions of radiotherapy planning agents

Background and purpose: Radiotherapy planning agents based on large language models (LLMs) decide when to submit a plan or request review but are evaluated mainly by dose. This study developed OpenGray, a benchmark of planning tasks with known correct decisions. Materials and methods: OpenGray adds tasks with known answers to the OpenKBP-Opt head-and-neck dataset, including two contradictions with dose goals proven incompatible and a feasible control with a stored plan meeting every hard goal. Four systems, from a rule-based planning script to a full LLM agent, were evaluated on 30 patients, the LLM-based ones with a commercial (Terra) and a local (Ministral 3 8B) LLM. Decisions, achieved dose, problem recognition, and technical failures were recorded and also read from logs of 39 stereotactic radiosurgery runs of SAGE, a clinical LLM agent. Results: With Terra, the script preceded by an LLM review and the full agent had decision accuracies of 95.4% and 92.1%, respectively, yet escalated only 50% (95% confidence interval, 25-75%) and 25% (10-40%) of overlap contradictions, which required arithmetic on the anatomy. All four systems submitted every feasible control, but 24% of these plans missed a hard goal that the stored plan had met. In four SAGE runs, one goal failed at every attempt; the agent identified it in every reply but had no action for stopping. Conclusions: Favorable aggregate scores concealed specific decision failures. Planning agents should be evaluated on their decisions as well as their dose and given an explicit action for stopping and requesting review.

Humza Nusrat, Kundan Thind

Department of Radiation Oncology, Henry Ford Health, Detroit, Michigan, USA · Department of Radiology, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA

Medical AI Agents LLM Agent Evaluation LLM Decision-Making AI Agent Benchmarks

Oct 26, 2026

ClinVerse: A Realistic Multi-Agent Diagnostic Environment for Training and Evaluating Medical Agents

Disease diagnosis is a key application of large language model (LLM) agents in healthcare. However, existing medical agents are primarily trained and evaluated with static question-answering data, providing limited opportunities to learn active information acquisition, examination decision-making, and dynamic clinical interaction. To address this limitation, we present ClinVerse, an interactive, real-data-grounded multi-agent environment designed for training and evaluating medical diagnostic agents. Built on ClinPatient, a scalable dataset comprising 150k diagnostic cases derived from real-world electronic health records, ClinVerse supports coordinated interactions among six specialized clinical roles. Specifically, a doctor agent starts from an initial patient complaint, progressively gathers clinical evidence through patient interviews and examination requests, and ultimately produces a diagnosis. For each interaction trajectory, a rule-based scoring framework quantifies information acquisition, examination ordering, and diagnostic accuracy. These trajectory-level scores serve as reward signals for agent training while also enabling scalable evaluation. In experiments, we evaluate various general-purpose and medical-domain models and show that nine self-evolution methods across three categories consistently improve agents' diagnostic capabilities within ClinVerse. We further analyze the interplay among model capability, environment feedback, and self-evolution methods.

Sirry Chen, Fangke Chen, Xuanwen Ding +2

Fudan University, Shanghai, China · Shanghai Innovation Institute, Shanghai, China · Zhejiang University, Hangzhou, China +2

Medical AI Agents LLM Agent Training Medical Diagnosis LLM Agent Evaluation Multi-Agent LLMs

Oct 22, 2026

nnInteractive Agent: General-Purpose AI Agents as 3D Image Annotators

Interactive 3D segmentation models such as nnInteractive turn a few spatial prompts (points, scribbles, boxes) into accurate volumetric masks, but a human still does the annotation work: finding each structure, placing prompts, checking the result and correcting it. General-purpose AI agents can now interpret images, call tools and write code. We show that such agents can take over this work without additional training: the user makes a request in plain language, and the agent works out what has to be segmented, locates the targets, prompts nnInteractive, inspects the 3D result, corrects it and responds to feedback. Asked for 'the muscles used for chewing', an agent identifies and segments the masseters and pterygoids; asked to count liver lesions, it writes its own code to find candidates and splits a merged lesion on request. Our open-source nninteractive-agent provides nnInteractive as tools over the Model Context Protocol (MCP), together with a skill that encodes how experienced users prompt it. On a benchmark spanning CT, MRI, PET and micro-CT of humans, a mouse and an ant (14 images; 51 targets from organs and tumours to muscles, foot bones, vessel trees and an insect brain), Claude Code and Codex reach a mean Dice of 0.81 and 0.84 from the request alone; when told where each target is, both reach 0.85 and prompt nearly as effectively as an oracle that places prompts using the reference segmentation. A text-prompted 3D model (VoxTell) is more accurate on most standard radiological targets but less robust: it returns an empty mask for one of them and fails on the leg muscles, the foot bones, the mouse and the ant, where the agents remain accurate. Code: https://github.com/MIC-DKFZ/nninteractive-agent

Fabian Isensee, Constantin Ulrich Harsy, Maximilian Rokuss +3

Division of Medical Image Computing (MIC), German Cancer Research Center (DKFZ), Heidelberg, Germany · National Center for Tumor Diseases (NCT) Heidelberg, a partnership between the German Cancer Research Center (DKFZ) and Heidelberg University Hospital (UKHD), Heidelberg, Germany · Helmholtz Imaging, German Cancer Research Center (DKFZ), Heidelberg, Germany +4

Medical AI Agents Tool-Using Agents Interactive Medical Image Segmentation 3D Medical Image Segmentation Human-in-the-Loop Annotation

