Daily Papers

We introduce ClarQ-LLM, an evaluation framework consisting of bilingual English-Chinese conversation tasks, conversational agents and evaluation metrics, designed to serve as a strong benchmark for assessing agents' ability to ask clarification questions in task-oriented dialogues. The benchmark includes 31 different task types, each with 10 unique dialogue scenarios between information seeker and provider agents. The scenarios require the seeker to ask questions to resolve uncertainty and gather necessary information to complete tasks. Unlike traditional benchmarks that evaluate agents based on fixed dialogue content, ClarQ-LLM includes a provider conversational agent to replicate the original human provider in the benchmark. This allows both current and future seeker agents to test their ability to complete information gathering tasks through dialogue by directly interacting with our provider agent. In tests, LLAMA3.1 405B seeker agent managed a maximum success rate of only 60.05\%, showing that ClarQ-LLM presents a strong challenge for future research.

With the deep integration of artificial intelligence and interactive technology, Graphical User Interface (GUI) Agent, as the carrier connecting goal-oriented natural language and real-world devices, has received widespread attention from the community. Contemporary benchmarks aim to evaluate the comprehensive capabilities of GUI agents in GUI operation tasks, generally determining task completion solely by inspecting the final screen state. However, GUI operation tasks consist of multiple chained steps while not all critical information is presented in the final few pages. Although a few research has begun to incorporate intermediate steps into evaluation, accurately and automatically capturing this process information still remains an open challenge. To address this weakness, we introduce ProBench, a comprehensive mobile benchmark with over 200 challenging GUI tasks covering widely-used scenarios. Remaining the traditional State-related Task evaluation, we extend our dataset to include Process-related Task and design a specialized evaluation method. A newly introduced Process Provider automatically supplies accurate process information, enabling presice assessment of agent's performance. Our evaluation of advanced GUI agents reveals significant limitations for real-world GUI scenarios. These shortcomings are prevalent across diverse models, including both large-scale generalist models and smaller, GUI-specific models. A detailed error analysis further exposes several universal problems, outlining concrete directions for future improvements.

We study a game between liquidity provider and liquidity taker agents interacting in an over-the-counter market, for which the typical example is foreign exchange. We show how a suitable design of parameterized families of reward functions coupled with shared policy learning constitutes an efficient solution to this problem. By playing against each other, our deep-reinforcement-learning-driven agents learn emergent behaviors relative to a wide spectrum of objectives encompassing profit-and-loss, optimal execution and market share. In particular, we find that liquidity providers naturally learn to balance hedging and skewing, where skewing refers to setting their buy and sell prices asymmetrically as a function of their inventory. We further introduce a novel RL-based calibration algorithm which we found performed well at imposing constraints on the game equilibrium. On the theoretical side, we are able to show convergence rates for our multi-agent policy gradient algorithm under a transitivity assumption, closely related to generalized ordinal potential games.

Follow-up question generation is an essential feature of dialogue systems as it can reduce conversational ambiguity and enhance modeling complex interactions. Conversational contexts often pose core NLP challenges such as (i) extracting relevant information buried in fragmented data sources, and (ii) modeling parallel thought processes. These two challenges occur frequently in medical dialogue as a doctor asks questions based not only on patient utterances but also their prior EHR data and current diagnostic hypotheses. Asking medical questions in asynchronous conversations compounds these issues as doctors can only rely on static EHR information to motivate follow-up questions. To address these challenges, we introduce FollowupQ, a novel framework for enhancing asynchronous medical conversation. FollowupQ is a multi-agent framework that processes patient messages and EHR data to generate personalized follow-up questions, clarifying patient-reported medical conditions. FollowupQ reduces requisite provider follow-up communications by 34%. It also improves performance by 17% and 5% on real and synthetic data, respectively. We also release the first public dataset of asynchronous medical messages with linked EHR data alongside 2,300 follow-up questions written by clinical experts for the wider NLP research community.

The rapid proliferation of LLM agent frameworks has forced developers to choose between vendor lock-in through provider-specific SDKs and complex multi-package ecosystems that obscure control flow and hinder reproducibility. Integrating tool calling across multiple LLM providers remains a core engineering challenge due to fragmented APIs, incompatible message formats, and inconsistent streaming and tool-calling behavior, making it difficult to build portable, reliable agent systems. We introduce Orchestral, a lightweight Python framework that provides a unified, type-safe interface for building LLM agents across major providers while preserving the simplicity required for scientific computing and production deployment. Orchestral defines a single universal representation for messages, tools, and LLM usage that operates seamlessly across providers, eliminating manual format translation and reducing framework-induced complexity. Automatic tool schema generation from Python type hints removes the need for handwritten descriptors while maintaining type safety across provider boundaries. A synchronous execution model with streaming support enables deterministic behavior, straightforward debugging, and real-time interaction without introducing server dependencies. The framework's modular architecture cleanly separates provider integration, tool execution, conversation orchestration, and user-facing interfaces, enabling extensibility without architectural entanglement. Orchestral supports advanced agent capabilities found in larger frameworks, including rich tool calling, context compaction, workspace sandboxing, user approval workflows, sub-agents, memory management, and MCP integration.

Multi-agent LLM ensembles can converge on coordinated, socially harmful equilibria. This paper advances an experimental framework for evaluating Institutional AI, our system-level approach to AI alignment that reframes alignment from preference engineering in agent-space to mechanism design in institution-space. Central to this approach is the governance graph, a public, immutable manifest that declares legal states, transitions, sanctions, and restorative paths; an Oracle/Controller runtime interprets this manifest, attaching enforceable consequences to evidence of coordination while recording a cryptographically keyed, append-only governance log for audit and provenance. We apply the Institutional AI framework to govern the Cournot collusion case documented by prior work and compare three regimes: Ungoverned (baseline incentives from the structure of the Cournot market), Constitutional (a prompt-only policy-as-prompt prohibition implemented as a fixed written anti-collusion constitution, and Institutional (governance-graph-based). Across six model configurations including cross-provider pairs (N=90 runs/condition), the Institutional regime produces large reductions in collusion: mean tier falls from 3.1 to 1.8 (Cohen's d=1.28), and severe-collusion incidence drops from 50% to 5.6%. The prompt-only Constitutional baseline yields no reliable improvement, illustrating that declarative prohibitions do not bind under optimisation pressure. These results suggest that multi-agent alignment may benefit from being framed as an institutional design problem, where governance graphs can provide a tractable abstraction for alignment-relevant collective behavior.

Legal contracts in the custody and fund services domain govern critical aspects such as key provider responsibilities, fee schedules, and indemnification rights. However, it is challenging for an off-the-shelf Large Language Model (LLM) to ingest these contracts due to the lengthy unstructured streams of text, limited LLM context windows, and complex legal jargon. To address these challenges, we introduce LAW (Legal Agentic Workflows for Custody and Fund Services Contracts). LAW features a modular design that responds to user queries by orchestrating a suite of domain-specific tools and text agents. Our experiments demonstrate that LAW, by integrating multiple specialized agents and tools, significantly outperforms the baseline. LAW excels particularly in complex tasks such as calculating a contract's termination date, surpassing the baseline by 92.9% points. Furthermore, LAW offers a cost-effective alternative to traditional fine-tuned legal LLMs by leveraging reusable, domain-specific tools.

In classical Reinforcement Learning from Human Feedback (RLHF), Reward Models (RMs) serve as the fundamental signal provider for model alignment. As Large Language Models evolve into agentic systems capable of autonomous tool invocation and complex reasoning, the paradigm of reward modeling faces unprecedented challenges--most notably, the lack of benchmarks specifically designed to assess RM capabilities within tool-integrated environments. To address this gap, we present Plan-RewardBench, a trajectory-level preference benchmark designed to evaluate how well judges distinguish preferred versus distractor agent trajectories in complex tool-using scenarios. Plan-RewardBench covers four representative task families -- (i) Safety Refusal, (ii) Tool-Irrelevance / Unavailability, (iii) Complex Planning, and (iv) Robust Error Recovery -- comprising validated positive trajectories and confusable hard negatives constructed via multi-model natural rollouts, rule-based perturbations, and minimal-edit LLM perturbations. We benchmark representative RMs (generative, discriminative, and LLM-as-Judge) under a unified pairwise protocol, reporting accuracy trends across varying trajectory lengths and task categories. Furthermore, we provide diagnostic analyses of prevalent failure modes. Our results reveal that all three evaluator families face substantial challenges, with performance degrading sharply on long-horizon trajectories, underscoring the necessity for specialized training in agentic, trajectory-level reward modeling. Ultimately, Plan-RewardBench aims to serve as both a practical evaluation suite and a reusable blueprint for constructing agentic planning preference data.

Ad hoc dataset search requires matching underspecified natural-language queries against sparse, heterogeneous metadata records, a task where typical lexical or dense retrieval alone falls short. We reposition dataset search as a software-architecture problem and propose a bounded, auditable reference architecture for agentic hybrid retrieval that combines BM25 lexical search with dense-embedding retrieval via reciprocal rank fusion (RRF), orchestrated by a large language model (LLM) agent that repeatedly plans queries, evaluates the sufficiency of results, and reranks candidates. To reduce the vocabulary mismatch between user intent and provider-authored metadata, we introduce an offline metadata augmentation step in which an LLM generates pseudo-queries for each dataset record, augmenting both retrieval indexes before query time. Two architectural styles are examined: a single ReAct agent and a multi-agent horizontal architecture with Feedback Control. Their quality-attribute tradeoffs are analyzed with respect to modifiability, observability, performance, and governance. An evaluation framework comprising seven system variants is defined to isolate the contribution of each architectural decision. The architecture is presented as an extensible reference design for the software architecture community, incorporating explicit governance tactics to bound and audit nondeterministic LLM components.

