# Agentic retrieval-augmented reasoning reshapes collective reliability under model variability in radiology question answering

arXiv: https://arxiv.org/abs/2603.06271 · HTML: https://mlsanity.com/paper/2603.06271/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 33 of its 81 references that are in the map.
- First posted on arXiv 6 Mar 2026.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)
- Retrieval-augmented generation / [Medical and biomedical RAG](https://mlsanity.com/rag/medical-and-biomedical-rag/)
- 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 33)

- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Qwen3 Technical Report](https://mlsanity.com/paper/2505.09388/) (2025)
- [ReAct: Synergizing Reasoning and Acting in Language Models](https://mlsanity.com/paper/2210.03629/) (2022)
- [DeepSeek-R1: Incentivizing Reasoning Capability in LLMs via Reinforcement Learning](https://mlsanity.com/paper/2501.12948/) (2025)
- [Qwen Technical Report](https://mlsanity.com/paper/2309.16609/) (2023)
- [Neural Machine Translation of Rare Words with Subword Units](https://mlsanity.com/paper/1508.07909/) (2015)
- [Benchmarking Neural Network Robustness to Common Corruptions and Perturbations](https://mlsanity.com/paper/1903.12261/) (2019)
- [Shortcut Learning in Deep Neural Networks](https://mlsanity.com/paper/2004.07780/) (2020)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Gemma 3 Technical Report](https://mlsanity.com/paper/2503.19786/) (2025)
- [Understanding Black-box Predictions via Influence Functions](https://mlsanity.com/paper/1703.04730/) (2017)
- [Can You Trust Your Model's Uncertainty? Evaluating Predictive Uncertainty Under Dataset Shift](https://mlsanity.com/paper/1906.02530/) (2019)
- [Language Models Don't Always Say What They Think: Unfaithful Explanations in Chain-of-Thought Prompting](https://mlsanity.com/paper/2305.04388/) (2023)
- [Attention is not Explanation](https://mlsanity.com/paper/1902.10186/) (2019)
- [Gemma: Open Models Based on Gemini Research and Technology](https://mlsanity.com/paper/2403.08295/) (2024)
- [GLM-5: from Vibe Coding to Agentic Engineering](https://mlsanity.com/paper/2602.15763/) (2026)
- [Kimi K2.5: Visual Agentic Intelligence](https://mlsanity.com/paper/2602.02276/) (2026)
- [Underspecification Presents Challenges for Credibility in Modern Machine Learning](https://mlsanity.com/paper/2011.03395/) (2020)
- [MedGemma Technical Report](https://mlsanity.com/paper/2507.05201/) (2025)
- [Does the Whole Exceed its Parts? The Effect of AI Explanations on Complementary Team Performance](https://mlsanity.com/paper/2006.14779/) (2020)
- [Revisiting the Calibration of Modern Neural Networks](https://mlsanity.com/paper/2106.07998/) (2021)
- [Faithful Chain-of-Thought Reasoning](https://mlsanity.com/paper/2301.13379/) (2023)
- [MiniMax-M1: Scaling Test-Time Compute Efficiently with Lightning Attention](https://mlsanity.com/paper/2506.13585/) (2025)
- [MiMo-V2-Flash Technical Report](https://mlsanity.com/paper/2601.02780/) (2026)
- [Med42-v2: A Suite of Clinical LLMs](https://mlsanity.com/paper/2408.06142/) (2024)
- [MedVersa: A Generalist Foundation Model for Medical Image Interpretation](https://mlsanity.com/paper/2405.07988/) (2024)
- [Large Language Models Streamline Automated Machine Learning for Clinical Studies](https://mlsanity.com/paper/2308.14120/) (2023)

## Built on by (most cited first, 2 of 2)

- [Safety and accuracy follow different scaling laws in clinical large language models](https://mlsanity.com/paper/2605.04039/) (2026)
- [Case-Grounded Evidence Verification: A Framework for Constructing Evidence-Sensitive Supervision](https://mlsanity.com/paper/2604.09537/) (2026)

## Abstract (arXiv)

Agentic retrieval-augmented reasoning pipelines are increasingly used to structure how large language models (LLMs) incorporate external evidence in clinical decision support. These systems iteratively retrieve curated domain knowledge and synthesize it into structured reports before answer selection. Although such pipelines can improve performance, their impact on reliability under model variability remains unclear. In real-world deployment, heterogeneous models may align, diverge, or synchronize errors in ways not captured by accuracy. We evaluated 34 LLMs on 169 expert-curated publicly available radiology questions, comparing zero-shot inference with a radiology-specific multi-step agentic retrieval condition in which all models received identical structured evidence reports derived from curated radiology knowledge. Agentic inference reduced inter-model decision dispersion (median entropy 0.48 vs. 0.13) and increased robustness of correctness across models (mean 0.74 vs. 0.81). Majority consensus also increased overall (P<0.001). Consensus strength and robust correctness remained correlated under both strategies (rho=0.88 for zero-shot; rho=0.87 for agentic), although high agreement did not guarantee correctness. Response verbosity showed no meaningful association with correctness. Among 572 incorrect outputs, 72% were associated with moderate or high clinically assessed severity, although inter-rater agreement was low (kappa=0.02). Agentic retrieval therefore was associated with more concentrated decision distributions, stronger consensus, and higher cross-model robustness of correctness. These findings suggest that evaluating agentic systems through accuracy or agreement alone may not always be sufficient, and that complementary analyses of stability, cross-model robustness, and potential clinical impact are needed to characterize reliability under model variability.