Oct 19, 2026

MMedAgent-Plus: Scaling Multimodal Medical Agents across Modalities, Tasks and Workflows

Medical workflows often require multiple interdependent analyses, but existing specialist and generalist AI models are not designed to coordinate them. We introduce MMedAgent-Plus, a multimodal medical tool-use agent that combines a vision-language planner with 18 leading specialist models spanning 12 tasks and 8 modalities. Through a unified tool interface, the planner selects specialists, executes them in sequence, and synthesizes responses grounded in their outputs. The planner is instruction-tuned on 208,928 samples from 32 public medical benchmarks, covering single- and multi-tool interactions across single and multiple rounds. We separately evaluate tool orchestration, response synthesis, and end-to-end execution on held-out samples. MMedAgent-Plus achieves tool-call accuracies of 91.0%, 98.1%, and 80.7% in single-tool multi-round, multi-tool multi-round, and multi-tool single-round settings, respectively. Given correct tool outputs, MMedAgent-Plus achieves scores of 14.4-14.8 out of 15 for faithfulness, completeness, and conciseness across 600 evaluation samples. In end-to-end execution without pre-supplied tool outputs, MMedAgent-Plus correctly invokes the required specialist in 90.6% of 350 evaluation cases spanning seven tasks. Its final-answer accuracy reaches 0.98, matching the dedicated leading specialist and exceeding the strongest baseline (0.28).

Ruoxin Wang, Yuanting Pan, Binxu Li +13

Duke University · Stanford University · Yale University +7

Medical AI Agents Tool-Using Vision-Language Agents Agentic AI LLM Agent Orchestration Multimodal Tool Use Medical VLMs

Oct 18, 2026

Auto-MD-bench: Evaluating Autoresearch Agents for Real-World Medical Tasks

Autonomous agents are increasingly capable of developing machine learning (ML) models end to end. In medical practice, however, strong performance on the target metric does not fully characterize how good the models are in real-world use cases. For example, medical ML models should also provide well-calibrated risk estimates and remain robust across patient populations. Yet autonomous model development is typically guided by task objectives that emphasize simple predictive discrimination (e.g. AUROC). This raises a key question: are these objectives sufficient to guide agents toward models that meet the broader requirements of real-world medical use? In this study, we introduce Auto-MD-bench, a benchmark of 15 real-world medical tasks from 10 clinical datasets, spanning survival analysis, classification and sequential prediction, with external validation across cohorts, hospitals and time periods. We evaluate four agents: AIDE, AI Scientist v2, Codex, and Autoresearch. The strongest agents achieve competitive primary scores, yet their predicted risks are less calibrated than those of the simple baseline models, which could lead to severe medical accidents. Moreover, models with nearly identical primary scores can exhibit markedly different calibration, while performance varies substantially across population shifts. These findings show that primary task performance alone is insufficient to assess autonomous clinical modeling and multiple different metrics widely used in healthcare practice need to be taken into consideration.

Shenqi Zhou, Qiran Zou, Wenhao Zhao +2

National University of Singapore · Zhejiang University · Amazon

Medical AI Agents Autonomous Research Agents AI Agent Benchmarks Clinical Risk Prediction Distribution Shift

Oct 14, 2026

CausalEvo: Causal Skill Self-Evolution for Health LLM Agents

Large language model (LLM) agents for health can accumulate reusable textual skills from task feedback, such as calculation criteria, measurement time points, and formula units. Deciding which skills to retain is consequential: useful rules improve later answers, while faulty generalizations propagate errors. We propose CausalEvo, a method for causal skill self-evolution that estimates the relative effects of deliberately changed skill sets while holding the model weights, feedback cases, and rule count fixed. At each evolution step, a frozen LLM proposes candidate rules, which are pooled with the incumbent skills so that the current skill set remains a feasible choice. Paired skill replacements against shared background rules are scored on the same feedback cases; least squares converts the score differences into relative skill values, and the top-ranked rules are retained, favoring incumbents on ties. A decision-loss bound separates candidate support, approximation, and estimation errors. On six MedCalc-Bench-Verified tasks with 120 held-out cases, CausalEvo achieves 60.00% accuracy, compared with 55.83% for SkillOpt and 51.67% without skills. Across the recorded training configurations, which use different optimization budgets, it consumes 55.6% fewer training tokens than SkillOpt. Gains concentrate in particular calculations alongside regressions on others, and paired accuracy intervals include zero. CausalEvo turns task feedback into controlled decisions about skill retention and replacement. Project repository: https://github.com/txbrook/CausalEvo

Yuchen Zhang

The University of Texas Health Science Center at Houston

LLM Agent Self-Improvement LLM Agent Skill Learning LLM Agents Medical AI Agents Medical LLMs

Oct 3, 2026

MedImageOSWorld: Benchmarking GUI Agents for Medical Image Consoles

Graphical consoles offer a practical interface for medical acquisition assistance, allowing agents to work through the controls and visual feedback used by human operators. Reliable assistance requires linking on-screen anatomy to acquisition decisions that determine what image evidence becomes available next. We introduce MedImageOSWorld, a benchmark for evaluating this capability in simulated CT, MR, and ultrasound consoles. Using screenshots and mouse-and-keyboard actions, agents configure protocols, plan acquisitions, inspect the resulting images, and make corrective adjustments across seven capability levels, from console operation to feedback-driven control. Evaluation combines task-specific workflow checks with hidden anatomical ground truth to assess procedural completion and acquisition outcomes separately. A common evaluation protocol specifies episode conditions and interaction budgets, while recorded trajectories support analysis of how agents observe, act, and respond to acquisition feedback. Across eleven open-weight agents, success rates range from 3.0 to 25.0 on a 0-100 scale while workflow-progress rates reach 21.5-74.5: agents complete much of the console workflow but rarely acquire the intended anatomy. Success collapses between perception and planning, from 79-90% at the lowest three levels for the best agent to at most 12% for millimetre-level planning and 0% for closed-loop control among open-weight agents. Two proprietary agents reach success rates of about 34 and exceed the best open-weight agent mainly in acquisition quality (61 versus 42). MedImageOSWorld provides a controlled setting for studying whether general-purpose GUI agents can translate visual observations into effective medical acquisition decisions.

