# Medchain: Bridging the Gap Between LLM Agents and Clinical Practice with Interactive Sequence

arXiv: https://arxiv.org/abs/2412.01605 · HTML: https://mlsanity.com/paper/2412.01605/

## Key facts

- Cited by 17 papers in the map (data through 14 Oct 2026).
- Placed in Medical and scientific domain agents, one of 16 directions in LLM agents and tool use.
- Builds on 38 of its 68 references that are in the map.
- First posted on arXiv 2 Dec 2024.

## Placed in

- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 30 of 38)

- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [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)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [Reflexion: Language Agents with Verbal Reinforcement Learning](https://mlsanity.com/paper/2303.11366/) (2023)
- [Qwen2-VL: Enhancing Vision-Language Model's Perception of the World at Any Resolution](https://mlsanity.com/paper/2409.12191/) (2024)
- [InternVL: Scaling up Vision Foundation Models and Aligning for Generic Visual-Linguistic Tasks](https://mlsanity.com/paper/2312.14238/) (2023)
- [Gemma 2: Improving Open Language Models at a Practical Size](https://mlsanity.com/paper/2408.00118/) (2024)
- [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)
- [ChatDev: Communicative Agents for Software Development](https://mlsanity.com/paper/2307.07924/) (2023)
- [MedMCQA : A Large-scale Multi-Subject Multi-Choice Dataset for Medical domain Question Answering](https://mlsanity.com/paper/2203.14371/) (2022)
- [PathVQA: 30000+ Questions for Medical Visual Question Answering](https://mlsanity.com/paper/2003.10286/) (2020)
- [MedAgents: Large Language Models as Collaborators for Zero-shot Medical Reasoning](https://mlsanity.com/paper/2311.10537/) (2023)
- [Towards Generalist Biomedical AI](https://mlsanity.com/paper/2307.14334/) (2023)
- [AgentClinic: a multimodal agent benchmark to evaluate AI in simulated clinical environments](https://mlsanity.com/paper/2405.07960/) (2024)
- [HuatuoGPT, towards Taming Language Model to Be a Doctor](https://mlsanity.com/paper/2305.15075/) (2023)
- [Leveraging Pre-trained Large Language Models to Construct and Utilize World Models for Model-based Task Planning](https://mlsanity.com/paper/2305.14909/) (2023)
- [CMB: A Comprehensive Medical Benchmark in Chinese](https://mlsanity.com/paper/2308.08833/) (2023)
- [Benchmarking Large Language Models on Answering and Explaining Challenging Medical Questions](https://mlsanity.com/paper/2402.18060/) (2024)
- [ToolChain*: Efficient Action Space Navigation in Large Language Models with A* Search](https://mlsanity.com/paper/2310.13227/) (2023)
- [GMAI-MMBench: A Comprehensive Multimodal Evaluation Benchmark Towards General Medical AI](https://mlsanity.com/paper/2408.03361/) (2024)
- [Towards Building Multilingual Language Model for Medicine](https://mlsanity.com/paper/2402.13963/) (2024)
- [A Survey on Retrieval-Augmented Text Generation for Large Language Models](https://mlsanity.com/paper/2404.10981/) (2024)
- [OfficeBench: Benchmarking Language Agents across Multiple Applications for Office Automation](https://mlsanity.com/paper/2407.19056/) (2024)
- [Don't Generate, Discriminate: A Proposal for Grounding Language Models to Real-World Environments](https://mlsanity.com/paper/2212.09736/) (2022)
- [CoD, Towards an Interpretable Medical Agent using Chain of Diagnosis](https://mlsanity.com/paper/2407.13301/) (2024)
- [Towards Evaluating and Building Versatile Large Language Models for Medicine](https://mlsanity.com/paper/2408.12547/) (2024)

## Built on by (most cited first, 17 of 17)

- [Baichuan-M3: Modeling Clinical Inquiry for Reliable Medical Decision-Making](https://mlsanity.com/paper/2602.06570/) (2026)
- [Evolving Medical Imaging Agents via Experience-driven Self-skill Discovery](https://mlsanity.com/paper/2603.05860/) (2026)
- [CHI-Bench: Can AI Agents Automate End-to-End, Long-Horizon, Policy-Rich Healthcare Workflows?](https://mlsanity.com/paper/2605.16679/) (2026)
- [WSI-Agents: A Collaborative Multi-Agent System for Multi-Modal Whole Slide Image Analysis](https://mlsanity.com/paper/2507.14680/) (2025)
- [Inflated Excellence or True Performance? Rethinking Medical Diagnostic Benchmarks with Dynamic Evaluation](https://mlsanity.com/paper/2510.09275/) (2025)
- [MedEinst: Benchmarking the Einstellung Effect in Medical LLMs through Counterfactual Differential Diagnosis](https://mlsanity.com/paper/2601.06636/) (2026)
- [ClinicalAgents: Multi-Agent Orchestration for Clinical Decision Making with Dual-Memory](https://mlsanity.com/paper/2603.26182/) (2026)
- [The Path to Self-Evolving Clinical Systems: Scaling Medical Agents from Assistance to Autonomy](https://mlsanity.com/paper/2607.11175/) (2026)
- [Benchmarking Egocentric Clinical Intent Understanding Capability for Medical Multimodal Large Language Models](https://mlsanity.com/paper/2601.06750/) (2026)
- [Baichuan-M4: A Clinical-Grade Medical Agent System for Continuous Care](https://mlsanity.com/paper/2606.08982/) (2026)
- [Safe to Stop? Risk-Constrained Stopping for Sequential Clinical Diagnosis Agents](https://mlsanity.com/paper/2609.09678/) (2026)
- [Frozen Models, Evolving Expertise: Model-Agnostic Learning from Deployment Experience for Multimodal Medical AI](https://mlsanity.com/paper/2610.09146/) (2026)
- [CAREAgent: Clinical Agent with Structured Reasoning and Tool-Integrated for Order Generation](https://mlsanity.com/paper/2606.01094/) (2026)
- [MedBench v5: A Dynamic, Process-Oriented, and Hallucination-Aware Benchmark for Clinical Multimodal Models](https://mlsanity.com/paper/2606.24155/) (2026)
- [When Language Models Meet NeuroGraphs: Exploring Enhanced Agentic LLM Framework Towards Brain Network Analysis](https://mlsanity.com/paper/2607.22082/) (2026)
- [Adaptive Memory and Reflection Multi-Agent System for Medical Question Answering](https://mlsanity.com/paper/2608.19029/) (2026)
- [From Given to Gathered Evidence: Agentic Learning for Longitudinal Medical Reasoning](https://mlsanity.com/paper/2609.39566/) (2026)

## Abstract (arXiv)

Clinical decision making (CDM) is a complex, dynamic process crucial to healthcare delivery, yet it remains a significant challenge for artificial intelligence systems. While Large Language Model (LLM)-based agents have been tested on general medical knowledge using licensing exams and knowledge question-answering tasks, their performance in the CDM in real-world scenarios is limited due to the lack of comprehensive testing datasets that mirror actual medical practice. To address this gap, we present MedChain, a dataset of 12,163 clinical cases that covers five key stages of clinical workflow. MedChain distinguishes itself from existing benchmarks with three key features of real-world clinical practice: personalization, interactivity, and sequentiality. Further, to tackle real-world CDM challenges, we also propose MedChain-Agent, an AI system that integrates a feedback mechanism and a MCase-RAG module to learn from previous cases and adapt its responses. MedChain-Agent demonstrates remarkable adaptability in gathering information dynamically and handling sequential clinical tasks, significantly outperforming existing approaches.