# A Knowledge-driven Adaptive Collaboration of LLMs for Enhancing Medical Decision-making

arXiv: https://arxiv.org/abs/2509.14998 · HTML: https://mlsanity.com/paper/2509.14998/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 16 of its 28 references that are in the map.
- First posted on arXiv 18 Sep 2025.

## Builds on (most cited first, 16 of 16)

- [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)
- [Encouraging Divergent Thinking in Large Language Models through Multi-Agent Debate](https://mlsanity.com/paper/2305.19118/) (2023)
- [ChatEval: Towards Better LLM-based Evaluators through Multi-Agent Debate](https://mlsanity.com/paper/2308.07201/) (2023)
- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [AgentVerse: Facilitating Multi-Agent Collaboration and Exploring Emergent Behaviors](https://mlsanity.com/paper/2308.10848/) (2023)
- [Mixture-of-Agents Enhances Large Language Model Capabilities](https://mlsanity.com/paper/2406.04692/) (2024)
- [Multi-Agent Collaboration Mechanisms: A Survey of LLMs](https://mlsanity.com/paper/2501.06322/) (2025)
- [MedAgents: Large Language Models as Collaborators for Zero-shot Medical Reasoning](https://mlsanity.com/paper/2311.10537/) (2023)
- [ReConcile: Round-Table Conference Improves Reasoning via Consensus among Diverse LLMs](https://mlsanity.com/paper/2309.13007/) (2023)
- [AutoAgents: A Framework for Automatic Agent Generation](https://mlsanity.com/paper/2309.17288/) (2023)
- [MediQ: Question-Asking LLMs and a Benchmark for Reliable Interactive Clinical Reasoning](https://mlsanity.com/paper/2406.00922/) (2024)
- [EvoAgent: Towards Automatic Multi-Agent Generation via Evolutionary Algorithms](https://mlsanity.com/paper/2406.14228/) (2024)
- [Cooperation, Competition, and Maliciousness: LLM-Stakeholders Interactive Negotiation](https://mlsanity.com/paper/2309.17234/) (2023)
- [Voting or Consensus? Decision-Making in Multi-Agent Debate](https://mlsanity.com/paper/2502.19130/) (2025)
- [MDTeamGPT: A Self-Evolving LLM-based Multi-Agent Framework for Multi-Disciplinary Team Medical Consultation](https://mlsanity.com/paper/2503.13856/) (2025)

## Built on by (most cited first, 3 of 3)

- [MedCoG: Maximizing LLM Inference Density in Medical Reasoning via Meta-Cognitive Regulation](https://mlsanity.com/paper/2602.07905/) (2026)
- [EviDx: Evidence-Aware Active Diagnosis with Scaffolded LLM Agents](https://mlsanity.com/paper/2608.24570/) (2026)
- [Pay for the Fault, Not the Flow: Label-Free In-Flow Multi-Agent Workflow Optimization](https://mlsanity.com/paper/2610.01017/) (2026)

## Abstract (arXiv)

Medical decision-making often involves integrating knowledge from multiple clinical specialties, typically achieved through multidisciplinary teams. Inspired by this collaborative process, recent work has leveraged large language models (LLMs) in multi-agent collaboration frameworks to emulate expert teamwork. While these approaches improve reasoning through agent interaction, they are limited by static, pre-assigned roles, which hinder adaptability and dynamic knowledge integration. To address these limitations, we propose KAMAC, a Knowledge-driven Adaptive Multi-Agent Collaboration framework that enables LLM agents to dynamically form and expand expert teams based on the evolving diagnostic context. KAMAC begins with one or more expert agents and then conducts a knowledge-driven discussion to identify and fill knowledge gaps by recruiting additional specialists as needed. This supports flexible, scalable collaboration in complex clinical scenarios, with decisions finalized through reviewing updated agent comments. Experiments on two real-world medical benchmarks demonstrate that KAMAC significantly outperforms both single-agent and advanced multi-agent methods, particularly in complex clinical scenarios (i.e., cancer prognosis) requiring dynamic, cross-specialty expertise. Our code is publicly available at: https://github.com/XiaoXiao-Woo/KAMAC.