Ziyang Long, Xinqi Li, Lujing Xing +1

Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA · University of California, Los Angeles, Los Angeles, CA, USA · Technical University of Munich +1

Medical AI Agents GUI Agents Computer-Use Agent Benchmarks Medical Imaging

Oct 1, 2026

A Multi-Agent LLM Framework for Personalized Health Checkup Interpretation and Guidance

Personalized interpretation of health checkup results requires reasoning across longitudinal records, medical knowledge, lifestyle guidance, and healthcare navigation. We present a multi-agent large language model (LLM) system that identifies multiple intents, maps each to a task-specific agent, executes them in parallel, and synthesizes their outputs. We compared answers generated in Single Agent and Multi Agent settings on 120 Korean compound queries combining two to four requirements, using synthetic health checkup records. The Multi Agent improved the weighted LLM-judge score from 1.695 to 1.797 (p = 0.027), and three additional LLM judges showed consistent improvements (

Δ

= +0.111 to +0.186, all p < 0.05). The gains came from usefulness, consistency, and the handling of every requirement in compound queries, whereas numerical accuracy and grounding improved significantly under only one of the four judges and medical safety did not differ, and critical failures occurred at similar rates (Single Agent 15.0% vs. Multi Agent 13.3%). Two human evaluators preferred Multi Agent in 66.7% and 68.3% of pairwise comparisons. Multi Agent execution increased latency and cost by 1.31

\times

and 2.02

\times

, respectively. In exploratory subgroup analyses, the improvement was concentrated in queries involving personal-record lookup.

HyungJun Kim, Taehan Lee, Soojin Cheon

DaNaA Data Co., Ltd.

Multi-Agent LLM Systems Healthcare LLM Agent Orchestration LLM Agent Evaluation Medical LLMs Medical AI Agents

Sep 28, 2026

ARCagent: An Adaptive Retrieval Calibration Agent for Clinical Question Answering

In diseases where clinical guidelines are incomplete, contested, or mutually contradictory, knowledge completeness and dynamic conflict-aware synthesis are two safety-critical properties that standard Retrieval-Augmented Generation systems do not provide. Therefore, we present \sysname, an adaptive retrieval calibration clinical question-answering agent for ME/CFS, a disease where diagnostic frameworks coexist and major guidelines actively contradict each other on treatment. ARCagent contributes three components. First, a 1,706-chunk, 10-source knowledge base with a structured inter-guideline conflict registry spanning all active ME/CFS diagnostic frameworks. Second, a conflict-aware retrieval calibration pipeline that re-ranks retrieved evidence using query-specific focus and conflict signals. Third, a benchmark scored by LLM-as-Judge, avoiding systematic underestimation averaging 10.1 percentage points caused by keyword matching. ARCagent achieves 95.3%, outperforming all base LLMs. Code is available at https://github.com/Yukyin/ARCagent.

Yuyan Chen

Clinical QA Agentic RAG Information Retrieval RAG Evaluation Medical AI Agents

Sep 25, 2026

A Safety-Bounded SDC-to-MCP Gateway for Medical AI Agents

The Model Context Protocol (MCP) provides a common interface through which AI applications discover and use external resources and tools. It allows language-model agents to ground their reasoning in current system state and interact with heterogeneous services. In medical environments, however, exposing device state and action affordances requires deterministic constraints on possible effects. We present an IEEE 11073 Service-Oriented Device Connectivity (SDC)-to-MCP gateway that exposes metrics, alarms, context references, and semantic metadata as read-only resources, while representing selected action affordances as policy-validated dry-run tools. The term safety-bounded denotes a narrow no-execution property: agent-facing requests dispatch no SDC device operation. A Python prototype supports simulated fault and lifecycle experiments, a software-reference protocol path spanning independent Java and Python implementations, deterministic baselines, representation ablations, and multi-model agent evaluation. The results show semantically explicit resource exposure, visible rejection of invalid or outdated state, and preservation of the no-execution boundary across resource, proposal, and authorization paths. Explicit semantic metadata improved conformity to required metric identifiers in structured alarm outputs relative to a generic representation, while retained structured-output failures reveal a distinction between plausible narrative answers and task-compliant machine-readable results.

