Abstract:Multimodal clinical reasoning in the field of gastrointestinal (GI) oncology necessitates the integrated interpretation of endoscopic imagery, radiological data, and biochemical markers. Despite the evident potential exhibited by Multimodal Large Language Models (MLLMs), they frequently encounter challenges such as context dilution and hallucination when confronted with intricate, heterogeneous medical histories. In order to address these limitations, a hierarchical Multi-Agent Framework is proposed, which emulates the collaborative workflow of a human Multidisciplinary Team (MDT). The system attained a composite expert evaluation score of 4.60/5.00, thereby demonstrating a substantial improvement over the monolithic baseline. It is noteworthy that the agent-based architecture yielded the most substantial enhancements in reasoning logic and medical accuracy. The findings indicate that mimetic, agent-based collaboration provides a scalable, interpretable, and clinically robust paradigm for automated decision support in oncology.
Abstract:Recent advances in medical large language models (LLMs), multimodal models, and agents demand evaluation frameworks that reflect real clinical workflows and safety constraints. We present MedBench v4, a nationwide, cloud-based benchmarking infrastructure comprising over 700,000 expert-curated tasks spanning 24 primary and 91 secondary specialties, with dedicated tracks for LLMs, multimodal models, and agents. Items undergo multi-stage refinement and multi-round review by clinicians from more than 500 institutions, and open-ended responses are scored by an LLM-as-a-judge calibrated to human ratings. We evaluate 15 frontier models. Base LLMs reach a mean overall score of 54.1/100 (best: Claude Sonnet 4.5, 62.5/100), but safety and ethics remain low (18.4/100). Multimodal models perform worse overall (mean 47.5/100; best: GPT-5, 54.9/100), with solid perception yet weaker cross-modal reasoning. Agents built on the same backbones substantially improve end-to-end performance (mean 79.8/100), with Claude Sonnet 4.5-based agents achieving up to 85.3/100 overall and 88.9/100 on safety tasks. MedBench v4 thus reveals persisting gaps in multimodal reasoning and safety for base models, while showing that governance-aware agentic orchestration can markedly enhance benchmarked clinical readiness without sacrificing capability. By aligning tasks with Chinese clinical guidelines and regulatory priorities, the platform offers a practical reference for hospitals, developers, and policymakers auditing medical AI.