# ARISE: Adaptive Agentic Reasoning with Image-grounded Self-Evaluation for Interpretable IBD Assessment

arXiv: https://arxiv.org/abs/2610.04777 · HTML: https://mlsanity.com/paper/2610.04777/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 14 of its 38 references that are in the map.
- First posted on arXiv 3 Oct 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, 14 of 14)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Qwen2-VL: Enhancing Vision-Language Model's Perception of the World at Any Resolution](https://mlsanity.com/paper/2409.12191/) (2024)
- [Gemini 2.5: Pushing the Frontier with Advanced Reasoning, Multimodality, Long Context, and Next Generation Agentic Capabilities](https://mlsanity.com/paper/2507.06261/) (2025)
- [Self-Refine: Iterative Refinement with Self-Feedback](https://mlsanity.com/paper/2303.17651/) (2023)
- [DeBERTa: Decoding-enhanced BERT with Disentangled Attention](https://mlsanity.com/paper/2006.03654/) (2020)
- [MMBench: Is Your Multi-modal Model an All-around Player?](https://mlsanity.com/paper/2307.06281/) (2023)
- [In-Context Retrieval-Augmented Language Models](https://mlsanity.com/paper/2302.00083/) (2023)
- [Logic-LM: Empowering Large Language Models with Symbolic Solvers for Faithful Logical Reasoning](https://mlsanity.com/paper/2305.12295/) (2023)
- [AgentClinic: a multimodal agent benchmark to evaluate AI in simulated clinical environments](https://mlsanity.com/paper/2405.07960/) (2024)
- [LINC: A Neurosymbolic Approach for Logical Reasoning by Combining Language Models with First-Order Logic Provers](https://mlsanity.com/paper/2310.15164/) (2023)
- [Treble Counterfactual VLMs: A Causal Approach to Hallucination](https://mlsanity.com/paper/2503.06169/) (2025)
- [Overconfidence and Calibration in Medical VQA: Empirical Findings and Hallucination-Aware Mitigation](https://mlsanity.com/paper/2604.02543/) (2026)
- [Retrieval-augmented in-context learning for multimodal large language models in disease classification](https://mlsanity.com/paper/2505.02087/) (2025)
- [Test-Time-Scaling for Zero-Shot Diagnosis with Visual-Language Reasoning](https://mlsanity.com/paper/2506.11166/) (2025)

## Abstract (arXiv)

Inflammatory bowel disease (IBD) requires frequent imaging-based assessment, yet interpretation of modalities such as wireless capsule endoscopy (WCE) and intestinal ultrasound remains heavily dependent on specialist expertise. Vision-Language Models (VLMs) demonstrate significant potential in multimodal medical image analysis, but their clinical adoption is hindered by their insufficient domain-specific reasoning, susceptibility to hallucination, scarcity of high quality training data in fine-grained diagnostics and limited interpretability. We introduce ARISE (Adaptive Agentic Reasoning with Image-grounded Self-Evaluation), an autonomous planning framework that models few-shot medical image understanding as a sequential agentic workflow. ARISE structures agent execution into a transparent 5-stage workflow: hypothesis generation, image-grounded evidence summarization, evidence-conditioned refinement, symbolic verification, and final diagnosis. We apply ARISE to IBD assessment across two independent patient cohorts: wireless capsule endoscopy (WCE) images for Crohn's disease and B-mode ultrasound data for ulcerative colitis. ARISE consistently improves diagnostic performance over baseline VLMs while exposing where reasoning succeeds or fails, providing a more interpretable basis for clinical decision support and realistic deployment.