Bennet Gerlach, Stefan Fischer

University of Lübeck, Lübeck, Germany

Medical AI Agents Tool Access Control for LLM Agents Runtime Enforcement for AI Agents MCP Security Agentic AI

Sep 25, 2026

PIA: A Personal Intelligence Agent Turning Health Conversations into Records and Records into Understanding

General-purpose agent memory summarizes conversations: it extracts salient snippets, embeds them, and retrieves the top-k into the prompt. A health agent cannot run on summaries: a dose becomes a sentence, "since last week" is resolved at the model's discretion, and a three-month glucose trend cannot be answered by text similarity. We present PIA, a personal intelligence agent deployed alongside a consumer health agent. PIA receives the agent's natural-language requests, decides for itself whether and how to write or read, and turns conversations into typed clinical records and records into a synthesized understanding of the user. Its memory harness consists of four controls -- extraction, memory, retrieval, and understanding -- each a domain-agnostic mechanism with a pluggable health module: schema, medical alias dictionary, knowledge graph, and temporal rules. We show how the same query receives a different answer as the memory injected into the response context deepens from one-dimensional recall, to a two-dimensional health snapshot, to a three-dimensional trajectory with causality, and report lessons from operation: self-reported health data are missing not at random, question phrasing governs the quality of synthesized understanding, and nearly a third of candidate causal links are structural noise that rules alone remove.

Jeonghun Yoon, Dongchan Kim, Hongyeon Yu +2

KAIST, Republic of Korea · NAVER Corp., Seongnam, Republic of Korea · NAVER Corp., Bellevue, WA, USA

Personal AI Agents LLM Agent Memory Medical AI Agents Healthcare Clinical Information Extraction

Aug 30, 2026

Source-Dependent Deference in Medical Imaging Agents Under Falsified Findings: A Pilot Audit

Tool-using agents are being proposed for medical imaging, and their behaviour when a tool returns a false finding is largely unmeasured. We audit whether a ReAct-style tool-calling agent abandons an answer it has already given correctly once a falsified finding arrives, and whether that depends on how the finding is presented. On 20 VQA-RAD closed questions across four vendor-designated model tiers, the agent commits to an answer from the image alone; a negated finding is then delivered either as JSON from an analyze_image tool the agent invokes itself, or as quoted prose attributed to a radiologist. Our outcome is the commission-error rate over cases answered correctly without any tool. Deference is much higher under the prose-attributed claim: at the strongest tier the agent revised its correct answer in 10 of 13 cases against 1 of 13 under the tool (exact McNemar p=0.0039, Holm-adjusted 0.012). We do not claim this isolates the source label. Attribution travels with the delivery channel in our design, and exposure differs because the tool claim reaches the agent only when it calls the tool. The finding is a joint source-and-delivery asymmetry from a small-scale pilot whose pre-specified stopping rule was not met.

Ridam Roy, Md Shahriar Rashid, Md. Rajib Mia

Daffodil International University Savar, Dhaka, Bangladesh · Boise State University Boise, Idaho, USA

Tool-Use Evaluation Medical VQA Tool-Using Agents LLM Agent Reliability Medical AI Agents

Aug 22, 2026

MSM-Mem: A Universal Medical Structured Multimodal Memory Framework for Medical AI Agents

Clinical decision-making is inherently experience-driven: physicians progressively refine their reasoning by synthesizing patient history, multimodal observations, and prior diagnostic experiences across interactions. In contrast, current multimodal large language model (MLLM)-based medical AI agents largely operate as stateless inference systems, generating decisions independently for each interaction without retaining or internalizing experiential knowledge. This discrepancy limits their ability to progressively improve reasoning reliability through usage and adapt to longitudinal patient contexts in real-world clinical workflows. In this study, we propose Medical Structured Multimodal Memory (MSM-Mem), an agentic memory framework that enables medical AI agents to evolve through accumulated clinical experiences. MSM-Mem organizes heterogeneous clinical experiences into semantic, episodic, and visual memory and incrementally updates them during inference, allowing the agent to retrieve prior experiences to inform current reasoning and progressively refine decision-making over time. Evaluations on MoE-LLaVA backbones demonstrate consistent performance improve- ments with further gains observed through continued usage. In general, MSM-Mem offers a viable pathway toward medical AI agents capable of evolving their reasoning competence in a manner analogous to the way clinicians learn from practice over time.

Md Asaduzzaman Jabin, Khoa Le, Lin Zhao +1

University of Georgia, Athens, GA, USA · New Jersey Institute of Technology, Newark, NJ, USA

Medical AI Agents LLM Agent Memory Memory-Augmented Language Model Agents Multimodal Agents Agentic AI Continual Learning for LLM Agents

Aug 20, 2026

Volumetric Radiology AI in the Era of Multimodal Large Language Models

Advances in multimodal large language models (MLLMs) are extending radiological artificial intelligence (AI) beyond task-specific image analysis toward multimodal understanding and reasoning. Volumetric radiology, however, presents a fundamental representational mismatch: clinical interpretation often requires full-volume spatial context and acquisition-dependent quantitative information, whereas current MLLMs are commonly conditioned on selected two-dimensional (2D) images, compressed visual representations, or report-derived text. Reliable volumetric radiology AI therefore requires representations that preserve task-relevant three-dimensional (3D) information and systems that can access, verify, and integrate this information across clinical workflows. In this Review, we examine more than 200 publications through July 2026. We organize the literature around volumetric representation and multimodal understanding at the model level, agentic orchestration at the system level, and their links to clinical applications and evaluation. We review volumetric foundation models, language alignment and compression strategies, and agentic systems that extend MLLMs through planning, tools, memory, and workflow interaction. We distinguish settings in which selected 2D views or report-mediated reasoning may suffice from those that warrant native volumetric modeling. We also introduce a Claim-Design-Validation framework to assess whether technical, workflow, and clinical claims are matched by appropriate design and validation. Across the literature, native volumetric modeling and agentic capabilities depend on the spatial, quantitative, contextual, and workflow requirements of the intended task. Clinical credibility requires faithful volumetric representation, traceable system behavior, claim-aligned validation, and clearly defined human oversight in realistic workflows.

