# MDAgents: An Adaptive Collaboration of LLMs for Medical Decision-Making

arXiv: https://arxiv.org/abs/2404.15155 · HTML: https://mlsanity.com/paper/2404.15155/

## Key facts

- Cited by 163 papers in the map (data through 14 Oct 2026).
- Builds on 33 of its 82 references that are in the map.
- First posted on arXiv 22 Apr 2024.

## Builds on (most cited first, 30 of 33)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [Self-Consistency Improves Chain of Thought Reasoning in Language Models](https://mlsanity.com/paper/2203.11171/) (2022)
- [Measuring Mathematical Problem Solving With the MATH Dataset](https://mlsanity.com/paper/2103.03874/) (2021)
- [Large Language Models are Zero-Shot Reasoners](https://mlsanity.com/paper/2205.11916/) (2022)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [The Rise and Potential of Large Language Model Based Agents: A Survey](https://mlsanity.com/paper/2309.07864/) (2023)
- [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)
- [ALFWorld: Aligning Text and Embodied Environments for Interactive Learning](https://mlsanity.com/paper/2010.03768/) (2020)
- [Encouraging Divergent Thinking in Large Language Models through Multi-Agent Debate](https://mlsanity.com/paper/2305.19118/) (2023)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [Large Language Models](https://mlsanity.com/paper/2307.05782/) (2023)
- [Causal Reasoning and Large Language Models: Opening a New Frontier for Causality](https://mlsanity.com/paper/2305.00050/) (2023)
- [Benchmarking Retrieval-Augmented Generation for Medicine](https://mlsanity.com/paper/2402.13178/) (2024)
- [Can Generalist Foundation Models Outcompete Special-Purpose Tuning? Case Study in Medicine](https://mlsanity.com/paper/2311.16452/) (2023)
- [ReConcile: Round-Table Conference Improves Reasoning via Consensus among Diverse LLMs](https://mlsanity.com/paper/2309.13007/) (2023)
- [A Dynamic LLM-Powered Agent Network for Task-Oriented Agent Collaboration](https://mlsanity.com/paper/2310.02170/) (2023)
- [Adapted Large Language Models Can Outperform Medical Experts in Clinical Text Summarization](https://mlsanity.com/paper/2309.07430/) (2023)
- [Large Language Models are Few-Shot Clinical Information Extractors](https://mlsanity.com/paper/2205.12689/) (2022)
- [Improving Language Model Negotiation with Self-Play and In-Context Learning from AI Feedback](https://mlsanity.com/paper/2305.10142/) (2023)
- [GeneGPT: Augmenting Large Language Models with Domain Tools for Improved Access to Biomedical Information](https://mlsanity.com/paper/2304.09667/) (2023)
- [Meta-Prompting: Enhancing Language Models with Task-Agnostic Scaffolding](https://mlsanity.com/paper/2401.12954/) (2024)
- [Towards Accurate Differential Diagnosis with Large Language Models](https://mlsanity.com/paper/2312.00164/) (2023)
- [Benchmarking Large Language Models on Answering and Explaining Challenging Medical Questions](https://mlsanity.com/paper/2402.18060/) (2024)
- [EHRAgent: Code Empowers Large Language Models for Few-shot Complex Tabular Reasoning on Electronic Health Records](https://mlsanity.com/paper/2401.07128/) (2024)
- [Large Language Models for Supply Chain Optimization](https://mlsanity.com/paper/2307.03875/) (2023)
- [EHRXQA: A Multi-Modal Question Answering Dataset for Electronic Health Records with Chest X-ray Images](https://mlsanity.com/paper/2310.18652/) (2023)
- [Uncertainty of Thoughts: Uncertainty-Aware Planning Enhances Information Seeking in Large Language Models](https://mlsanity.com/paper/2402.03271/) (2024)

