# ClinicalAgent: Clinical Trial Multi-Agent System with Large Language Model-based Reasoning

arXiv: https://arxiv.org/abs/2404.14777 · HTML: https://mlsanity.com/paper/2404.14777/

## Key facts

- Cited by 31 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 13 of its 27 references that are in the map.
- First posted on arXiv 23 Apr 2024.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)
- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 13 of 13)

- [Measuring Massive Multitask Language Understanding](https://mlsanity.com/paper/2009.03300/) (2020)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [BioGPT: Generative Pre-trained Transformer for Biomedical Text Generation and Mining](https://mlsanity.com/paper/2210.10341/) (2022)
- [Can large language models reason about medical questions?](https://mlsanity.com/paper/2207.08143/) (2022)
- [HEAD-QA: A Healthcare Dataset for Complex Reasoning](https://mlsanity.com/paper/1906.04701/) (2019)
- [HINT: Hierarchical Interaction Network for Trial Outcome Prediction Leveraging Web Data](https://mlsanity.com/paper/2102.04252/) (2021)
- [COMPOSE: Cross-Modal Pseudo-Siamese Network for Patient Trial Matching](https://mlsanity.com/paper/2006.08765/) (2020)
- [Uncertainty Quantification on Clinical Trial Outcome Prediction](https://mlsanity.com/paper/2401.03482/) (2024)
- [Deep Learning based Multi-Label Image Classification of Protest Activities](https://mlsanity.com/paper/2301.04212/) (2023)
- [TrialDura: Hierarchical Attention Transformer for Interpretable Clinical Trial Duration Prediction](https://mlsanity.com/paper/2404.13235/) (2024)

## Built on by (most cited first, 30 of 31)

- [Latent Collaboration in Multi-Agent Systems](https://mlsanity.com/paper/2511.20639/) (2025)
- [LLM-MedQA: Enhancing Medical Question Answering through Case Studies in Large Language Models](https://mlsanity.com/paper/2501.05464/) (2024)
- [AgentDistill: Training-Free Agent Distillation with Generalizable MCP Boxes](https://mlsanity.com/paper/2506.14728/) (2025)
- [GraphRAG under Fire](https://mlsanity.com/paper/2501.14050/) (2025)
- [ReflecTool: Towards Reflection-Aware Tool-Augmented Clinical Agents](https://mlsanity.com/paper/2410.17657/) (2024)
- [Medical Reasoning in the Era of LLMs: A Systematic Review of Enhancement Techniques and Applications](https://mlsanity.com/paper/2508.00669/) (2025)
- [Code2MCP: Transforming Code Repositories into MCP Services](https://mlsanity.com/paper/2509.05941/) (2025)
- [AUTOCT: Automating Interpretable Clinical Trial Prediction with LLM Agents](https://mlsanity.com/paper/2506.04293/) (2025)
- [Autonomous Research Agents: A Survey of AI Scientists and the Verification Gap](https://mlsanity.com/paper/2608.05179/) (2026)
- [BioMamba: Domain-Adaptive Biomedical Language Models](https://mlsanity.com/paper/2408.02600/) (2024)
- [MedMMV: A Controllable Multimodal Multi-Agent Framework for Reliable and Verifiable Clinical Reasoning](https://mlsanity.com/paper/2509.24314/) (2025)
- [CXRAgent: Director-Orchestrated Multi-Stage Reasoning for Chest X-Ray Interpretation](https://mlsanity.com/paper/2510.21324/) (2025)
- [MTBBench: A Multimodal Sequential Clinical Decision-Making Benchmark in Oncology](https://mlsanity.com/paper/2511.20490/) (2025)
- [Retrieval-Reasoning Large Language Model-based Synthetic Clinical Trial Generation](https://mlsanity.com/paper/2410.12476/) (2024)
- [CFDLLMBench: A Benchmark Suite for Evaluating Large Language Models in Computational Fluid Dynamics](https://mlsanity.com/paper/2509.20374/) (2025)
- [StateBridge: Training-free Hidden-state Alignment for Latent Communication in LLM Multi-Agent Systems](https://mlsanity.com/paper/2608.13317/) (2026)
- [Agentic AutoSurvey: Let LLMs Survey LLMs](https://mlsanity.com/paper/2509.18661/) (2025)
- [Generative AI for Healthcare: Fundamentals, Challenges, and Perspectives](https://mlsanity.com/paper/2510.24551/) (2025)
- [Critique of Impure Reason: Unveiling the reasoning behaviour of medical Large Language Models](https://mlsanity.com/paper/2412.15748/) (2024)
- [Training-Free Multimodal Large Language Model Orchestration](https://mlsanity.com/paper/2508.10016/) (2025)
- [CT Open: An Open-Access, Uncontaminated, Live Platform for the Open Challenge of Clinical Trial Outcome Prediction](https://mlsanity.com/paper/2604.16742/) (2026)
- [Reviewing Clinical Knowledge in Medical Large Language Models: Training and Beyond](https://mlsanity.com/paper/2502.20988/) (2025)
- [MedCoAct: Confidence-Aware Multi-Agent Collaboration for Complete Clinical Decision](https://mlsanity.com/paper/2510.10461/) (2025)
- [Agentic AI in Healthcare & Medicine: A Seven-Dimensional Taxonomy for Empirical Evaluation of LLM-based Agents](https://mlsanity.com/paper/2602.04813/) (2026)
- [Expertise-aware Multi-LLM Recruitment and Collaboration for Medical Decision-Making](https://mlsanity.com/paper/2508.13754/) (2025)
- [MedGuards: Multi-Agent System for Reliable Medical Error Detection and Correction](https://mlsanity.com/paper/2606.25651/) (2026)
- [Agentic AI in medicine: architectures, applications, evaluation, and challenges for clinical translation](https://mlsanity.com/paper/2607.25489/) (2026)
- [Adaptive Arena-based Contestable Argumentative Network-of-Experts for Open-Ended Care Plan Coordination](https://mlsanity.com/paper/2608.05391/) (2026)
- [Coupled Graph--Policy Distillation for Personalized Medication Safety in Older Adults with Multimorbidity](https://mlsanity.com/paper/2608.09443/) (2026)
- [GxP-Agent: Process-DAG Topology for Reliable Clinical Trial Programming with LLM Agents](https://mlsanity.com/paper/2608.16890/) (2026)

## Abstract (arXiv)

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.