Clinical communication is central to patient outcomes, yet large-scale human annotation of patient-provider conversation remains labor-intensive, inconsistent, and difficult to scale. Existing approaches based on large language models typically rely on single-task models that lack adaptability, interpretability, and reliability, especially when applied across various communication frameworks and clinical domains. In this study, we developed a Multi-framework Structured Agentic AI system for Clinical Communication (MOSAIC), built on a LangGraph-based architecture that orchestrates four core agents, including a Plan Agent for codebook selection and workflow planning, an Update Agent for maintaining up-to-date retrieval databases, a set of Annotation Agents that applies codebook-guided retrieval-augmented generation (RAG) with dynamic few-shot prompting, and a Verification Agent that provides consistency checks and feedback. To evaluate performance, we compared MOSAIC outputs against gold-standard annotations created by trained human coders. We developed and evaluated MOSAIC using 26 gold standard annotated transcripts for training and 50 transcripts for testing, spanning rheumatology and OB/GYN domains. On the test set, MOSAIC achieved an overall F1 score of 0.928. Performance was highest in the Rheumatology subset (F1 = 0.962) and strongest for Patient Behavior (e.g., patients asking questions, expressing preferences, or showing assertiveness). Ablations revealed that MOSAIC outperforms baseline benchmarking.

The development of large language models (LLMs) has entered in a experience-driven era, flagged by the emergence of environment feedback-driven learning via reinforcement learning and tool-using agents. This encourages the emergenece of model context protocol (MCP), which defines the standard on how should a LLM interact with external services, such as \api and data. However, as MCP becomes the de facto standard for LLM agent systems, it also introduces new safety risks. In particular, MCP introduces third-party services, which are not controlled by the LLM developers, into the agent systems. These third-party MCP services provider are potentially malicious and have the economic incentives to exploit vulnerabilities and sabotage user-agent interactions. In this position paper, we advocate the research community in LLM safety to pay close attention to the new safety risks issues introduced by MCP, and develop new techniques to build safe MCP-powered agent systems. To establish our position, we argue with three key parts. (1) We first construct \framework, a controlled framework to examine safety issues in MCP-powered agent systems. (2) We then conduct a series of pilot experiments to demonstrate the safety risks in MCP-powered agent systems is a real threat and its defense is not trivial. (3) Finally, we give our outlook by showing a roadmap to build safe MCP-powered agent systems. In particular, we would call for researchers to persue the following research directions: red teaming, MCP safe LLM development, MCP safety evaluation, MCP safety data accumulation, MCP service safeguard, and MCP safe ecosystem construction. We hope this position paper can raise the awareness of the research community in MCP safety and encourage more researchers to join this important research direction. Our code is available at https://github.com/littlelittlenine/SafeMCP.git.

End-to-end automation of realistic healthcare operations stresses three capabilities underrepresented in current benchmarks: policy density, decisions must be grounded in a large library of medical, insurance, and operational rules; Multi-role composition: a single task requires the agent to play multiple roles with handoffs; and multilateral interaction: intermediate workflow steps are multi-turn dialogs, such as peer-to-peer review and patient outreach. We introduce χ-Bench, a benchmark of long-horizon healthcare workflows across three domains: provider prior authorization, payer utilization management, and care management. Each task hands the agent a clinical case in a high-fidelity simulator of 20 healthcare apps exposed via 87 MCP tools, which it must drive to a terminal status through tool calls and writing the role's artifacts, guided by a 1,290+ document managed-care operations handbook skill. Across 30 agent harness/models configurations, the best agent resolves only 28.0% of tasks, no agent clears 20% on strict pass^3, and executing all tasks in a single session slumps the performance to 3.8%. These results raise the hypothesis that similar gaps are likely to surface in other policy-dense, role-composed, irreversible enterprise domains.

Large language model (LLM) agents are evolving from request-response assistants into long-running software actors: they maintain state across model calls, fork subtasks, wait for external events, request human authority, generate tools, and perform side effects that must be resumed and audited. This paper presents Agent libOS, a library-OS-inspired runtime substrate for LLM agents. Agent libOS runs above a conventional host operating system; it does not implement hardware drivers, kernel-mode isolation, or a POSIX-compatible operating system. Instead, it treats an agent as an AgentProcess: a schedulable execution subject with process identity, parent-child lineage, lifecycle state, a tool table derived from an AgentImage, typed Object Memory, explicit capabilities, human queues, checkpoints, events, and audit records. Its central design rule is tools are libc-like wrappers; runtime primitives are the authority boundary. Filesystem access, object access, sleeps, human approval, JIT tool registration, and external side effects are checked at primitive boundaries under explicit capabilities and policy. We describe the design, threat model, Python prototype, and safety-oriented evaluation. The current prototype implements async scheduling, namespace-local Object Memory, runtime-integrated human approval, one-shot permission grants, per-process working directories, shell and image-registration primitives, Deno/TypeScript JIT tools over a libOS syscall broker, filesystem/object bridge tools, an injectable Resource Provider Substrate, deterministic demos, real-model smoke scripts, and 123 regression tests at the time of writing. Rather than improving planner accuracy, Agent libOS demonstrates a runtime substrate in which long-running LLM agents can be scheduled, authorized, resumed, and audited without treating tool dispatch as the trust boundary.

The rise of Software Engineering (SE) agents, i.e., LLM-based agents that can understand large codebases and carry out engineering tasks with limited human intervention, has been marked by rapid advances and adoption, but little is known about how developers build these systems in practice: existing studies mine repositories or examine deployment, but few investigate how SE agents are constructed. Through semi-structured interviews with 20 practitioners from 12 organizations and an online survey of 80 practitioners, this paper is the first to study how SE processes are changing in the development of SE agents and what challenges developers face. We find that as implementation becomes cheaper, bottlenecks shift rather than disappear: long-standing non-coding work such as requirements, coordination, review, and deployment becomes more visible, while reviewing and evaluating agent output becomes new and central. We characterize a seven-stage workflow and a shift toward evaluation-driven development, in which evaluation steers iteration and specifications become versioned artifacts read by both humans and agents. We further identify six challenges that teams face, together with the practices they adopt to address them, including unreliable evaluation signals, comprehension debt as code outpaces understanding, and behavioral changes introduced by provider-side model updates.

AI-agent guardrails are memoryless: each message is judged in isolation, so an adversary who spreads a single attack across dozens of sessions slips past every session-bound detector because only the aggregate carries the payload. We make three contributions to cross-session threat detection. (1) Dataset. CSTM-Bench is 26 executable attack taxonomies classified by kill-chain stage and cross-session operation (accumulate, compose, launder, inject_on_reader), each bound to one of seven identity anchors that ground-truth "violation" as a policy predicate, plus matched Benign-pristine and Benign-hard confounders. Released on Hugging Face as intrinsec-ai/cstm-bench with two 54-scenario splits: dilution (compositional) and cross_session (12 isolation-invisible scenarios produced by a closed-loop rewriter that softens surface phrasing while preserving cross-session artefacts). (2) Measurement. Framing cross-session detection as an information bottleneck to a downstream correlator LLM, we find that a session-bound judge and a Full-Log Correlator concatenating every prompt into one long-context call both lose roughly half their attack recall moving from dilution to cross_session, well inside any frontier context window. Scope: 54 scenarios per shard, one correlator family (Anthropic Claude), no prompt optimisation; we release it to motivate larger, multi-provider datasets. (3) Algorithm and metric. A bounded-memory Coreset Memory Reader retaining highest-signal fragments at K=50 is the only reader whose recall survives both shards. Because ranker reshuffles break KV-cache prefix reuse, we promote CSR_prefix (ordered prefix stability, LLM-free) to a first-class metric and fuse it with detection into CSTM = 0.7 F_1(CSDA@action, precision) + 0.3 CSR_prefix, benchmarking rankers on a single Pareto of recall versus serving stability.

Modern agent systems often suffer from fragmented runtime state: transcripts, tool effects, memory events, workspace placement, branch provenance, and replay evidence are recorded separately and become difficult to inspect or reproduce. OpenRath addresses this issue with a PyTorch-like programming model for multi-agent, multi-session systems. The analogy concerns the role of a central first-class runtime abstraction, not tensor computation. Its core abstraction is Session, the runtime value passed between agents and workflows. A Session is branchable, inspectable, replayable, backend-aware, and composable. It records conversation chunks, sandbox placement, lineage metadata, token usage, pending work, and tool evidence, while defining where memory interactions enter the runtime record. Since this state is carried by the same value used in program execution, fork, merge, and replay become explicit runtime operations rather than states reconstructed from external traces. OpenRath further defines Sandbox, Tool, Agent, Memory, Workflow, and Selector, with Selector turning control flow into runtime-routed decisions. This report presents the programming model, architecture, audited milestones, and evidence protocol. Its claims are limited to controlled runtime properties, while broad quantitative comparisons, live-provider quality, optional-backend availability, and memory quality are left for follow-on evaluation. The central thesis is that Session provides agent systems with a first-class runtime value for auditable composition.

The Model Context Protocol (MCP) standardizes how AI agents discover and invoke external tools, with over 10,000 active servers and 97 million monthly SDK downloads as of early 2026. Yet MCP does not yet standardize how agents safely operate those tools at production scale. Three protocol-level primitives remain missing: identity propagation, adaptive tool budgeting, and structured error semantics. This paper identifies these gaps through field lessons from an enterprise deployment of an AI agent platform integrated with a major cloud provider's MCP servers (client name redacted). We propose three mechanisms to fill them: (1) the Context-Aware Broker Protocol (CABP), which extends JSON-RPC with identity-scoped request routing via a six-stage broker pipeline; (2) Adaptive Timeout Budget Allocation (ATBA), which frames sequential tool invocation as a budget allocation problem over heterogeneous latency distributions; and (3) the Structured Error Recovery Framework (SERF), which provides machine-readable failure semantics that enable deterministic agent self-correction. We organize production failure modes into five design dimensions (server contracts, user context, timeouts, errors, and observability), document concrete failure vignettes, and present a production readiness checklist. All three algorithms are formalized as testable hypotheses with reproducible experimental methodology. Field observations demonstrate that while MCP provides a solid protocol foundation, reliable agent tool integration requires infrastructure-level mechanisms that the specification does not yet address.