Zanting Ye, Shengyuan Liu, Xin Liu +16

Southern Medical University · The Chinese University of Hong Kong · Fudan University +6

Medical AI Agents Radiology VLMs 3D Medical Imaging Medical Imaging Foundation Models 3D VLMs Agentic AI+1

Aug 17, 2026

BaT: Towards Self-Evolving Medical Research Agent with Stage Rubrics

Long-horizon agents are beginning to automate complete workflows that produce code, reports, and research artifacts. Medical imaging workflows are multi-stage and data-sensitive, while expert trajectories remain scarce and difficult to share. Structured benchmarks can localize failures through stage-level rubrics, but standard post-training discards these diagnostics before the next training round. We present Benchmark-as-Teacher (BaT), a recursive self-improvement system for agent post-training. BaT contains two linked components: the asynchronous Stage Bank data pipeline and BiCuRL (Bilevel Curriculum Reinforcement Learning), its self-improving post-training method. Stage Bank synthesizes content-isolated training states outside the policy-update loop. BiCuRL uses a fixed held-out evaluation to select the next stage curriculum, verifies rollouts with task rubrics, updates the policy with GRPO, and returns the candidate checkpoint to evaluation. On AutoMedBench-Lite, BaT-4B and BaT-9B more than double the Overall scores of their Qwen Instruct baselines. BaT-9B Agent reaches 79.6 Overall, exceeding Claude Opus 4.6 with Claude Code at 77.5.

Junqi Liu, Yufan He, Yexiao He +9

University of California, Santa Cruz · NVIDIA

LLM Agent Self-Improvement LLM Agent Training Autonomous Research Agents RL for LLM Agents Medical AI Agents Curriculum Learning

Aug 13, 2026

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

We present Multi-Agent Reasoning and Coordination (MARC), an open-source framework that replaces monolithic LLM prompting with deterministic multi-agent orchestration for clinical reasoning. MARC coordinates role-specialized agents for extraction, reasoning, answer generation, and evaluation, with explicit context passing and traceable intermediate outputs, enabling stage-wise failure attribution. We additionally introduce a Decomposer module that generates task-specific agent prompts from a plain-language description, eliminating manual prompt engineering. The framework supports both API-based and local CPU-compatible deployments and is entirely configurable via YAML, without code modifications. MARC is designed to be model-agnostic, interpretable, and accessible to clinical domain experts without programming expertise. The full framework is available at https://github.com/Penn-RAIL/MARC-v1.

Saisha Shetty, Satvik Tripathi, Austin Lin +6

1. College of Engineering, University of California, Davis · 2. Perelman School of Medicine, University of Pennsylvania · 3. School of Engineering and Applied Science, University of Pennsylvania +2

Multi-Agent LLM Systems LLM Agent Orchestration Clinical Reasoning Multi-Agent Reasoning Medical AI Agents

Aug 4, 2026

Agents Catching Agents: Shortcut Cascades and Benchmark Gaming in Clinical Multi-Agent Systems

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

Sebastián Andrés Cajas Ordóñez, Agastya Munnangi, Aldo Marzullo +13

MIT Critical Data, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States · Georgia State University, Atlanta, Georgia, United States · Politecnico di Milano, Milan, Italy +12

Emergent Behavior in Multi-Agent Systems Multi-Agent LLM Systems AI Agent Safety Benchmarks AI Agent Reliability Clinical Decision Support LLM Agent Evaluation+3

Jul 28, 2026

Agentic AI in medicine: architectures, applications, evaluation, and challenges for clinical translation

Large language models and multimodal foundation models are enabling medical artificial intelligence (AI) systems to move beyond isolated prediction and undertake multistep clinical tasks that require planning, tool use, memory, iterative correction, and coordination among specialized agents. However, the scope of agentic AI in medicine remains unsettled, and current evaluation practices are not yet aligned with the requirements of clinical use. We conducted a scoping review with systematic evidence mapping across five electronic sources, screened 1,649 exportable records, and provisionally included 557 unique studies that met predefined criteria for goal-directed task execution, tool use, interaction with external resources, feedback-based refinement, or multi-agent collaboration. The included studies describe single agents that use external tools, workflows supported by retrieval and external knowledge, multimodal agents, and multi-agent systems applied to medical question answering, image interpretation, electronic health record analysis, drug safety, and clinical trial prediction. The evidence base remains dominated by public benchmarks, simulated settings, retrospective datasets, and small-scale expert evaluation. Process reliability, evidence traceability, uncertainty, safety, workflow impact, and external validity are evaluated less consistently. Clinical translation will depend on clearer definitions, reproducible evaluation, auditable oversight, interoperable system design, and prospective validation in real-world clinical workflows.

