# Thinking Like a Clinician: A Cognitive AI Agent for Clinical Diagnosis via Panoramic Profiling and Adversarial Debate

arXiv: https://arxiv.org/abs/2604.23605 · HTML: https://mlsanity.com/paper/2604.23605/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 19 of its 50 references that are in the map.
- First posted on arXiv 26 Apr 2026.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)
- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 19 of 19)

- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [A Survey of Large Language Models](https://mlsanity.com/paper/2303.18223/) (2023)
- [PaLM 2 Technical Report](https://mlsanity.com/paper/2305.10403/) (2023)
- [MedGemma Technical Report](https://mlsanity.com/paper/2507.05201/) (2025)
- [Towards Reasoning Era: A Survey of Long Chain-of-Thought for Reasoning Large Language Models](https://mlsanity.com/paper/2503.09567/) (2025)
- [A Survey of Large Language Models in Medicine: Progress, Application, and Challenge](https://mlsanity.com/paper/2311.05112/) (2023)
- [A Survey of LLM-based Agents in Medicine: How far are we from Baymax?](https://mlsanity.com/paper/2502.11211/) (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)
- [Baichuan-M2: Scaling Medical Capability with Large Verifier System](https://mlsanity.com/paper/2509.02208/) (2025)
- [MAM: Modular Multi-Agent Framework for Multi-Modal Medical Diagnosis via Role-Specialized Collaboration](https://mlsanity.com/paper/2506.19835/) (2025)
- [iMAD: Intelligent Multi-Agent Debate for Efficient and Accurate LLM Inference](https://mlsanity.com/paper/2511.11306/) (2025)
- [Medical large language models are easily distracted](https://mlsanity.com/paper/2504.01201/) (2025)
- [WSI-Agents: A Collaborative Multi-Agent System for Multi-Modal Whole Slide Image Analysis](https://mlsanity.com/paper/2507.14680/) (2025)
- [Clinical-R1: Empowering Large Language Models for Faithful and Comprehensive Reasoning with Clinical Objective Relative Policy Optimization](https://mlsanity.com/paper/2512.00601/) (2025)
- [MoodAngels: A Retrieval-augmented Multi-agent Framework for Psychiatry Diagnosis](https://mlsanity.com/paper/2506.03750/) (2025)
- [Beyond Detection: Exploring Evidence-based Multi-Agent Debate for Misinformation Intervention and Persuasion](https://mlsanity.com/paper/2511.07267/) (2025)
- [AI-MASLD Metabolic Dysfunction and Information Steatosis of Large Language Models in Unstructured Clinical Narratives](https://mlsanity.com/paper/2512.11544/) (2025)

## Built on by (most cited first, 1 of 1)

- [Safe to Stop? Risk-Constrained Stopping for Sequential Clinical Diagnosis Agents](https://mlsanity.com/paper/2609.09678/) (2026)

## Abstract (arXiv)

The application of large language models (LLMs) in clinical decision support faces significant challenges of "tunnel vision" and diagnostic hallucinations present in their processing unstructured electronic health records (EHRs). To address these challenges, we propose a novel chain-based clinical reasoning framework, called DxChain, which transforms the diagnostic workflow into an iterative process by mirroring a clinician's cognitive trajectory that consists of "Memory Anchoring", "Navigation" and "Verification" phases. DxChain introduces three key methodological innovations to elicit the potential of LLM: (i) a Profile-Then-Plan paradigm to mitigate cold-start hallucinations by establishing a panoramic patient baseline, (ii) a Medical Tree-of-Thoughts (Med-ToT) algorithm for strategic look ahead planning and resource aware navigation, and (iii) a Dialectical Diagnostic Verification procedure utilizing "Angel-Devil" adversarial debates to resolve complex evidence conflicts. Evaluated on two real world benchmarks, MIMIC-IV-Ext Cardiac Disease and MIMIC-IV-Ext CDM, DxChain achieves state-of-the-art performances in both diagnostic accuracy and logical consistency, offering a modular and reliable architecture for next-generation clinical AI. The code is at https://anonymous.4open.science/r/Dx-Chain.