The rapid development of the AI agent communication protocols, including the Model Context Protocol (MCP), Agent2Agent (A2A), Agora, and Agent Network Protocol (ANP), is reshaping how AI agents communicate with tools, services, and each other. While these protocols support scalable multi-agent interaction and cross-organizational interoperability, their security principles remain understudied, and standardized threat modeling is limited; no protocol-centric risk assessment framework has been established yet. This paper presents a systematic security analysis of four emerging AI agent communication protocols. First, we develop a structured threat modeling analysis that examines protocol architectures, trust assumptions, interaction patterns, and lifecycle behaviors to identify protocol-specific and cross-protocol risk surfaces. Second, we introduce a qualitative risk assessment framework that identifies twelve protocol-level risks and evaluates security posture across the creation, operation, and update phases through systematic assessment of likelihood, impact, and overall protocol risk, with implications for secure deployment and future standardization. Third, we provide a measurement-driven case study on MCP that formalizes the risk of missing mandatory validation/attestation for executable components as a falsifiable security claim by quantifying wrong-provider tool execution under multi-server composition across representative resolver policies. Collectively, our results highlight key design-induced risk surfaces and provide actionable guidance for secure deployment and future standardization of agent communication ecosystems.

Large Language Model (LLM)-based agents increasingly interact, collaborate, and delegate tasks to one another autonomously with minimal human interaction. Industry guidelines for agentic system governance emphasize the need for users to maintain comprehensive control over their agents, mitigating potential damage from malicious agents. Several proposed agentic system designs address agent identity, authorization, and delegation, but remain purely theoretical, without concrete implementation and evaluation. Most importantly, they do not provide user-controlled agent management. To address this gap, we propose SAGA, a scalable Security Architecture for Governing Agentic systems, that offers user oversight over their agents' lifecycle. In our design, users register their agents with a central entity, the Provider, that maintains agent contact information, user-defined access control policies, and helps agents enforce these policies on inter-agent communication. We introduce a cryptographic mechanism for deriving access control tokens, that offers fine-grained control over an agent's interaction with other agents, providing formal security guarantees. We evaluate SAGA on several agentic tasks, using agents in different geolocations, and multiple on-device and cloud LLMs, demonstrating minimal performance overhead with no impact on underlying task utility in a wide range of conditions. Our architecture enables secure and trustworthy deployment of autonomous agents, accelerating the responsible adoption of this technology in sensitive environments.

Long-term memory remains a structural weakness of AI agents. The dominant approach, retrieval-augmented generation (RAG), relies on embedding-based similarity search, which is opaque by construction, difficult to audit, and bounded by the theoretical limits of vector representations. We present the Memory-Orchestrated Semantic System (MOSS), an agentic memory architecture in which the agent drives retrieval over a structured relational database. MOSS is model-agnostic, storage-agnostic, and API-agnostic: it runs on any relational engine, connects to any LLM provider (or to deterministic non-LLM processes), and deploys on any infrastructure, local or cloud. Its retrieval execution is symbolic and reproducible (once a query is formulated, no LLM participates in the retrieval loop) and every step of the system, from indexing to answer formulation, is logged and inspectable, making MOSS auditable by construction. Rather than imposing an external ontology, MOSS derives its conceptual vocabulary from the corpus itself. We report on a longitudinal deployment unique in the agentic-memory literature: a year of continuous production over an individual scholar's working corpus--a conversational corpus reaching back to October 2024 (some 44 million tokens, retroactively indexed) comprising 110,183 segments, alongside 163,494 catalogued documents, 569 inductively derived concepts, 322,662 concept annotations, and eleven metadata graphs totaling approximately five million relations--across four successive infrastructure generations. While the present case is that of a single researcher, the architecture is in no way specific to one person: it serves a team, an institution, or any entity that accumulates knowledge over time. We argue that auditable, sovereign, structurally unbounded memory is a precondition for AI agents intended to accompany a person or an organization over years rather than sessions.

We present Qualixar OS, the first application-layer operating system for universal AI agent orchestration. Unlike kernel-level approaches (AIOS) or single-framework tools (AutoGen, CrewAI), Qualixar OS provides a complete runtime for heterogeneous multi-agent systems spanning 10 LLM providers, 8+ agent frameworks, and 7 transports. We contribute: (1) execution semantics for 12 multi-agent topologies including grid, forest, mesh, and maker patterns; (2) Forge, an LLM-driven team design engine with historical strategy memory; (3) three-layer model routing combining Q-learning, five strategies, and Bayesian POMDP with dynamic multi-provider discovery; (4) a consensus-based judge pipeline with Goodhart detection, JSD drift monitoring, and alignment trilemma navigation; (5) four-layer content attribution with HMAC signing and steganographic watermarks; (6) universal compatibility via the Claw Bridge supporting MCP and A2A protocols with a 25-command Universal Command Protocol; (7) a 24-tab production dashboard with visual workflow builder and skill marketplace. Qualixar OS is validated by 2,821 test cases across 217 event types and 8 quality modules. On a custom 20-task evaluation suite, the system achieves 100% accuracy at a mean cost of $0.000039 per task. Source-available under the Elastic License 2.0.

Building a deep research agent today is an exercise in glue code: the same backbone evaluated on the same benchmark can report different accuracies in different papers because harness and tool registry all differ, and integrating a new foundation model into a comparable evaluation surface costs weeks of model-specific engineering. We call this the per-paper engineering tax and release BioMedArena, an open-source toolkit that not only alleviates it but also provides an arena for fair comparison of different foundation models when evaluating them as deep-research agents. BioMedArena decouples six layers of biomedical agent evaluation -- benchmark loading, tool exposure, tool selection, execution mode, context management, and scoring -- and exposes 147 biomedical benchmarks and 75 biomedical tools across 9 functional families. Adding a new model, benchmark, or tool reduces to registering a few-line provider adapter. We further provide 6 agent harnesses with 6 context-management strategies, which provide 12 backbones with competitive research capabilities and significantly improved performance, achieving state-of-the-art (SOTA) results on 8 representative biomedical benchmarks, with an average lift of +15.03 percentage points over prior SOTA. The toolkit, configurations, and per-task traces are available at https://github.com/AI-in-Health/BioMedArena

AI memory systems are evolving toward unified context layers that enable efficient cross-agent collaboration and multi-tool workflows, facilitating better accumulation of personal data and learning of user preferences. However, centralization creates a trust crisis where users must entrust cloud providers with sensitive digital memory data. We identify a core tension between personalization demands and data sovereignty: centralized memory systems enable efficient cross-agent collaboration but expose users' sensitive data to cloud provider risks, while private deployments provide security but limit collaboration. To resolve this tension, we aim to achieve local-equivalent security while enabling superior maintenance efficiency and collaborative capabilities. We propose a five-layer architecture abstracting common functional components of AI memory systems: Storage, Extraction, Learning, Retrieval, and Governance. By applying TEE protection to each layer, we establish a trustworthy framework. Based on this, we design MemTrust, a hardware-backed zero-trust architecture that provides cryptographic guarantees across all layers. Our contributions include the five-layer abstraction, "Context from MemTrust" protocol for cross-application sharing, side-channel hardened retrieval with obfuscated access patterns, and comprehensive security analysis. The architecture enables third-party developers to port existing systems with acceptable development costs, achieving system-wide trustworthiness. We believe that AI memory plays a crucial role in enhancing the efficiency and collaboration of agents and AI tools. AI memory will become the foundational infrastructure for AI agents, and MemTrust serves as a universal trusted framework for AI memory systems, with the goal of becoming the infrastructure of memory infrastructure.

Large Language Models (LLMs) have become an integral part of software development, especially with the advent of agentic capabilities. Yet, many frontier LLMs are affiliated with specific providers. This raises the question of whether generated code favors the provider's own ecosystem over comparable alternatives, potentially constraining developers' choices and increasing dependence on a single provider. We define this behavior as Vertical Integration Bias (VIB) and introduce VIBench, a benchmark for measuring VIB in direct and agentic code generation across 20 provider-selectable software-integration scenarios. Evaluating 10 frontier provider-affiliated models against 3 non-affiliated controls, we find positive VIB in direct generation, with six of ten affiliated models showing statistically significant effects up to +18.8 percentage points (pp). Agentic workflows further amplify VIB, reaching +39.2 pp. Moreover, early affiliated-ecosystem choices in agentic workflows can persist into conceptually decoupled downstream files, with persistence as high as 90.3%. These findings underscore the need to measure and account for VIB in code generation, especially as agentic capabilities become more prevalent.

Over the past year, the vLLM Semantic Router project has released a series of work spanning: (1) core routing mechanisms -- signal-driven routing, context-length pool routing, router performance engineering, policy conflict detection, low-latency embedding models, category-aware semantic caching, user-feedback-driven routing adaptation, hallucination detection, and hierarchical content-safety classification for privacy and jailbreak protection; (2) fleet optimization -- fleet provisioning and energy-efficiency analysis; (3) agentic and multimodal routing -- multimodal agent routing, tool selection, CUA security, and multi-turn context memory and safety; (4) governance and standards -- inference routing protocols and multi-provider API extensions. Each paper tackled a specific problem in LLM inference, but the problems are not independent; for example, fleet provisioning depends on the routing policy, which depends on the workload mix, shifting as organizations adopt agentic and multimodal workloads. This paper distills those results into the Workload-Router-Pool (WRP) architecture, a three-dimensional framework for LLM inference optimization. Workload characterizes what the fleet serves (chat vs. agent, single-turn vs. multi-turn, warm vs. cold, prefill-heavy vs. decode-heavy). Router determines how each request is dispatched (static semantic rules, online bandit adaptation, RL-based model selection, quality-aware cascading). Pool defines where inference runs (homogeneous vs. heterogeneous GPU, disaggregated prefill/decode, KV-cache topology). We map our prior work onto a 3x3 WRP interaction matrix, identify which cells we have covered and which remain open, and propose twenty-one concrete research directions at the intersections, each grounded in our prior measurements, tiered by maturity from engineering-ready to open research.