Zheng Tong, Yang Liu, Wanshu Fan +6

School of Software Engineering, Dalian University, Dalian, China · Department of Surgery, Affiliated Zhongshan Hospital of Dalian University, Dalian, China · The Chinese University of Hong Kong, Shenzhen, China +3

Medical AI Agents AI Agent Evaluation Agentic Workflows Multimodal Agents Multi-Agent LLMs Agentic AI

Jul 12, 2026

Policy-Driven CT-Agent: Modeling Phase-Aware Diagnostic Control for Clinically Consistent CT Reasoning

Computed Tomography (CT) diagnosis often relies on dynamic selection of imaging phases, such as non-contrast, arterial, or venous phases, based on preliminary findings, clinical suspicion, and diagnostic guidelines. This phase-wise decision process is critical for reducing unnecessary radiation exposure while supporting timely staging and treatment planning. However, phase-selection protocols can vary across hospitals, regions, and guidelines, while most existing CT-based AI methods assume that all phases are available and focus on static tasks under a fixed imaging phase, failing to model whether additional phases are required. This limitation stems from heterogeneous multi-phase representations, the need for knowledge-guided phase control beyond visual cues, and the lack of supervision for phase-sufficiency decisions in existing datasets. To address these challenges, we propose Policy-Driven CT-Agent (PD-CTAgent) for clinically consistent CT phase selection and diagnostic reasoning. PD-CTAgent introduces a Clinical Structure Abstraction Module (CSAM) to harmonize heterogeneous CT phases into a unified, phase-aware evidence representation. Based on this representation, a Knowledge-Guided Diagnostic Control Model (KDCM) evaluates phase sufficiency and iteratively requests additional phases when necessary. The policy-driven agent design further allows PD-CTAgent to flexibly follow different institutional, regional, or guideline-specific diagnostic protocols. Together, PD-CTAgent bridges static CT analysis and real-world clinical workflows. Experiments on two public datasets, LIDC and MCT-LTDiag, and one private dataset demonstrate its effectiveness and clinical consistency. Code will be made public upon acceptance.

Yanmeng Dong, Han Li, Yujia Li +7

University of Science and Technology of China · Technical University of Munich

Medical AI Agents Clinical Decision Support Clinical Decision-Making Computed Tomography Agentic AI

Jul 1, 2026

World Feedback for Clinical Agents: Diagnosing RL in FHIR Environments

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 MedAgentBench-v3 (MAB-v3) (508 tasks, 8.9% ceiling). Training Qwen3-8B exposes two structural barriers: a capability ceiling (10/20 task types have 0% base performance, zero gradient) and a 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.

Ananya Mantravadi, Harshit Rajgarhia, Prasanna Desikan +1

Centific Global Solutions, Inc.

LLM Agent Evaluation AI Agent Benchmarks Workflow Automation Reinforcement Learning with Verifiable Rewards RL for LLM Agents Medical AI Agents

Jun 30, 2026

HealthAgentBench: A Unified Benchmark Suite of Realistic Agentic Healthcare Environments for Challenging Frontier AI Agents

As AI agents become increasingly capable of complex, long-horizon reasoning, rigorous evaluation is essential for measuring progress toward real-world healthcare applications. However, existing healthcare benchmarks are often static or narrow in clinical scope, motivating broader evaluation of agents acting on raw patient data. We introduce HealthAgentBench, a suite of 75 agentic healthcare tasks across 9 categories each with its unique environment. The benchmark suite spans diagnosis, specimen assessment, research, and data management workflows and a broad range of modalities. Each task is designed to replicate an end-to-end clinical workflow: given task instructions and supporting resources, an agent must explore raw healthcare data, operate within a complex environment, and execute multi-step solutions that go beyond naive prompting, such as querying large clinical databases or interpreting gigapixel pathology images. All tasks are scored using binary success criteria derived from reference labels, executable rules, or computational baselines. We evaluate six agents (three GPT models through Codex and three Claude models through Claude Code) with one scored attempt per task (450 evaluations). Overall success ranges from 32.0% to 57.3%; Claude Code Opus-5.5 leads with a 57.3% success rate, followed by GPT-6-astra and Sonnet-5.5 at 50.7% each. Performance varies substantially by category with specialized imaging modalities such as CT and MRI being especially difficult. HealthAgentBench provides a challenging and realistic benchmark with substantial room for future progress. We release our benchmark athttps://github.com/microsoft/HealthAgentBench.

Qianchu Liu, Sheng Zhang, Guanghui Qin +18

Microsoft Research

Long-Horizon Agent Evaluation AI Agent Benchmarks Medical AI Agents

Jun 20, 2026

OpenBioRQ: Unsolved Biomedical Research Questions for Agents

A working citation looks like proof -- but the fact that a link resolves does not mean the cited paper supports the claim. I find that current agentic models rarely fabricate citations (over

99\%

resolve), yet roughly

15.9\%

link to the wrong paper. Existing benchmarks miss this failure mode: when a question has a fixed answer key, a model can reproduce the expected source from that key rather than independently verifying that the source supports the claim. I introduce \openbiorq{}, a retrieval-grounded agentic benchmark of

12{,}553

unsolved biomedical research questions across

12

domains that treats open questions as a faithfulness-and-abstention probe. To my knowledge, this is the first biomedical benchmark to combine an agentic setting -- where the model must issue multiple tool calls -- with unsolved questions that have no answer key. Openness is verified against real follow-up evidence rather than a model's parametric knowledge. Difficulty is empirical: I anchor it on questions that three open-weight reference models fail to answer, rather than on subjective hardness labels. On this hardest subset, held-out models from the same lineage as the difficulty anchors solve only ~17%, while three independent frontier agents (Gemini-3-Pro, Opus-4.7, GPT-5.5) span a wide 29-60% range. The benchmark is thus hard, non-saturating (the best agent still leaves ~33-40% unsolved), and discriminating across capability tiers. Beyond difficulty, I observe agentic collapse on the hardest questions, where agents stop using their tools. For the most collapse-prone model, blocking tool access entirely barely changes its score -- so tools stop paying off exactly where they are needed most. A frozen per-question checklist raises inter-judge agreement from Spearman 0.35 to 0.82.

