Coding-Free and Privacy-Preserving MCP Framework for Clinical Agentic Research Intelligence System

Clinical research involves labor-intensive processes such as study design, cohort construction, model development, and documentation, requiring domain expertise, programming skills, and access to sensitive patient data. These demands create barriers for clinicians and external researchers conducting data-driven studies. To overcome these limitations, we developed a Clinical Agentic Research Intelligence System (CARIS) that automates the clinical research workflow while preserving data privacy, enabling comprehensive studies without direct access to raw data. CARIS integrates Large Language Models (LLMs) with modular tools via the Model Context Protocol (MCP), enabling natural language-driven orchestration of appropriate tools. Databases remain securely within the MCP server, and users access only the outputs and final research reports. Based on user intent, CARIS automatically executes the full pipeline: research planning, literature search, cohort construction, Institutional Review Board (IRB) documentation, Vibe Machine Learning (ML), and report generation, with iterative human-in-the-loop refinement. We evaluated CARIS on three heterogeneous datasets with distinct clinical tasks. Research plans and IRB documents were finalized within three to four iterations, using evidence from literature and data. The system supported Vibe ML by exploring feature-model combinations, ranking the top ten models, and generating performance visualizations. Final reports showed high completeness based on a checklist derived from the TRIPOD+AI framework, achieving 96% coverage in LLM evaluation and 82% in human evaluation. CARIS demonstrates that agentic AI can transform clinical hypotheses into executable research workflows across heterogeneous datasets. By eliminating the need for coding and direct data access, the system lowers barriers and bridges public and private clinical data environments.

Tiered Agentic Oversight: A Hierarchical Multi-Agent System for AI Safety in Healthcare

Current large language models (LLMs), despite their power, can introduce safety risks in clinical settings due to limitations such as poor error detection and single point of failure. To address this, we propose Tiered Agentic Oversight (TAO), a hierarchical multi-agent framework that enhances AI safety through layered, automated supervision. Inspired by clinical hierarchies (e.g., nurse, physician, specialist), TAO conducts agent routing based on task complexity and agent roles. Leveraging automated inter- and intra-tier collaboration and role-playing, TAO creates a robust safety framework. Ablation studies reveal that TAO's superior performance is driven by its adaptive tiered architecture, which improves safety by over 3.2% compared to static single-tier configurations; the critical role of its lower tiers, particularly tier 1, whose removal most significantly impacts safety; and the strategic assignment of more advanced LLM to these initial tiers, which boosts performance by over 2% compared to less optimal allocations while achieving near-peak safety efficiently. These mechanisms enable TAO to outperform single-agent and multi-agent frameworks in 4 out of 5 healthcare safety benchmarks, showing up to an 8.2% improvement over the next-best methods in these evaluations. Finally, we validate TAO via an auxiliary clinician-in-the-loop study where integrating expert feedback improved TAO's accuracy in medical triage from 40% to 60%.

BehaviorSFT: Behavioral Token Conditioning for Clinical Agents Across the Proactivity Spectrum

Large Language Models (LLMs) as clinical agents require careful behavioral adaptation. While adept at reactive tasks (e.g., diagnosis reasoning), LLMs often struggle with proactive engagement, like unprompted identification of critical missing information or risks. We introduce BehaviorBench, a comprehensive dataset to evaluate agent behaviors across a clinical assistance spectrum, ranging from reactive query responses to proactive interventions (e.g., clarifying ambiguities, flagging overlooked critical data). Our BehaviorBench experiments reveal LLMs' inconsistent proactivity. To address this, we propose BehaviorSFT, a novel training strategy using behavioral tokens to explicitly condition LLMs for dynamic behavioral selection along this spectrum. BehaviorSFT boosts performance, achieving up to 97.3% overall Macro F1 on BehaviorBench and improving proactive task scores (e.g., from 95.0% to 96.5% for Qwen2.5-7B-Ins). Crucially, blind clinician evaluations confirmed BehaviorSFT-trained agents exhibit more realistic clinical behavior, striking a superior balance between helpful proactivity (e.g., timely, relevant suggestions) and necessary restraint (e.g., avoiding over-intervention) versus standard fine-tuning or explicit instructed agents.

VocalAgent: Large Language Models for Vocal Health Diagnostics with Safety-Aware Evaluation

Vocal health plays a crucial role in peoples' lives, significantly impacting their communicative abilities and interactions. However, despite the global prevalence of voice disorders, many lack access to convenient diagnosis and treatment. This paper introduces VocalAgent, an audio large language model (LLM) to address these challenges through vocal health diagnosis. We leverage Qwen-Audio-Chat fine-tuned on three datasets collected in-situ from hospital patients, and present a multifaceted evaluation framework encompassing a safety assessment to mitigate diagnostic biases, cross-lingual performance analysis, and modality ablation studies. VocalAgent demonstrates superior accuracy on voice disorder classification compared to state-of-the-art baselines. Its LLM-based method offers a scalable solution for broader adoption of health diagnostics, while underscoring the importance of ethical and technical validation.

A Demonstration of Adaptive Collaboration of Large Language Models for Medical Decision-Making

Medical Decision-Making (MDM) is a multi-faceted process that requires clinicians to assess complex multi-modal patient data patient, often collaboratively. Large Language Models (LLMs) promise to streamline this process by synthesizing vast medical knowledge and multi-modal health data. However, single-agent are often ill-suited for nuanced medical contexts requiring adaptable, collaborative problem-solving. Our MDAgents addresses this need by dynamically assigning collaboration structures to LLMs based on task complexity, mimicking real-world clinical collaboration and decision-making. This framework improves diagnostic accuracy and supports adaptive responses in complex, real-world medical scenarios, making it a valuable tool for clinicians in various healthcare settings, and at the same time, being more efficient in terms of computing cost than static multi-agent decision making methods.