In this paper, we introduce a simulacrum of hospital called Agent Hospital that simulates the entire process of treating illness. All patients, nurses, and doctors are autonomous agents powered by large language models (LLMs). Our central goal is to enable a doctor agent to learn how to treat illness within the simulacrum. To do so, we propose a method called MedAgent-Zero. As the simulacrum can simulate disease onset and progression based on knowledge bases and LLMs, doctor agents can keep accumulating experience from both successful and unsuccessful cases. Simulation experiments show that the treatment performance of doctor agents consistently improves on various tasks. More interestingly, the knowledge the doctor agents have acquired in Agent Hospital is applicable to real-world medicare benchmarks. After treating around ten thousand patients (real-world doctors may take over two years), the evolved doctor agent achieves a state-of-the-art accuracy of 93.06% on a subset of the MedQA dataset that covers major respiratory diseases. This work paves the way for advancing the applications of LLM-powered agent techniques in medical scenarios.

Health is a fundamental pillar of human wellness, and the rapid advancements in large language models (LLMs) have driven the development of a new generation of health agents. However, the application of health agents to fulfill the diverse needs of individuals in daily non-clinical settings is underexplored. In this work, we aim to build a comprehensive personal health agent that is able to reason about multimodal data from everyday consumer wellness devices and common personal health records, and provide personalized health recommendations. To understand end-users' needs when interacting with such an assistant, we conducted an in-depth analysis of web search and health forum queries, alongside qualitative insights from users and health experts gathered through a user-centered design process. Based on these findings, we identified three major categories of consumer health needs, each of which is supported by a specialist sub-agent: (1) a data science agent that analyzes personal time-series wearable and health record data, (2) a health domain expert agent that integrates users' health and contextual data to generate accurate, personalized insights, and (3) a health coach agent that synthesizes data insights, guiding users using a specified psychological strategy and tracking users' progress. Furthermore, we propose and develop the Personal Health Agent (PHA), a multi-agent framework that enables dynamic, personalized interactions to address individual health needs. To evaluate each sub-agent and the multi-agent system, we conducted automated and human evaluations across 10 benchmark tasks, involving more than 7,000 annotations and 1,100 hours of effort from health experts and end-users. Our work represents the most comprehensive evaluation of a health agent to date and establishes a strong foundation towards the futuristic vision of a personal health agent accessible to everyone.

Clinical calculators play a vital role in healthcare by offering accurate evidence-based predictions for various purposes such as prognosis. Nevertheless, their widespread utilization is frequently hindered by usability challenges, poor dissemination, and restricted functionality. Augmenting large language models with extensive collections of clinical calculators presents an opportunity to overcome these obstacles and improve workflow efficiency, but the scalability of the manual curation process poses a significant challenge. In response, we introduce AgentMD, a novel language agent capable of curating and applying clinical calculators across various clinical contexts. Using the published literature, AgentMD has automatically curated a collection of 2,164 diverse clinical calculators with executable functions and structured documentation, collectively named RiskCalcs. Manual evaluations show that RiskCalcs tools achieve an accuracy of over 80% on three quality metrics. At inference time, AgentMD can automatically select and apply the relevant RiskCalcs tools given any patient description. On the newly established RiskQA benchmark, AgentMD significantly outperforms chain-of-thought prompting with GPT-4 (87.7% vs. 40.9% in accuracy). Additionally, we also applied AgentMD to real-world clinical notes for analyzing both population-level and risk-level patient characteristics. In summary, our study illustrates the utility of language agents augmented with clinical calculators for healthcare analytics and patient care.

Large Action Models (LAMs) have revolutionized intelligent automation, but their application in healthcare faces challenges due to privacy concerns, latency, and dependency on internet access. This report introduces an ondevice, multi-agent healthcare assistant that overcomes these limitations. The system utilizes smaller, task-specific agents to optimize resources, ensure scalability and high performance. Our proposed system acts as a one-stop solution for health care needs with features like appointment booking, health monitoring, medication reminders, and daily health reporting. Powered by the Qwen Code Instruct 2.5 7B model, the Planner and Caller Agents achieve an average RougeL score of 85.5 for planning and 96.5 for calling for our tasks while being lightweight for on-device deployment. This innovative approach combines the benefits of ondevice systems with multi-agent architectures, paving the way for user-centric healthcare solutions.

Recent large language models (LLMs) have demonstrated significant advancements, particularly in their ability to serve as agents thereby surpassing their traditional role as chatbots. These agents can leverage their planning and tool utilization capabilities to address tasks specified at a high level. However, a standardized dataset to benchmark the agent capabilities of LLMs in medical applications is currently lacking, making the evaluation of LLMs on complex tasks in interactive healthcare environments challenging. To address this gap, we introduce MedAgentBench, a broad evaluation suite designed to assess the agent capabilities of large language models within medical records contexts. MedAgentBench encompasses 300 patient-specific clinically-derived tasks from 10 categories written by human physicians, realistic profiles of 100 patients with over 700,000 data elements, a FHIR-compliant interactive environment, and an accompanying codebase. The environment uses the standard APIs and communication infrastructure used in modern EMR systems, so it can be easily migrated into live EMR systems. MedAgentBench presents an unsaturated agent-oriented benchmark that current state-of-the-art LLMs exhibit some ability to succeed at. The best model (Claude 3.5 Sonnet v2) achieves a success rate of 69.67%. However, there is still substantial space for improvement which gives the community a next direction to optimize. Furthermore, there is significant variation in performance across task categories. MedAgentBench establishes this and is publicly available at https://github.com/stanfordmlgroup/MedAgentBench , offering a valuable framework for model developers to track progress and drive continuous improvements in the agent capabilities of large language models within the medical domain.

Smart contract vulnerabilities have led to billions in losses, yet finding actionable exploits remains challenging. Traditional fuzzers rely on rigid heuristics and struggle with complex attacks, while human auditors are thorough but slow and don't scale. Large Language Models offer a promising middle ground, combining human-like reasoning with machine speed. Early studies show that simply prompting LLMs generates unverified vulnerability speculations with high false positive rates. To address this, we present A1, an agentic system that transforms any LLM into an end-to-end exploit generator. A1 provides agents with six domain-specific tools for autonomous vulnerability discovery, from understanding contract behavior to testing strategies on real blockchain states. All outputs are concretely validated through execution, ensuring only profitable proof-of-concept exploits are reported. We evaluate A1 across 36 real-world vulnerable contracts on Ethereum and Binance Smart Chain. A1 achieves a 63% success rate on the VERITE benchmark. Across all successful cases, A1 extracts up to \8.59 million per exploit and 9.33 million total. Using Monte Carlo analysis of historical attacks, we demonstrate that immediate vulnerability detection yields 86-89% success probability, dropping to 6-21% with week-long delays. Our economic analysis reveals a troubling asymmetry: attackers achieve profitability at \6,000 exploit values while defenders require 60,000 -- raising fundamental questions about whether AI agents inevitably favor exploitation over defense.

As large language models (LLMs) evolve into sophisticated autonomous agents capable of complex software development tasks, evaluating their real-world capabilities becomes critical. While existing benchmarks like LoCoBench~qiu2025locobench assess long-context code understanding, they focus on single-turn evaluation and cannot capture the multi-turn interactive nature, tool usage patterns, and adaptive reasoning required by real-world coding agents. We introduce LoCoBench-Agent, a comprehensive evaluation framework specifically designed to assess LLM agents in realistic, long-context software engineering workflows. Our framework extends LoCoBench's 8,000 scenarios into interactive agent environments, enabling systematic evaluation of multi-turn conversations, tool usage efficiency, error recovery, and architectural consistency across extended development sessions. We also introduce an evaluation methodology with 9 metrics across comprehension and efficiency dimensions. Our framework provides agents with 8 specialized tools (file operations, search, code analysis) and evaluates them across context lengths ranging from 10K to 1M tokens, enabling precise assessment of long-context performance. Through systematic evaluation of state-of-the-art models, we reveal several key findings: (1) agents exhibit remarkable long-context robustness; (2) comprehension-efficiency trade-off exists with negative correlation, where thorough exploration increases comprehension but reduces efficiency; and (3) conversation efficiency varies dramatically across models, with strategic tool usage patterns differentiating high-performing agents. As the first long-context LLM agent benchmark for software engineering, LoCoBench-Agent establishes a rigorous foundation for measuring agent capabilities, identifying performance gaps, and advancing autonomous software development at scale.

Large Language Model Multi-Agent Systems (LLM-MAS) have achieved great progress in solving complex tasks. It performs communication among agents within the system to collaboratively solve tasks, under the premise of shared information. However, when agents' communication is leveraged to enhance human cooperation, a new challenge arises due to information asymmetry, since each agent can only access the information of its human user. Previous MAS struggle to complete tasks under this condition. To address this, we propose a new MAS paradigm termed iAgents, which denotes Informative Multi-Agent Systems. In iAgents, the human social network is mirrored in the agent network, where agents proactively exchange human information necessary for task resolution, thereby overcoming information asymmetry. iAgents employs a novel agent reasoning mechanism, InfoNav, to navigate agents' communication towards effective information exchange. Together with InfoNav, iAgents organizes human information in a mixed memory to provide agents with accurate and comprehensive information for exchange. Additionally, we introduce InformativeBench, the first benchmark tailored for evaluating LLM agents' task-solving ability under information asymmetry. Experimental results show that iAgents can collaborate within a social network of 140 individuals and 588 relationships, autonomously communicate over 30 turns, and retrieve information from nearly 70,000 messages to complete tasks within 3 minutes.

Agentic coding tools receive goals written in natural language as input, break them down into specific tasks, and write/execute the actual code with minimal human intervention. Key to this process are agent manifests, configuration files (such as Claude.md) that provide agents with essential project context, identity, and operational rules. However, the lack of comprehensive and accessible documentation for creating these manifests presents a significant challenge for developers. We analyzed 253 Claude.md files from 242 repositories to identify structural patterns and common content. Our findings show that manifests typically have shallow hierarchies with one main heading and several subsections, with content dominated by operational commands, technical implementation notes, and high-level architecture.