Minbyul Jeong

Upstage AI

Agentic RAG AI Agent Benchmarks AI Agent Reliability Citation Verification LLM Agent Evaluation Biomedical QA+2

Jun 10, 2026

MedCTA: A Benchmark for Clinical Tool Agents

To make clinically grounded decisions, medical AI agents are expected to go beyond simple recognition and be capable of tool retrieval, evidence acquisition, and integration. Existing benchmarks largely evaluate isolated perception or single-turn question answering, and therefore provide limited visibility into failures of planning, tool recruitment, and rollout reliability. We introduce MedCTA, a benchmark for evaluating medical tool agents on clinician-validated, step-implicit tasks grounded in realistic multimodal clinical inputs, including radiology images, pathology slides, and reports. MedCTA comprises 107 real-world clinical tasks with clinician-verified executable trajectories over 5 deployed tools, and supports process-aware evaluation of tool selection, argument validity, execution stability, trajectory fidelity, and outcome quality. We benchmark 18 open- and closed-source multimodal models and find that even frontier systems remain brittle in multi-step clinical tool use: autonomous rollouts are dominated by protocol failures, premature stopping, and incorrect tool recruitment, while gold-standard tool routing yields large but still incomplete gains. These results show that strong backbone perception does not translate into reliable agentic behavior in clinical settings. MedCTA provides a rigorous testbed for auditing, diagnosing, and advancing trustworthy medical AI agents. The dataset and evaluation suite are available at https://ivul-kaust.github.io/MedCTA/

Tajamul Ashraf, Hyewon Jeong, Fida Mohammad Thoker +1

King Abdullah University of Science and Technology (KAUST), Saudi Arabia · Massachusetts Institute of Technology (MIT), USA

Agent Evaluation AI Agent Benchmarks Tool-Using Agents Multimodal Agents Medical AI Agents

Jun 8, 2026

Baichuan-M4: A Clinical-Grade Medical Agent System for Continuous Care

Baichuan-M4 is Baichuan Intelligence's clinical-grade medical large model, designed for continuous care rather than single-turn medical question answering. It is built as a coordinated medical agent system around three pillars: Baichuan-Harness, a unified runtime that keeps reinforcement-learning training and real-world deployment consistent while enforcing action constraints, tool use, long-term patient memory, and multi-agent coordination; a core reasoning model trained with a continuous-care reinforcement-learning framework that integrates span-level reward modeling (SPAR++), reasoning-path compression, curriculum learning, and stabilized policy optimization; and a clinical tool layer for patient-memory management, authoritative evidence-based retrieval, and multimodal medical perception across documents, X-rays, and dermatology. On a cross-dimensional medical evaluation suite, Baichuan-M4 attains leading results in static medical knowledge and safety, dynamic OSCE-style consultation, long-context clinical memory, evidence-based retrieval, medical document OCR, and multimodal image understanding, while lowering the hallucination rate to 3.3%.

Aiyuan Yang, Canbin Piao, Chengfeng Dou +25

Baichuan AI and THUBPM Group, Tsinghua University

Clinical Reasoning Healthcare Memory-Augmented Language Model Agents RL for Language Models LLM Agent Training Medical LLMs+1

Jun 2, 2026

MeDxAgent: Multi-Agent Consultation for Interactive Medical Diagnosis

Large language models (LLMs) are increasingly used for health-related decision support. Yet most evaluations treat diagnosis as a single-shot task with complete information provided upfront, often as a multiple-choice selection. This diverges from clinical practice, where diagnosis is interactive and open-ended, involving sequential hypothesis refinement through targeted questioning. We address this gap. We build MeDxBench, a large-scale benchmark of 4,421 clinical cases across 20 specialties. We further propose MeDxAgent, a multi-agent consultation system for interactive diagnosis, and systematically study its prompt-, flow- and agent-level design choices. MeDxAgent achieves a 10.3% accuracy gain over the baseline on MeDxBench, closing 52.3% of the gap to a full-information oracle. We find that specific design choices: collecting demographics first, passing summarized dialogue for diagnosis, and feeding candidate diagnoses for targeted questioning, improve accuracy, mirroring how physicians reason, though their effect emerges fully only in combination. Code and dataset will be released upon publication.

Akshat Sanghvi, Naren Akash, Raza Imam +2

Microsoft Research India · Institute of AI and Innovation, AIG Hospitals · Mohamed bin Zayed University of Artificial Intelligence

Multi-Agent LLM Systems Medical Diagnosis AI Agent Benchmarks Clinical Reasoning Medical AI Agents

Jun 2, 2026

MedCUA-Bench: A Screenshot-Only Benchmark for Clinical Computer-Use Agents

Computer-use agents could automate repetitive screen-based clinical work, but their reliability in medical graphical user interfaces remains largely unvalidated. Existing benchmarks focus on general web or desktop tasks and underrepresent medical software, which requires domain knowledge, exhibits markedly different UI design from mainstream applications, lacks public testing environments, and demands safety validation beyond task completion. We introduce MedCUA-Bench, an interactive benchmark for clinical computer-use agents. It covers 18 clinical scenarios across 10 medical domains, reconstructed from real product manuals and open-source medical systems to capture authentic clinical interfaces while avoiding licensing and privacy constraints. Each task ships with paired intent- and step-level goals to disentangle clinical reasoning from UI execution, and is evaluated by a deterministic checker over task completion and five clinical safety dimensions. Across 23 agents, the best closed-source model reaches 54.2% strict success, while all models remain below 9% on the real OpenEMR. Open-source agents average only 2.5%, with the best reaching 16.2%. MedCUA-Bench exposes the gap between current agents and reliable clinical software use, providing a reproducible testbed for future research.

