# BLUEmed: Retrieval-Augmented Multi-Agent Debate for Clinical Error Detection

arXiv: https://arxiv.org/abs/2604.10389 · HTML: https://mlsanity.com/paper/2604.10389/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical and biomedical RAG, one of 15 directions in Retrieval-augmented generation.
- Builds on 39 of its 60 references that are in the map.
- First posted on arXiv 12 Apr 2026.

## Placed in

- 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 39)

- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [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)
- [GPT-4o System Card](https://mlsanity.com/paper/2410.21276/) (2024)
- [Retrieval-Augmented Generation for Large Language Models: A Survey](https://mlsanity.com/paper/2312.10997/) (2023)
- [Self-RAG: Learning to Retrieve, Generate, and Critique through Self-Reflection](https://mlsanity.com/paper/2310.11511/) (2023)
- [Improving Factuality and Reasoning in Language Models through Multiagent Debate](https://mlsanity.com/paper/2305.14325/) (2023)
- [Calibrate Before Use: Improving Few-Shot Performance of Language Models](https://mlsanity.com/paper/2102.09690/) (2021)
- [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)
- [Retrieval Augmentation Reduces Hallucination in Conversation](https://mlsanity.com/paper/2104.07567/) (2021)
- [Making Retrieval-Augmented Language Models Robust to Irrelevant Context](https://mlsanity.com/paper/2310.01558/) (2023)
- [Benchmarking Retrieval-Augmented Generation for Medicine](https://mlsanity.com/paper/2402.13178/) (2024)
- [RAGTruth: A Hallucination Corpus for Developing Trustworthy Retrieval-Augmented Language Models](https://mlsanity.com/paper/2401.00396/) (2023)
- [Chain-of-Note: Enhancing Robustness in Retrieval-Augmented Language Models](https://mlsanity.com/paper/2311.09210/) (2023)
- [Should we be going MAD? A Look at Multi-Agent Debate Strategies for LLMs](https://mlsanity.com/paper/2311.17371/) (2023)
- [On scalable oversight with weak LLMs judging strong LLMs](https://mlsanity.com/paper/2407.04622/) (2024)
- [Examining Inter-Consistency of Large Language Models Collaboration: An In-depth Analysis via Debate](https://mlsanity.com/paper/2305.11595/) (2023)
- [Gemini Embedding: Generalizable Embeddings from Gemini](https://mlsanity.com/paper/2503.07891/) (2025)
- [Enhancing Noise Robustness of Retrieval-Augmented Language Models with Adaptive Adversarial Training](https://mlsanity.com/paper/2405.20978/) (2024)
- [MEDEC: A Benchmark for Medical Error Detection and Correction in Clinical Notes](https://mlsanity.com/paper/2412.19260/) (2024)
- [RAGChecker: A Fine-grained Framework for Diagnosing Retrieval-Augmented Generation](https://mlsanity.com/paper/2408.08067/) (2024)
- [R2-Guard: Robust Reasoning Enabled LLM Guardrail via Knowledge-Enhanced Logical Reasoning](https://mlsanity.com/paper/2407.05557/) (2024)
- [RAG-Fusion: a New Take on Retrieval-Augmented Generation](https://mlsanity.com/paper/2402.03367/) (2024)
- [MedHallu: A Comprehensive Benchmark for Detecting Medical Hallucinations in Large Language Models](https://mlsanity.com/paper/2502.14302/) (2025)
- [Multi-Agent Debate for LLM Judges with Adaptive Stability Detection](https://mlsanity.com/paper/2510.12697/) (2025)
- [Comparing Two Model Designs for Clinical Note Generation; Is an LLM a Useful Evaluator of Consistency?](https://mlsanity.com/paper/2404.06503/) (2024)
- [Retrieval-Augmented Generation with Estimation of Source Reliability](https://mlsanity.com/paper/2410.22954/) (2024)
- [SLOT: Structuring the Output of Large Language Models](https://mlsanity.com/paper/2505.04016/) (2025)
- [Selective Generation for Controllable Language Models](https://mlsanity.com/paper/2307.09254/) (2023)

## Abstract (arXiv)

Terminology substitution errors in clinical notes, where one medical term is replaced by a linguistically valid but clinically different term, pose a persistent challenge for automated error detection in healthcare. We introduce BLUEmed, a multi-agent debate framework augmented with hybrid Retrieval-Augmented Generation (RAG) that combines evidence-grounded reasoning with multi-perspective verification for clinical error detection. BLUEmed decomposes each clinical note into focused sub-queries, retrieves source-partitioned evidence through dense, sparse, and online retrieval, and assigns two domain expert agents distinct knowledge bases to produce independent analyses; when the experts disagree, a structured counter-argumentation round and cross-source adjudication resolve the conflict, followed by a cascading safety layer that filters common false-positive patterns. We evaluate BLUEmed on a clinical terminology substitution detection benchmark under both zero-shot and few-shot prompting with multiple backbone models spanning proprietary and open-source families. Experimental results show that BLUEmed achieves the best accuracy (69.13%), ROC-AUC (74.45%), and PR-AUC (72.44%) under few-shot prompting, outperforming both single-agent RAG and debate-only baselines. Further analyses across six backbone models and two prompting strategies confirm that retrieval augmentation and structured debate are complementary, and that the framework benefits most from models with sufficient instruction-following and clinical language understanding.