## Built on by (most cited first, 30 of 163)

- [Large Language Model Agent: A Survey on Methodology, Applications and Challenges](https://mlsanity.com/paper/2503.21460/) (2025)
- [From LLM Reasoning to Autonomous AI Agents: A Comprehensive Review](https://mlsanity.com/paper/2504.19678/) (2025)
- [Towards a Science of Scaling Agent Systems](https://mlsanity.com/paper/2512.08296/) (2025)
- [Agentic AI for Scientific Discovery: A Survey of Progress, Challenges, and Future Directions](https://mlsanity.com/paper/2503.08979/) (2025)
- [MedAgent-Pro: Towards Evidence-based Multi-modal Medical Diagnosis via Reasoning Agentic Workflow](https://mlsanity.com/paper/2503.18968/) (2025)
- [MedRAX: Medical Reasoning Agent for Chest X-ray](https://mlsanity.com/paper/2502.02673/) (2025)
- [MDocAgent: A Multi-Modal Multi-Agent Framework for Document Understanding](https://mlsanity.com/paper/2503.13964/) (2025)
- [An Agentic System for Rare Disease Diagnosis with Traceable Reasoning](https://mlsanity.com/paper/2506.20430/) (2025)
- [A Survey on the Optimization of Large Language Model-based Agents](https://mlsanity.com/paper/2503.12434/) (2025)
- [MedicalAgentsBench for Complex Medical Reasoning: Comparing Internalized Reasoning Models versus Externalized Agent-based Frameworks](https://mlsanity.com/paper/2503.07459/) (2025)
- [MMedAgent-RL: Optimizing Multi-Agent Collaboration for Multimodal Medical Reasoning](https://mlsanity.com/paper/2506.00555/) (2025)
- [BlindGuard: Safeguarding LLM-based Multi-Agent Systems under Unknown Attacks](https://mlsanity.com/paper/2508.08127/) (2025)
- [Medical World Model: Generative Simulation of Tumor Evolution for Treatment Planning](https://mlsanity.com/paper/2506.02327/) (2025)
- [PatientSim: A Persona-Driven Simulator for Realistic Doctor-Patient Interactions](https://mlsanity.com/paper/2505.17818/) (2025)
- [From Language to Action: A Review of Large Language Models as Autonomous Agents and Tool Users](https://mlsanity.com/paper/2508.17281/) (2025)
- [ClinicalLab: Aligning Agents for Multi-Departmental Clinical Diagnostics in the Real World](https://mlsanity.com/paper/2406.13890/) (2024)
- [Where Did It All Go Wrong? A Hierarchical Look into Multi-Agent Error Attribution](https://mlsanity.com/paper/2510.04886/) (2025)
- [MedAgentGym: A Scalable Agentic Training Environment for Code-Centric Reasoning in Biomedical Data Science](https://mlsanity.com/paper/2506.04405/) (2025)
- [LLM-Powered AI Agent Systems and Their Applications in Industry](https://mlsanity.com/paper/2505.16120/) (2025)
- [MedAide: Information Fusion and Anatomy of Medical Intents via LLM-based Agent Collaboration](https://mlsanity.com/paper/2410.12532/) (2024)
- [Cancer-Myth: Evaluating Large Language Models on Patient Questions with False Presuppositions](https://mlsanity.com/paper/2504.11373/) (2025)
- [PixelCraft: A Multi-Agent System for High-Fidelity Visual Reasoning on Structured Images](https://mlsanity.com/paper/2509.25185/) (2025)
- [Cascaded Language Models for Cost-effective Human-AI Decision-Making](https://mlsanity.com/paper/2506.11887/) (2025)
- [Enhancing Jailbreak Attacks on LLMs via Persona Prompts](https://mlsanity.com/paper/2507.22171/) (2025)
- [HealthFlow: A Self-Evolving AI Agent with Meta Planning for Autonomous Healthcare Research](https://mlsanity.com/paper/2508.02621/) (2025)
- [Evolving Medical Imaging Agents via Experience-driven Self-skill Discovery](https://mlsanity.com/paper/2603.05860/) (2026)
- [A Survey of Scaling in Large Language Model Reasoning](https://mlsanity.com/paper/2504.02181/) (2025)
- [Beyond Reactivity: Measuring Proactive Problem Solving in LLM Agents](https://mlsanity.com/paper/2510.19771/) (2025)
- [TAMA: A Human-AI Collaborative Thematic Analysis Framework Using Multi-Agent LLMs for Clinical Interviews](https://mlsanity.com/paper/2503.20666/) (2025)
- [MedSentry: Understanding and Mitigating Safety Risks in Medical LLM Multi-Agent Systems](https://mlsanity.com/paper/2505.20824/) (2025)

## Abstract (arXiv)

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.