Robotic agents that operate autonomously in the real world need to continuously explore their environment and learn from the data collected, with minimal human supervision. While it is possible to build agents that can learn in such a manner without supervision, current methods struggle to scale to the real world. Thus, we propose ALAN, an autonomously exploring robotic agent, that can perform tasks in the real world with little training and interaction time. This is enabled by measuring environment change, which reflects object movement and ignores changes in the robot position. We use this metric directly as an environment-centric signal, and also maximize the uncertainty of predicted environment change, which provides agent-centric exploration signal. We evaluate our approach on two different real-world play kitchen settings, enabling a robot to efficiently explore and discover manipulation skills, and perform tasks specified via goal images. Website at https://robo-explorer.github.io/

Building a general-purpose agent is a long-standing vision in the field of artificial intelligence. Existing agents have made remarkable progress in many domains, yet they still struggle to complete long-horizon tasks in an open world. We attribute this to the lack of necessary world knowledge and multimodal experience that can guide agents through a variety of long-horizon tasks. In this paper, we propose a Hybrid Multimodal Memory module to address the above challenges. It 1) transforms knowledge into Hierarchical Directed Knowledge Graph that allows agents to explicitly represent and learn world knowledge, and 2) summarises historical information into Abstracted Multimodal Experience Pool that provide agents with rich references for in-context learning. On top of the Hybrid Multimodal Memory module, a multimodal agent, Optimus-1, is constructed with dedicated Knowledge-guided Planner and Experience-Driven Reflector, contributing to a better planning and reflection in the face of long-horizon tasks in Minecraft. Extensive experimental results show that Optimus-1 significantly outperforms all existing agents on challenging long-horizon task benchmarks, and exhibits near human-level performance on many tasks. In addition, we introduce various Multimodal Large Language Models (MLLMs) as the backbone of Optimus-1. Experimental results show that Optimus-1 exhibits strong generalization with the help of the Hybrid Multimodal Memory module, outperforming the GPT-4V baseline on many tasks.

Recent advances in coding agents have made them capable of planning, editing, running, and testing complex code bases. Despite their growing ability in coding tasks, these systems still struggle to infer and track user intent, especially when instructions are underspecified or context-dependent. To bridge this gap, we introduce ToM-SWE, a dual-agent architecture that pairs a primary software-engineering (SWE) agent with a lightweight theory-of-mind (ToM) partner agent dedicated to modeling the user's mental state. The ToM agent infers user goals, constraints, and preferences from instructions and interaction history, maintains a persistent memory of the user, and provides user-related suggestions to the SWE agent. In two software engineering benchmarks (ambiguous SWE-bench and stateful SWE-bench), ToM-SWE improves task success rates and user satisfaction. Notably, on the stateful SWE benchmark, a newly introduced evaluation that provides agents with a user simulator along with previous interaction histories, ToM-SWE achieves a substantially higher task success rate of 59.7\% compared to 18.1\% for OpenHands, a state-of-the-art SWE agent. Furthermore, in a three-week study with professional developers using ToM-SWE in their daily work, participants found it useful 86\% of the time, underscoring the value of stateful user modeling for practical coding agents.

A growing body of multi-agent studies with LLMs explores how norms and cooperation emerge in mixed-motive scenarios, where pursuing individual gain can undermine the collective good. While prior work has explored these dynamics in both richly contextualized simulations and simplified game-theoretic environments, most LLM systems featuring common-pool resource (CPR) games provide agents with explicit reward functions directly tied to their actions. In contrast, human cooperation often emerges without explicit knowledge of the payoff structure or how individual actions translate into long-run outcomes, relying instead on heuristics, communication, and enforcement. We introduce a CPR simulation framework that removes explicit reward signals and embeds cultural-evolutionary mechanisms: social learning (adopting strategies and beliefs from successful peers) and norm-based punishment, grounded in Ostrom's principles of resource governance. Agents also individually learn from the consequences of harvesting, monitoring, and punishing via environmental feedback, enabling norms to emerge endogenously. We establish the validity of our simulation by reproducing key findings from existing studies on human behavior. Building on this, we examine norm evolution across a 2times2 grid of environmental and social initialisations (resource-rich vs. resource-scarce; altruistic vs. selfish) and benchmark how agentic societies comprised of different LLMs perform under these conditions. Our results reveal systematic model differences in sustaining cooperation and norm formation, positioning the framework as a rigorous testbed for studying emergent norms in mixed-motive LLM societies. Such analysis can inform the design of AI systems deployed in social and organizational contexts, where alignment with cooperative norms is critical for stability, fairness, and effective governance of AI-mediated environments.

As AI agents become increasingly capable of complex, long-horizon reasoning, rigorous and holistic evaluation is essential for measuring progress toward real-world healthcare applications. We introduce HealthAgentBench, a suite of 54 agentic healthcare tasks across 7 categories each with its unique environment. The benchmark suite spans diverse workflows throughout the patient journey and a broad range of modalities. Each task is designed to replicate an end-to-end clinical workflow: given minimal instructions, an agent must explore raw healthcare data, operate within a complex environment, and execute multi-step solutions that go beyond naive prompting. A final task success rate is reported to provide a single, interpretable metric for HealthAgentBench overall performance for each agent. Evaluating frontier agents on HealthAgentBench, we find that overall task success rate remains low, underscoring the difficulty of the suite. The strongest and the most cost effective agent, Codex GPT-5.5, achieves only approximately 42% success rate. Beyond aggregate performance, HealthAgentBench reveals nuanced strengths and weaknesses across task categories. Frontier agents show promise in automatically developing research modeling pipelines over EHR data, but medical imaging remains especially challenging, particularly for Claude Code models, while Codex GPT-5.5 shows emerging capability. Tasks that combine large search spaces with compositional reasoning requirements remain difficult for all current agents. Together, these results suggest that HealthAgentBench provides a challenging and realistic benchmark with substantial room for future progress. We release our benchmark at https://github.com/microsoft/HealthAgentBench.

In this work, we introduce MedAgentSim, an open-source simulated clinical environment with doctor, patient, and measurement agents designed to evaluate and enhance LLM performance in dynamic diagnostic settings. Unlike prior approaches, our framework requires doctor agents to actively engage with patients through multi-turn conversations, requesting relevant medical examinations (e.g., temperature, blood pressure, ECG) and imaging results (e.g., MRI, X-ray) from a measurement agent to mimic the real-world diagnostic process. Additionally, we incorporate self improvement mechanisms that allow models to iteratively refine their diagnostic strategies. We enhance LLM performance in our simulated setting by integrating multi-agent discussions, chain-of-thought reasoning, and experience-based knowledge retrieval, facilitating progressive learning as doctor agents interact with more patients. We also introduce an evaluation benchmark for assessing the LLM's ability to engage in dynamic, context-aware diagnostic interactions. While MedAgentSim is fully automated, it also supports a user-controlled mode, enabling human interaction with either the doctor or patient agent. Comprehensive evaluations in various simulated diagnostic scenarios demonstrate the effectiveness of our approach. Our code, simulation tool, and benchmark are available at https://medagentsim.netlify.app/.

Healthcare AI agents handle patient consultation, clinical reasoning over text and images, interactive diagnosis, and electronic health record (EHR) tool use, yet specialized agentic models that cover these use cases together remain limited. These capabilities fail in different ways, and a narrow update for one task can degrade another. We present Cura 1T, a healthcare-specialized LLM built on the open-weight Kimi-K2.6 and trained through a human-gated recursive self-improvement (RSI) loop. Specifically, in each round, the RSI harness plans a target capability, trains the model, evaluates benchmark trajectories, and refines the data mixture from observed failures with targeted synthetic and curated examples rather than a single generic medical-data update. Across the healthcare evaluation suite, Cura 1T ranks at or near the top among frontier baselines while remaining competitive on out-of-domain reasoning and agentic benchmarks.

Medical question answering systems face deployment challenges including hallucinations, bias, computational demands, privacy concerns, and the need for specialized expertise across diverse domains. Here, we present SOLVE-Med, a multi-agent architecture combining domain-specialized small language models for complex medical queries. The system employs a Router Agent for dynamic specialist selection, ten specialized models (1B parameters each) fine-tuned on specific medical domains, and an Orchestrator Agent that synthesizes responses. Evaluated on Italian medical forum data across ten specialties, SOLVE-Med achieves superior performance with ROUGE-1 of 0.301 and BERTScore F1 of 0.697, outperforming standalone models up to 14B parameters while enabling local deployment. Our code is publicly available on GitHub: https://github.com/PRAISELab-PicusLab/SOLVE-Med.

Diagnosing and managing a patient is a complex, sequential decision making process that requires physicians to obtain information -- such as which tests to perform -- and to act upon it. Recent advances in artificial intelligence (AI) and large language models (LLMs) promise to profoundly impact clinical care. However, current evaluation schemes overrely on static medical question-answering benchmarks, falling short on interactive decision-making that is required in real-life clinical work. Here, we present AgentClinic: a multimodal benchmark to evaluate LLMs in their ability to operate as agents in simulated clinical environments. In our benchmark, the doctor agent must uncover the patient's diagnosis through dialogue and active data collection. We present two open medical agent benchmarks: a multimodal image and dialogue environment, AgentClinic-NEJM, and a dialogue-only environment, AgentClinic-MedQA. We embed cognitive and implicit biases both in patient and doctor agents to emulate realistic interactions between biased agents. We find that introducing bias leads to large reductions in diagnostic accuracy of the doctor agents, as well as reduced compliance, confidence, and follow-up consultation willingness in patient agents. Evaluating a suite of state-of-the-art LLMs, we find that several models that excel in benchmarks like MedQA are performing poorly in AgentClinic-MedQA. We find that the LLM used in the patient agent is an important factor for performance in the AgentClinic benchmark. We show that both having limited interactions as well as too many interaction reduces diagnostic accuracy in doctor agents. The code and data for this work is publicly available at https://AgentClinic.github.io.