Jia Yu, Zilong Wang, Xinyang Jiang +2

Microsoft Research Asia, Shanghai, China · Digital Medical Research Center, School of Basic Medical Sciences, Fudan University, Shanghai, China · Shanghai Key Laboratory of MICCAI, Shanghai, China

Computer-Use Agent Benchmarks LLM Agent Evaluation AI Agent Benchmarks Workflow Automation Computer-Use Agents GUI Agent Benchmarks+2

Jun 1, 2026

AutoMedBench: Towards Medical AutoResearch with Agentic AI Models

Autonomous agents are increasingly expected to support end-to-end medical-AI research workflows, moving beyond isolated prediction tasks or short-form clinical question answering. However, existing medical agent benchmarks primarily evaluate final outputs, providing limited visibility into agent behavior within the research process. To address this gap, we present AutoMedBench, a workflow-aware benchmark for autonomous medical-AI research across diverse medical imaging and multimodal inference tasks, organizing agent execution into a unified five-stage workflow (S1-S5): Plan, Setup, Validate, Inference, and Submit. It comprises long-horizon tasks with each run averaging 33 agent turns, spanning five research tracks: segmentation, image enhancement, visual question answering (VQA), report generation, and lesion detection. Each task is evaluated under two difficulty tiers, Lite and Standard, which use the same data and metrics but differ in the amount of task-brief scaffolding, and each run is scored using both final task performance and S1-S5 stage scores, enabling stage-level analysis from the initial task brief to the final submitted artifact. Across thousands of recorded runs, stage-level scoring reveals that Validate is the weakest workflow stage on average, whereas Setup is the strongest, suggesting that current agents are better at making pipelines executable than at verifying their reliability. Post-run error analysis further shows that verification and submission failures dominate tagged errors, accounting for 37.7% and 38.1% of fired codes respectively, whereas task-understanding errors are rare at 0.9%, and runs with one fired error code have a 48% lower overall score than runs with no error code on average.

Junqi Liu, Selena Song, Yuhan Wang +12

University of California, Santa Cruz · 2NVIDIA

AI Agent Evaluation AI Agent Benchmarks Scientific Workflow Automation Autonomous Research Agents Medical AI Agents

May 23, 2026

MDIA: A Multi-Agent Diagnostic Intelligence Pipeline on HealthBench Professional

Most reported gains on agentic-LLM clinical benchmarks are often attributed to prompt engineering, yet our results suggest that larger improvements can come from architectural and engine-level design. We present MDIA, a Multi-agent Diagnostic Intelligence Agent implemented as a 7-node specialty-routed clinical reasoning graph, on the full HealthBench Professional benchmark (n = 525), on a non-fine-tuned LLM. MDIA achieves 0.6272 under OpenAI's GPT-5.4-2026-03-05, which is +3.72 pp above the performance of OpenAI's ChatGPT for Clinicians. The experimental work shows that performance lift is attributable to system architecture: specialty routing, multi-turn context preservation, drug-state safety gating, site-filtered search, length-aware synthesis, and engine-level reliability. These findings support the view that agentic clinical benchmark performance is shaped both by the underlying foundation model and the orchestration architecture. Nevertheless, we also noticed notable differences when using other models as a grader; in particular, when using Gemini 2.5 Pro, MDIA scored 0.6585, which suggests that the choice of grader is a source of variability. Robust evaluation of LLMs would therefore require assessment across several independent grader models.

Roberto Cruz, David Rey-Blanco

TietAI

Multi-Agent LLM Systems Healthcare LLM Agent Orchestration Clinical Reasoning Clinical Language Model Evaluation Medical AI Agents

May 11, 2026

ABRA: Agent Benchmark for Radiology Applications

Existing medical-agent benchmarks deliver imaging as pre-selected samples, never as an environment the agent must navigate. We introduce ABRA, a radiology-agent benchmark in which the agent operates an OHIF viewer and an Orthanc DICOM server through twenty-one function-calling tools that span slice navigation, windowing, series selection, pixel-coordinate annotation, and structured reporting. ABRA contains 655 programmatically generated tasks across three difficulty tiers and eight types (viewer control, metadata QA, vision probe, annotation, longitudinal comparison, BI-RADS reporting, and oracle variants of annotation and BI-RADS reporting), drawn from LIDC-IDRI, Duke Breast Cancer MRI, and NLST New-Lesion LongCT. Each episode is scored along Planning, Execution, and Outcome (Bluethgen et al., 2025) by task-type-specific automatic scorers. Ten current models, five closed-weight and five open-weight, reach at least 89% Execution on real annotation but only 0-25% Outcome; on the paired oracle variant where a simulated detector supplies the finding, Outcome on the same task reaches 69-100% across the models evaluated, localising the bottleneck to perception rather than tool orchestration. Code, task generators, and scorers are released at https://github.com/Luab/ABRA

Bulat Maksudov, Vladislav Kurenkov, Kathleen M. Curran +1

School of Computing Dublin City University Dublin, Ireland · AXXX · School of Medicine University College Dublin Dublin, Ireland

Radiology Report Generation Healthcare Medical Image Analysis AI Agent Evaluation AI Agent Benchmarks Medical AI Agents

May 8, 2026

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.

Yicheng Gao, Xiaolin Zhou, Yahan Li +2

University of Southern California · Arizona State University

Healthcare Medical Diagnosis LLM Agent Training RL for LLM Agents LLM Agent Reliability Medical AI Agents