The paper introduces AGVF, a multi‑agent framework for generating medical‑necessity appeals that must adhere to payer policy and evidence constraints. AGVF treats appeal synthesis as a Constrained Markov Decision Process involving five agents—policy formalization, evidence retrieval, gap analysis, adversarial critique, and gated synthesis—and proves that refining the policy constraint graph monotonically reduces evidence deficiency. A deterministic citation‑grounding gate ensures no unsupported assertions enter the shared state, and validation on 1,000 synthetic cases shows zero citation violations and monotonic deficiency reduction.
arXiv:2606. 05463v1 Announce Type: new Abstract: Patient safety event triage, determining whether a clinical event is reportable under jurisdiction-specific policy, is a high-stakes task typically performed manually by patient safety experts.
The paper introduces MIMIC-DOS, a dataset derived from MIMIC-IV that focuses on ICU cases where patient symptoms and medical signs are discordant. It presents CARE, a privacy‑compliant multi‑stage agentic reasoning framework that uses a proprietary LLM to generate structured categories and transitions, while a local LLM performs evidence acquisition and decision‑making. In retrospective evaluations on MIMIC‑DOS, CARE outperforms other LLMs and agentic workflows, demonstrating stronger handling of conflicting clinical evidence while preserving patient privacy.
arXiv:2606. 14149v1 Announce Type: new Abstract: Large Language Models (LLMs) are increasingly deployed in healthcare settings, yet their tendency to hallucinate poses risks when clinical decisions are involved.
arXiv:2606. 28692v1 Announce Type: new Abstract: Treatment reasoning underpins every therapeutic decision, integrating disease context, comorbidities, medications, contraindications, and evolving biomedical knowledge to select an appropriate therapy.
arXiv:2608. 07796v1 Announce Type: new Abstract: Large language models perform strongly on medical knowledge benchmarks, but reliable clinical deployment requires agents to conduct defensible investigations over heterogeneous, longitudinal records: determining what evidence is needed, retrieving and reconciling structured and free-text data, grounding conclusions in verifiable evidence, and deferring cases that cannot be resolved reliably.
arXiv:2609.05531v1 Announce Type: cross Abstract: No specification says how a governed autotelic AI agent organization, where agents pursue self-generated goals inside guardrails, should be designed...
The paper introduces CLEAR, an agentic framework designed to improve the reliability of large language models (LLMs) in medical contexts by adjudicating evidence from multiple sources. CLEAR generates candidate answers from three distinct pathways—parametric knowledge, locally curated corpora, and dynamically retrieved evidence—and then uses an aggregation verifier to evaluate agreement and conflict among these sources. An adjudication module decides whether to preserve or revise conclusions, employing override-guard and challenge-audit mechanisms, and initiates targeted follow-up searches when conflicts remain unresolved.
arXiv:2608. 14804v1 Announce Type: new Abstract: Large language models (LLMs) have become the dominant interface of clinical artificial intelligence, yet the interface they expose (text in, text out, one context window at a time) maintains no explicit, persistent, governed representation of what is currently true about a patient.
EviDx is a new framework for evidence-aware active diagnosis that pairs patient-specific diagnostic environments with a clinical scaffold and an observer-guided runtime harness. The framework constructs interactive environments from raw clinical cases, organizes role-specialized agents and evidence tools, and regulates diagnostic termination by tracking uncertainty and evidence coverage. Experiments demonstrate that EviDx improves diagnostic performance and process stability while revealing model-dependent capability boundaries.
arXiv:2606. 13262v1 Announce Type: new Abstract: Recent approaches combining Large Language Models (LLMs) with retrieval-augmented reasoning have shown promise for automated fact verification.
arXiv:2606. 16149v3 Announce Type: replace Abstract: Rare disease diagnosis depends on expert reasoning that is scarce and difficult to transfer; off-the-shelf large language models (LLMs) rank the correct disease first in only 35.
AI Morbidity and Mortality (AI M&M) is a structured, blameless framework designed to review clinical AI failures. It combines standardized case intake, evidence preservation, investigator reconstruction, tool‑in‑loop attribution, and corrective‑action tracking, classifying each event across four linked dimensions: Trigger, Mechanism, Clinical Pathway, and Corrective Action. The authors demonstrate the framework with five outpatient medication and clinical decision‑support cases, achieving full agreement among reviewers on all classification axes.