We develop Polaris, the first safety-focused LLM constellation for real-time patient-AI healthcare conversations. Unlike prior LLM works in healthcare focusing on tasks like question answering, our work specifically focuses on long multi-turn voice conversations. Our one-trillion parameter constellation system is composed of several multibillion parameter LLMs as co-operative agents: a stateful primary agent that focuses on driving an engaging conversation and several specialist support agents focused on healthcare tasks performed by nurses to increase safety and reduce hallucinations. We develop a sophisticated training protocol for iterative co-training of the agents that optimize for diverse objectives. We train our models on proprietary data, clinical care plans, healthcare regulatory documents, medical manuals, and other medical reasoning documents. We align our models to speak like medical professionals, using organic healthcare conversations and simulated ones between patient actors and experienced nurses. This allows our system to express unique capabilities such as rapport building, trust building, empathy and bedside manner. Finally, we present the first comprehensive clinician evaluation of an LLM system for healthcare. We recruited over 1100 U.S. licensed nurses and over 130 U.S. licensed physicians to perform end-to-end conversational evaluations of our system by posing as patients and rating the system on several measures. We demonstrate Polaris performs on par with human nurses on aggregate across dimensions such as medical safety, clinical readiness, conversational quality, and bedside manner. Additionally, we conduct a challenging task-based evaluation of the individual specialist support agents, where we demonstrate our LLM agents significantly outperform a much larger general-purpose LLM (GPT-4) as well as from its own medium-size class (LLaMA-2 70B).

Large language models (LLMs) integrated into agent-driven workflows hold immense promise for healthcare, yet a significant gap exists between their potential and practical implementation within clinical settings. To address this, we present a practitioner-oriented field manual for deploying generative agents that use electronic health record (EHR) data. This guide is informed by our experience deploying the "irAE-Agent", an automated system to detect immune-related adverse events from clinical notes at Mass General Brigham, and by structured interviews with 21 clinicians, engineers, and informatics leaders involved in the project. Our analysis reveals a critical misalignment in clinical AI development: less than 20% of our effort was dedicated to prompt engineering and model development, while over 80% was consumed by the sociotechnical work of implementation. We distill this effort into five "heavy lifts": data integration, model validation, ensuring economic value, managing system drift, and governance. By providing actionable solutions for each of these challenges, this field manual shifts the focus from algorithmic development to the essential infrastructure and implementation work required to bridge the "valley of death" and successfully translate generative AI from pilot projects into routine clinical care.

Large Language Models (LLMs) and multi-agent systems have shown impressive capabilities in natural language tasks but face challenges in clinical trial applications, primarily due to limited access to external knowledge. Recognizing the potential of advanced clinical trial tools that aggregate and predict based on the latest medical data, we propose an integrated solution to enhance their accessibility and utility. We introduce Clinical Agent System (ClinicalAgent), a clinical multi-agent system designed for clinical trial tasks, leveraging GPT-4, multi-agent architectures, LEAST-TO-MOST, and ReAct reasoning technology. This integration not only boosts LLM performance in clinical contexts but also introduces novel functionalities. The proposed method achieves competitive predictive performance in clinical trial outcome prediction (0.7908 PR-AUC), obtaining a 0.3326 improvement over the standard prompt Method. Publicly available code can be found at https://anonymous.4open.science/r/ClinicalAgent-6671.

Healthcare automation is shaped by local procedures and organizational constraints, so agent capabilities rarely transfer unchanged across settings. Agent skills, self-contained directories that package reusable procedures for AI agents, are emerging as a procedural layer for adapting healthcare agents across diverse healthcare settings. We present the first empirical analysis of healthcare agent skills, drawing on 557 healthcare-related skills filtered from 58,159 public skills on ClawHub and annotated along ten dimensions covering function, deployment context, autonomy, and safety. We find that public healthcare skills emphasize patient-facing workflow automation and monitoring rather than the diagnostic and treatment-oriented tasks foregrounded in healthcare-agent research; coverage of the healthcare lifecycle and specialized clinical inputs remains uneven; and general technical risk does not reliably capture clinical risk. These findings position healthcare skills as a procedural layer not yet addressed by current benchmarks and risk frameworks.

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.

Medical Large Vision-Language Models (Med-LVLMs) have shown strong potential in multimodal diagnostic tasks. However, existing single-agent models struggle to generalize across diverse medical specialties, limiting their performance. Recent efforts introduce multi-agent collaboration frameworks inspired by clinical workflows, where general practitioners (GPs) and specialists interact in a fixed sequence. Despite improvements, these static pipelines lack flexibility and adaptability in reasoning. To address this, we propose MMedAgent-RL, a reinforcement learning (RL)-based multi-agent framework that enables dynamic, optimized collaboration among medical agents. Specifically, we train two GP agents based on Qwen2.5-VL via RL: the triage doctor learns to assign patients to appropriate specialties, while the attending physician integrates the judgments from multi-specialists and its own knowledge to make final decisions. To address the inconsistency in specialist outputs, we introduce a curriculum learning (CL)-guided RL strategy that progressively teaches the attending physician to balance between imitating specialists and correcting their mistakes. Experiments on five medical VQA benchmarks demonstrate that MMedAgent-RL not only outperforms both open-source and proprietary Med-LVLMs, but also exhibits human-like reasoning patterns. Notably, it achieves an average performance gain of 20.7% over supervised fine-tuning baselines.

We introduce PhysicianBench, a benchmark for evaluating LLM agents on physician tasks grounded in real clinical setting within electronic health record (EHR) environments. Existing medical agent benchmarks primarily focus on static knowledge recall, single-step atomic actions, or action intent without verifiable execution against the environment. As a result, they fail to capture the long-horizon, composite workflows that characterize real clinical systems. PhysicianBench comprises 100 long-horizon tasks adapted from real consultation cases between primary care and subspecialty physicians, with each task independently reviewed by a separate panel of physicians. Tasks are instantiated in an EHR environment with real patient records and accessed through the same standard APIs used by commercial EHR vendors. Tasks span 21 specialties (e.g., cardiology, endocrinology, oncology, psychiatry) and diverse workflow types (e.g., diagnosis interpretation, medication prescribing, treatment planning), requiring an average of 27 tool calls per task. Solving each task requires retrieving data across encounters, reasoning over heterogeneous clinical information, executing consequential clinical actions, and producing clinical documentation. Each task is decomposed into structured checkpoints (670 in total across the benchmark) capturing distinct stages of completion graded by task-specific scripts with execution-grounded verification. Across 13 proprietary and open-source LLM agents, the best-performing model achieves only 46% success rate (pass@1), while open-source models reach at most 19%, revealing a substantial gap between current agent capabilities and the demands of real-world clinical workflows. PhysicianBench provides a realistic and execution-grounded benchmark for measuring progress toward autonomous clinical agents.

Large language models (LLMs) have demonstrated excellent capabilities in the field of biomedical question answering, but their application in real-world clinical consultations still faces core challenges. Existing systems rely on a one-way information transmission mode where patients must fully describe their symptoms in a single round, leading to nonspecific diagnostic recommendations when complaints are vague. Traditional multi-turn dialogue methods based on supervised learning are constrained by static data-driven paradigms, lacking generalizability and struggling to intelligently extract key clinical information. To address these limitations, we propose DoctorAgent-RL, a reinforcement learning (RL)-based multi-agent collaborative framework that models medical consultations as a dynamic decision-making process under uncertainty. The doctor agent continuously optimizes its questioning strategy within the RL framework through multi-turn interactions with the patient agent, dynamically adjusting its information-gathering path based on comprehensive rewards from the Consultation Evaluator. This RL fine-tuning mechanism enables LLMs to autonomously develop interaction strategies aligned with clinical reasoning logic, rather than superficially imitating patterns in existing dialogue data. Notably, we constructed MTMedDialog, the first English multi-turn medical consultation dataset capable of simulating patient interactions. Experiments demonstrate that DoctorAgent-RL outperforms existing models in both multi-turn reasoning capability and final diagnostic performance, demonstrating practical value in assisting clinical consultations. https://github.com/JarvisUSTC/DoctorAgent-RL

Precision therapeutics require multimodal adaptive models that generate personalized treatment recommendations. We introduce TxAgent, an AI agent that leverages multi-step reasoning and real-time biomedical knowledge retrieval across a toolbox of 211 tools to analyze drug interactions, contraindications, and patient-specific treatment strategies. TxAgent evaluates how drugs interact at molecular, pharmacokinetic, and clinical levels, identifies contraindications based on patient comorbidities and concurrent medications, and tailors treatment strategies to individual patient characteristics. It retrieves and synthesizes evidence from multiple biomedical sources, assesses interactions between drugs and patient conditions, and refines treatment recommendations through iterative reasoning. It selects tools based on task objectives and executes structured function calls to solve therapeutic tasks that require clinical reasoning and cross-source validation. The ToolUniverse consolidates 211 tools from trusted sources, including all US FDA-approved drugs since 1939 and validated clinical insights from Open Targets. TxAgent outperforms leading LLMs, tool-use models, and reasoning agents across five new benchmarks: DrugPC, BrandPC, GenericPC, TreatmentPC, and DescriptionPC, covering 3,168 drug reasoning tasks and 456 personalized treatment scenarios. It achieves 92.1% accuracy in open-ended drug reasoning tasks, surpassing GPT-4o and outperforming DeepSeek-R1 (671B) in structured multi-step reasoning. TxAgent generalizes across drug name variants and descriptions. By integrating multi-step inference, real-time knowledge grounding, and tool-assisted decision-making, TxAgent ensures that treatment recommendations align with established clinical guidelines and real-world evidence, reducing the risk of adverse events and improving therapeutic decision-making.

