Chanwoo Park

Yubin Kim, Chanwoo Park, Hyewon Jeong et al. · mit

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.

Yubin Kim, Chanwoo Park, Hyewon Jeong et al.

Medical Decision-Making (MDM) is a multi-faceted process that requires clinicians to assess complex multi-modal patient data patient, often collaboratively. Large Language Models (LLMs) promise to streamline this process by synthesizing vast medical knowledge and multi-modal health data. However, single-agent are often ill-suited for nuanced medical contexts requiring adaptable, collaborative problem-solving. Our MDAgents addresses this need by dynamically assigning collaboration structures to LLMs based on task complexity, mimicking real-world clinical collaboration and decision-making. This framework improves diagnostic accuracy and supports adaptive responses in complex, real-world medical scenarios, making it a valuable tool for clinicians in various healthcare settings, and at the same time, being more efficient in terms of computing cost than static multi-agent decision making methods.

Yubin Kim, Zhiyuan Hu, Hyewon Jeong et al.

Large Language Models (LLMs) as clinical agents require careful behavioral adaptation. While adept at reactive tasks (e.g., diagnosis reasoning), LLMs often struggle with proactive engagement, like unprompted identification of critical missing information or risks. We introduce BehaviorBench, a comprehensive dataset to evaluate agent behaviors across a clinical assistance spectrum, ranging from reactive query responses to proactive interventions (e.g., clarifying ambiguities, flagging overlooked critical data). Our BehaviorBench experiments reveal LLMs' inconsistent proactivity. To address this, we propose BehaviorSFT, a novel training strategy using behavioral tokens to explicitly condition LLMs for dynamic behavioral selection along this spectrum. BehaviorSFT boosts performance, achieving up to 97.3% overall Macro F1 on BehaviorBench and improving proactive task scores (e.g., from 95.0% to 96.5% for Qwen2.5-7B-Ins). Crucially, blind clinician evaluations confirmed BehaviorSFT-trained agents exhibit more realistic clinical behavior, striking a superior balance between helpful proactivity (e.g., timely, relevant suggestions) and necessary restraint (e.g., avoiding over-intervention) versus standard fine-tuning or explicit instructed agents.

Yubin Kim, Hyewon Jeong, Chanwoo Park et al.

Large language models (LLMs) deployed as agents introduce significant safety risks in clinical settings due to their potential for error and single points of failure. We introduce Tiered Agentic Oversight (TAO), a hierarchical multi-agent system that enhances AI safety through layered, automated supervision. Inspired by clinical hierarchies (e.g., nurse-physician-specialist) in hospital, TAO routes tasks to specialized agents based on complexity, creating a robust safety framework through automated inter- and intra-tier communication and role-playing. Crucially, this hierarchical structure functions as an effective error-correction mechanism, absorbing up to 24% of individual agent errors before they can compound. Our experiments reveal TAO outperforms single-agent and other multi-agent systems on 4 out of 5 healthcare safety benchmarks, with up to an 8.2% improvement. Ablation studies confirm key design principles of the system: (i) its adaptive architecture is over 3% safer than static, single-tier configurations, and (ii) its lower tiers are indispensable, as their removal causes the most significant degradation in overall safety. Finally, we validated the system's synergy with human doctors in a user study where a physician, acting as the highest tier agent, provided corrective feedback that improved medical triage accuracy from 40% to 60%. Project Page: https://tiered-agentic-oversight.github.io/