# Role-Specialized Mixture-of-Agents with Open-Weight LLMs for Clinical Prediction

arXiv: https://arxiv.org/abs/2608.22176 · HTML: https://mlsanity.com/paper/2608.22176/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical and scientific domain agents, one of 16 directions in LLM agents and tool use.
- Builds on 12 of its 18 references that are in the map.
- First posted on arXiv 23 Aug 2026.

## 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, 12 of 12)

- [Qwen2.5 Technical Report](https://mlsanity.com/paper/2412.15115/) (2024)
- [Improving Factuality and Reasoning in Language Models through Multiagent Debate](https://mlsanity.com/paper/2305.14325/) (2023)
- [Mixture-of-Agents Enhances Large Language Model Capabilities](https://mlsanity.com/paper/2406.04692/) (2024)
- [Benchmarking Retrieval-Augmented Generation for Medicine](https://mlsanity.com/paper/2402.13178/) (2024)
- [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)
- [MedCPT: Contrastive Pre-trained Transformers with Large-scale PubMed Search Logs for Zero-shot Biomedical Information Retrieval](https://mlsanity.com/paper/2307.00589/) (2023)
- [GRAM: Graph-based Attention Model for Healthcare Representation Learning](https://mlsanity.com/paper/1611.07012/) (2016)
- [GraphCare: Enhancing Healthcare Predictions with Personalized Knowledge Graphs](https://mlsanity.com/paper/2305.12788/) (2023)
- [Reasoning-Enhanced Healthcare Predictions with Knowledge Graph Community Retrieval](https://mlsanity.com/paper/2410.04585/) (2024)
- [ColaCare: Enhancing Electronic Health Record Modeling through Large Language Model-Driven Multi-Agent Collaboration](https://mlsanity.com/paper/2410.02551/) (2024)
- [RAM-EHR: Retrieval Augmentation Meets Clinical Predictions on Electronic Health Records](https://mlsanity.com/paper/2403.00815/) (2024)

## Abstract (arXiv)

Large Language Models (LLMs) are increasingly applied to clinical prediction tasks such as in-hospital mortality and readmission from electronic health records (EHRs). Privacy and compliance constraints motivate systems that can be deployed locally, which has increased interest in open-weight multi-agent designs. However, most medical multi-agent systems are evaluated as a single block, leaving unclear which agent role contributes to prediction and whether retrieval drives observed gains. We study a role-specialized Mixture-of-Agents (MoA) that combines medical knowledge retrieval with contrastive similar-patient reasoning. By varying the role design while holding the retrieval setup fixed, we localize the main effect to the final integrator. Pairing large open-weight analysts with a small open-weight integrator matches closed-model prompting on F1 for mortality prediction while flagging substantially more true high-risk patients. Mechanism analysis shows the role assignment directly yields a high-recall operating point without threshold tuning. The effect is task-dependent, with smaller gains for readmission because the available records correlate weakly with this longer-horizon outcome. These results position role design as a key factor in privacy-constrained, training-free clinical LLM prediction.