Diagnosing lung cancer typically involves physicians identifying lung nodules in Computed tomography (CT) scans and generating diagnostic reports based on their morphological features and medical expertise. Although advancements have been made in using multimodal large language models for analyzing lung CT scans, challenges remain in accurately describing nodule morphology and incorporating medical expertise. These limitations affect the reliability and effectiveness of these models in clinical settings. Collaborative multi-agent systems offer a promising strategy for achieving a balance between generality and precision in medical applications, yet their potential in pathology has not been thoroughly explored. To bridge these gaps, we introduce LungNoduleAgent, an innovative collaborative multi-agent system specifically designed for analyzing lung CT scans. LungNoduleAgent streamlines the diagnostic process into sequential components, improving precision in describing nodules and grading malignancy through three primary modules. The first module, the Nodule Spotter, coordinates clinical detection models to accurately identify nodules. The second module, the Radiologist, integrates localized image description techniques to produce comprehensive CT reports. Finally, the Doctor Agent System performs malignancy reasoning by using images and CT reports, supported by a pathology knowledge base and a multi-agent system framework. Extensive testing on two private datasets and the public LIDC-IDRI dataset indicates that LungNoduleAgent surpasses mainstream vision-language models, agent systems, and advanced expert models. These results highlight the importance of region-level semantic alignment and multi-agent collaboration in diagnosing nodules. LungNoduleAgent stands out as a promising foundational tool for supporting clinical analyses of lung nodules.

The professionalism of a human doctor in outpatient service depends on two core abilities: the ability to make accurate medical decisions and the medical consultation skill to conduct strategic, empathetic patient inquiry. Existing Large Language Models (LLMs) have achieved remarkable accuracy on medical decision-making benchmarks. However, they often lack the ability to conduct the strategic and empathetic consultation, which is essential for real-world clinical scenarios. To address this gap, we propose Doctor-R1, an AI doctor agent trained to master both of the capabilities by ask high-yield questions and conduct strategic multi-turn inquiry to guide decision-making. Our framework introduces three key components: a multi-agent interactive environment, a two-tiered reward architecture that separately optimizes clinical decision-making and communicative inquiry skills, and an experience repository to ground policy learning in high-quality prior trajectories. We evaluate Doctor-R1 on OpenAI's HealthBench and MAQuE, assessed across multi-facet metrics, such as communication quality, user experience, and task accuracy. Remarkably, Doctor-R1 surpasses state-of-the-art open-source specialized LLMs by a substantial margin with higher parameter efficiency and outperforms powerful proprietary models. Furthermore, the human evaluations show a strong preference for Doctor-R1 to generate human-preferred clinical dialogue, demonstrating the effectiveness of the framework.

Most medical multimodal benchmarks focus on static tasks such as image question answering, report generation, and plain-language rewriting. Patient education is more demanding: systems must identify relevant evidence across images, show patients where to look, explain findings in accessible language, and handle confusion or distress. Yet most patient education work remains text-only, even though combined image-and-text explanations may better support understanding. We introduce MedImageEdu, a benchmark for multi-turn, evidence-grounded radiology patient education. Each case provides a radiology report with report text and case images. A DoctorAgent interacts with a PatientAgent, conditioned on a hidden profile that captures factors such as education level, health literacy, and personality. When a patient question would benefit from visual support, the DoctorAgent can issue drawing instructions grounded in the report, case images, and the current question to a benchmark-provided drawing tool. The tool returns image(s), after which the DoctorAgent produces a final multimodal response consisting of the image(s) and a grounded plain-language explanation. MedImageEdu contains 150 cases from three sources and evaluates both the consultation process and the final multimodal response along five dimensions: Consultation, Safety and Scope, Language Quality, Drawing Quality, and Image-Text Response Quality. Across representative open- and closed-source vision-language model agents, we find three consistent gaps: fluent language often outpaces faithful visual grounding, safety is the weakest dimension across disease categories, and emotionally tense interactions are harder than low education or low health literacy. MedImageEdu provides a controlled testbed for assessing whether multimodal agents can teach from evidence rather than merely answer from text.

Healthcare organizations are beginning to embed agentic AI into routine workflows, including clinical documentation support and early-warning monitoring. As these capabilities diffuse across departments and vendors, health systems face agent sprawl, causing duplicated agents, unclear accountability, inconsistent controls, and tool permissions that persist beyond the original use case. Existing AI governance frameworks emphasize lifecycle risk management but provide limited guidance for the day-to-day operations of agent fleets. We propose a Unified Agent Lifecycle Management (UALM) blueprint derived from a rapid, practice-oriented synthesis of governance standards, agent security literature, and healthcare compliance requirements. UALM maps recurring gaps onto five control-plane layers: (1) an identity and persona registry, (2) orchestration and cross-domain mediation, (3) PHI-bounded context and memory, (4) runtime policy enforcement with kill-switch triggers, and (5) lifecycle management and decommissioning linked to credential revocation and audit logging. A companion maturity model supports staged adoption. UALM offers healthcare CIOs, CISOs, and clinical leaders an implementable pattern for audit-ready oversight that preserves local innovation and enables safer scaling across clinical and administrative domains.

Accessibility remains a critical concern in today's society, as many technologies are not developed to support the full range of user needs. Existing multi-agent systems (MAS) often cannot provide comprehensive assistance for users in need due to the lack of customization stemming from closed-source designs. Consequently, individuals with disabilities frequently encounter significant barriers when attempting to interact with digital environments. We introduce MATE, a multimodal accessibility MAS, which performs the modality conversions based on the user's needs. The system is useful for assisting people with disabilities by ensuring that data will be converted to an understandable format. For instance, if the user cannot see well and receives an image, the system converts this image to its audio description. MATE can be applied to a wide range of domains, industries, and areas, such as healthcare, and can become a useful assistant for various groups of users. The system supports multiple types of models, ranging from LLM API calling to using custom machine learning (ML) classifiers. This flexibility ensures that the system can be adapted to various needs and is compatible with a wide variety of hardware. Since the system is expected to run locally, it ensures the privacy and security of sensitive information. In addition, the framework can be effectively integrated with institutional technologies (e.g., digital healthcare service) for real-time user assistance. Furthermore, we introduce ModCon-Task-Identifier, a model that is capable of extracting the precise modality conversion task from the user input. Numerous experiments show that ModCon-Task-Identifier consistently outperforms other LLMs and statistical models on our custom data. Our code and data are publicly available at https://github.com/AlgazinovAleksandr/Multi-Agent-MATE.

The rapid advancement of Large Language Models (LLMs) has stimulated interest in multi-agent collaboration for addressing complex medical tasks. However, the practical advantages of multi-agent collaboration approaches remain insufficiently understood. Existing evaluations often lack generalizability, failing to cover diverse tasks reflective of real-world clinical practice, and frequently omit rigorous comparisons against both single-LLM-based and established conventional methods. To address this critical gap, we introduce MedAgentBoard, a comprehensive benchmark for the systematic evaluation of multi-agent collaboration, single-LLM, and conventional approaches. MedAgentBoard encompasses four diverse medical task categories: (1) medical (visual) question answering, (2) lay summary generation, (3) structured Electronic Health Record (EHR) predictive modeling, and (4) clinical workflow automation, across text, medical images, and structured EHR data. Our extensive experiments reveal a nuanced landscape: while multi-agent collaboration demonstrates benefits in specific scenarios, such as enhancing task completeness in clinical workflow automation, it does not consistently outperform advanced single LLMs (e.g., in textual medical QA) or, critically, specialized conventional methods that generally maintain better performance in tasks like medical VQA and EHR-based prediction. MedAgentBoard offers a vital resource and actionable insights, emphasizing the necessity of a task-specific, evidence-based approach to selecting and developing AI solutions in medicine. It underscores that the inherent complexity and overhead of multi-agent collaboration must be carefully weighed against tangible performance gains. All code, datasets, detailed prompts, and experimental results are open-sourced at https://medagentboard.netlify.app/.

Agents are rapidly advancing in automating digital work, but enterprises face a harder challenge: moving beyond prototypes to deployed systems that deliver measurable business value. This path is complicated by fragmented frameworks, slow development, and the absence of standardized evaluation practices. Generalist agents have emerged as a promising direction, excelling on academic benchmarks and offering flexibility across task types, applications, and modalities. Yet, evidence of their use in production enterprise settings remains limited. This paper reports IBM's experience developing and piloting the Computer Using Generalist Agent (CUGA), which has been open-sourced for the community (https://github.com/cuga-project/cuga-agent). CUGA adopts a hierarchical planner--executor architecture with strong analytical foundations, achieving state-of-the-art performance on AppWorld and WebArena. Beyond benchmarks, it was evaluated in a pilot within the Business-Process-Outsourcing talent acquisition domain, addressing enterprise requirements for scalability, auditability, safety, and governance. To support assessment, we introduce BPO-TA, a 26-task benchmark spanning 13 analytics endpoints. In preliminary evaluations, CUGA approached the accuracy of specialized agents while indicating potential for reducing development time and cost. Our contribution is twofold: presenting early evidence of generalist agents operating at enterprise scale, and distilling technical and organizational lessons from this initial pilot. We outline requirements and next steps for advancing research-grade architectures like CUGA into robust, enterprise-ready systems.

Realistic environments often provide agents with very limited feedback. When the environment is initially unknown, the feedback, in the beginning, can be completely absent, and the agents may first choose to devote all their effort on exploring efficiently. The exploration remains a challenge while it has been addressed with many hand-tuned heuristics with different levels of generality on one side, and a few theoretically-backed exploration strategies on the other. Many of them are incarnated by intrinsic motivation and in particular explorations bonuses. A common rule of thumb for exploration bonuses is to use 1/n bonus that is added to the empirical estimates of the reward, where n is a number of times this particular state (or a state-action pair) was visited. We show that, surprisingly, for a pure-exploration objective of reward-free exploration, bonuses that scale with 1/n bring faster learning rates, improving the known upper bounds with respect to the dependence on the horizon H. Furthermore, we show that with an improved analysis of the stopping time, we can improve by a factor H the sample complexity in the best-policy identification setting, which is another pure-exploration objective, where the environment provides rewards but the agent is not penalized for its behavior during the exploration phase.

Fast Healthcare Interoperability Resources (FHIR) is the dominant standard for interoperable exchange of healthcare data. In FHIR, electronic health records form a directed graph of resources. Answering clinically meaningful questions over FHIR requires agents to perform multi-step reasoning, filtering, and aggregation across multiple resource types. Prior work shows that even tool-augmented LLM agents (retrieval, code execution, multi-turn planning) often select the wrong resources or violate traversal constraints. We study this problem in the context of FHIR-AgentBench, a benchmark for realistic question answering over real-world hospital data, and frame reasoning on FHIR as a sequential decision-making problem over a queryable structured graph. We implement a multi-turn CodeAct agent and post-train it with reinforcement learning using a custom harness and tools. A LLM Judge provides execution-grounded rewards. Compared to prompt-based, closed-model baselines, RL post-training improves performance while enforcing data-integrity constraints. Empirically, our approach improves answer correctness from 50% (o4-mini) to 77% on FHIR-AgentBench using a smaller and cheaper Qwen3-8B model. We present an end-to-end post-training pipeline (environment building, harness construction, model training and custom evaluation) that reliably improves multi-turn reasoning over structured clinical graphs.

Zero-shot reinforcement learning (RL) promises to provide agents that can perform any task in an environment after an offline pre-training phase. Forward-backward (FB) representations represent remarkable progress towards this ideal, achieving 85% of the performance of task-specific agents in this setting. However, such performance is contingent on access to large and diverse datasets for pre-training, which cannot be expected for most real problems. Here, we explore how FB performance degrades when trained on small datasets that lack diversity, and mitigate it with conservatism, a well-established feature of performant offline RL algorithms. We evaluate our family of methods across various datasets, domains and tasks, reaching 150% of vanilla FB performance in aggregate. Somewhat surprisingly, conservative FB algorithms also outperform the task-specific baseline, despite lacking access to reward labels and being required to maintain policies for all tasks. Conservative FB algorithms perform no worse than FB on full datasets, and so present little downside over their predecessor. Our code is available open-source via https://enjeeneer.io/projects/conservative-world-models/.

Multi-View Reinforcement Learning (MVRL) seeks to provide agents with multi-view observations, enabling them to perceive environment with greater effectiveness and precision. Recent advancements in MVRL focus on extracting latent representations from multiview observations and leveraging them in control tasks. However, it is not straightforward to learn compact and task-relevant representations, particularly in the presence of redundancy, distracting information, or missing views. In this paper, we propose Multi-view Fusion State for Control (MFSC), firstly incorporating bisimulation metric learning into MVRL to learn task-relevant representations. Furthermore, we propose a multiview-based mask and latent reconstruction auxiliary task that exploits shared information across views and improves MFSC's robustness in missing views by introducing a mask token. Extensive experimental results demonstrate that our method outperforms existing approaches in MVRL tasks. Even in more realistic scenarios with interference or missing views, MFSC consistently maintains high performance.

Recent research looks to harness the general knowledge and reasoning of large language models (LLMs) into agents that accomplish user-specified goals in interactive environments. Vision-language models (VLMs) extend LLMs to multi-modal data and provide agents with the visual reasoning necessary for new applications in areas such as computer automation. However, agent tasks emphasize skills where accessible open-weight VLMs lag behind their LLM equivalents. For example, VLMs are less capable of following an environment's strict output syntax requirements and are more focused on open-ended question answering. Overcoming these limitations requires supervised fine-tuning (SFT) on task-specific expert demonstrations. Our work approaches these challenges from an offline-to-online reinforcement learning (RL) perspective. RL lets us fine-tune VLMs to agent tasks while learning from the unsuccessful decisions of our own model or more capable (larger) models. We explore an off-policy RL solution that retains the stability and simplicity of the widely used SFT workflow while allowing our agent to self-improve and learn from low-quality datasets. We demonstrate this technique with two open-weight VLMs across three multi-modal agent domains.

Healthcare administration accounts for over $1 trillion in annual spending, making it a promising target for LLM-based computer-use agents (CUAs). While clinical applications of LLMs have received significant attention, no benchmark exists for evaluating CUAs on end-to-end administrative workflows. To address this gap, we introduce HealthAdminBench, a benchmark comprising four realistic GUI environments: an EHR, two payer portals, and a fax system, and 135 expert-defined tasks spanning three administrative task types: Prior Authorization, Appeals and Denials Management, and Durable Medical Equipment (DME) Order Processing. Each task is decomposed into fine-grained, verifiable subtasks, yielding 1,698 evaluation points. We evaluate seven agent configurations under multiple prompting and observation settings and find that, despite strong subtask performance, end-to-end reliability remains low: the best-performing agent (Claude Opus 4.6 CUA) achieves only 36.3 percent task success, while GPT-5.4 CUA attains the highest subtask success rate (82.8 percent). These results reveal a substantial gap between current agent capabilities and the demands of real-world administrative workflows. HealthAdminBench provides a rigorous foundation for evaluating progress toward safe and reliable automation of healthcare administrative workflows.

Customer-service LLM agents must follow organizational policy when acting on a user's behalf. Compliance failures arise from either forbidden actions, such as granting an ineligible change, or omitted procedural requirements, such as identification or confirmation. Runtime safeguards can intervene on risky actions, but action-local checks do not guide an agent through a multi-step procedure. Workflow-following systems support prescribed process execution, but primarily target workflow completion rather than safeguarding agent behavior. PolicyGuide instead compiles each domain policy into a workflow graph and invokes a proactive verifier at user-turn boundaries. From persisted graph state, the verifier reconciles open requests and returns step-specific remediation along a policy-compliant path. Across the τ^2-bench airline, retail, and telecom domains with a GPT-5.4 agent and verifier, PolicyGuide raises mean Pass^4 from 0.42 to 0.62, with the largest gain on telecom (0.19 to 0.61), the most workflow-structured domain. The same workflows transfer to Claude Sonnet 4.6 and Gemini 2.5 Pro agents. Complementary evaluations find the lowest observed attack-success rate under adversarial users and the strongest procedural compliance in an author-designed workflow-level validation.

Simulating high-fidelity patients offers a powerful avenue for studying complex diseases while addressing the challenges of fragmented, biased, and privacy-restricted real-world data. In this study, we introduce SynthAgent, a novel Multi-Agent System (MAS) framework designed to model obesity patients with comorbid mental disorders, including depression, anxiety, social phobia, and binge eating disorder. SynthAgent integrates clinical and medical evidence from claims data, population surveys, and patient-centered literature to construct personalized virtual patients enriched with personality traits that influence adherence, emotion regulation, and lifestyle behaviors. Through autonomous agent interactions, the system simulates disease progression, treatment response, and life management across diverse psychosocial contexts. Evaluation of more than 100 generated patients demonstrated that GPT-5 and Claude 4.5 Sonnet achieved the highest fidelity as the core engine in the proposed MAS framework, outperforming Gemini 2.5 Pro and DeepSeek-R1. SynthAgent thus provides a scalable and privacy-preserving framework for exploring patient journeys, behavioral dynamics, and decision-making processes in both medical and psychological domains.

Foundation models are becoming valuable tools in medicine. Yet despite their promise, the best way to leverage Large Language Models (LLMs) in complex medical tasks remains an open question. We introduce a novel multi-agent framework, named Medical Decision-making Agents (MDAgents) that helps address this gap by automatically assigning a collaboration structure to a team of LLMs. The assigned solo or group collaboration structure is tailored to the medical task at hand, emulating real-world medical decision-making processes adapted to tasks of varying complexities. We evaluate our framework and baseline methods using state-of-the-art LLMs across a suite of real-world medical knowledge and medical diagnosis benchmarks, including a comparison of LLMs' medical complexity classification against human physicians. MDAgents achieved the best performance in seven out of ten benchmarks on tasks requiring an understanding of medical knowledge and multi-modal reasoning, showing a significant improvement of up to 4.2% (p < 0.05) compared to previous methods' best performances. Ablation studies reveal that MDAgents effectively determines medical complexity to optimize for efficiency and accuracy across diverse medical tasks. Notably, the combination of moderator review and external medical knowledge in group collaboration resulted in an average accuracy improvement of 11.8%. Our code can be found at https://github.com/mitmedialab/MDAgents.

Multi-Modal Large Language Models (MLLMs), despite being successful, exhibit limited generality and often fall short when compared to specialized models. Recently, LLM-based agents have been developed to address these challenges by selecting appropriate specialized models as tools based on user inputs. However, such advancements have not been extensively explored within the medical domain. To bridge this gap, this paper introduces the first agent explicitly designed for the medical field, named Multi-modal Medical Agent (MMedAgent). We curate an instruction-tuning dataset comprising six medical tools solving seven tasks across five modalities, enabling the agent to choose the most suitable tools for a given task. Comprehensive experiments demonstrate that MMedAgent achieves superior performance across a variety of medical tasks compared to state-of-the-art open-source methods and even the closed-source model, GPT-4o. Furthermore, MMedAgent exhibits efficiency in updating and integrating new medical tools. Codes and models are all available.

Effective guardrails are essential for safely deploying LLM-based agents in critical applications. Despite recent advances, existing guardrails suffer from two fundamental limitations: (i) they apply uniform guardrail policies to all users, ignoring that the same agent behavior can harm some users while being safe for others; (ii) they check each response in isolation, missing how risks evolve and accumulate across multiple interactions. To solve these issues, we propose PSG-Agent, a personalized and dynamic system for LLM-based agents. First, PSG-Agent creates personalized guardrails by mining the interaction history for stable traits and capturing real-time states from current queries, generating user-specific risk thresholds and protection strategies. Second, PSG-Agent implements continuous monitoring across the agent pipeline with specialized guards, including Plan Monitor, Tool Firewall, Response Guard, Memory Guardian, that track cross-turn risk accumulation and issue verifiable verdicts. Finally, we validate PSG-Agent in multiple scenarios including healthcare, finance, and daily life automation scenarios with diverse user profiles. It significantly outperform existing agent guardrails including LlamaGuard3 and AGrail, providing an executable and auditable path toward personalized safety for LLM-based agents.