Daily Papers

Artificial intelligence holds great promise for expanding access to expert medical knowledge and reasoning. However, most evaluations of language models rely on static vignettes and multiple-choice questions that fail to reflect the complexity and nuance of evidence-based medicine in real-world settings. In clinical practice, physicians iteratively formulate and revise diagnostic hypotheses, adapting each subsequent question and test to what they've just learned, and weigh the evolving evidence before committing to a final diagnosis. To emulate this iterative process, we introduce the Sequential Diagnosis Benchmark, which transforms 304 diagnostically challenging New England Journal of Medicine clinicopathological conference (NEJM-CPC) cases into stepwise diagnostic encounters. A physician or AI begins with a short case abstract and must iteratively request additional details from a gatekeeper model that reveals findings only when explicitly queried. Performance is assessed not just by diagnostic accuracy but also by the cost of physician visits and tests performed. We also present the MAI Diagnostic Orchestrator (MAI-DxO), a model-agnostic orchestrator that simulates a panel of physicians, proposes likely differential diagnoses and strategically selects high-value, cost-effective tests. When paired with OpenAI's o3 model, MAI-DxO achieves 80% diagnostic accuracy--four times higher than the 20% average of generalist physicians. MAI-DxO also reduces diagnostic costs by 20% compared to physicians, and 70% compared to off-the-shelf o3. When configured for maximum accuracy, MAI-DxO achieves 85.5% accuracy. These performance gains with MAI-DxO generalize across models from the OpenAI, Gemini, Claude, Grok, DeepSeek, and Llama families. We highlight how AI systems, when guided to think iteratively and act judiciously, can advance diagnostic precision and cost-effectiveness in clinical care.

Agentic systems built on large language models (LLMs) offer promising capabilities for automating complex workflows in healthcare AI. We introduce mAIstro, an open-source, autonomous multi-agentic framework for end-to-end development and deployment of medical AI models. The system orchestrates exploratory data analysis, radiomic feature extraction, image segmentation, classification, and regression through a natural language interface, requiring no coding from the user. Built on a modular architecture, mAIstro supports both open- and closed-source LLMs, and was evaluated using a large and diverse set of prompts across 16 open-source datasets, covering a wide range of imaging modalities, anatomical regions, and data types. The agents successfully executed all tasks, producing interpretable outputs and validated models. This work presents the first agentic framework capable of unifying data analysis, AI model development, and inference across varied healthcare applications, offering a reproducible and extensible foundation for clinical and research AI integration. The code is available at: https://github.com/eltzanis/mAIstro

Differential Diagnosis (DDx) is a fundamental yet complex aspect of clinical decision-making, in which physicians iteratively refine a ranked list of possible diseases based on symptoms, antecedents, and medical knowledge. While recent advances in large language models (LLMs) have shown promise in supporting DDx, existing approaches face key limitations, including single-dataset evaluations, isolated optimization of components, unrealistic assumptions about complete patient profiles, and single-attempt diagnosis. We introduce a Modular Explainable DDx Agent (MEDDxAgent) framework designed for interactive DDx, where diagnostic reasoning evolves through iterative learning, rather than assuming a complete patient profile is accessible. MEDDxAgent integrates three modular components: (1) an orchestrator (DDxDriver), (2) a history taking simulator, and (3) two specialized agents for knowledge retrieval and diagnosis strategy. To ensure robust evaluation, we introduce a comprehensive DDx benchmark covering respiratory, skin, and rare diseases. We analyze single-turn diagnostic approaches and demonstrate the importance of iterative refinement when patient profiles are not available at the outset. Our broad evaluation demonstrates that MEDDxAgent achieves over 10% accuracy improvements in interactive DDx across both large and small LLMs, while offering critical explainability into its diagnostic reasoning process.

Large language model (LLM)-powered agents are transforming digital devices from passive tools into proactive intelligent collaborators. However, most existing frameworks remain confined to a single OS or device, making cross-device workflows brittle and largely manual. We present UFO^3, a system that unifies heterogeneous endpoints, desktops, servers, mobile devices, and edge, into a single orchestration fabric. UFO^3 models each user request as a mutable TaskConstellation: a distributed DAG of atomic subtasks (TaskStars) with explicit control and data dependencies (TaskStarLines). The TaskConstellation continuously evolves as results stream in from distributed devices, enabling asynchronous execution, adaptive recovery, and dynamic optimization. A Constellation Orchestrator} executes tasks safely and asynchronously while applying dynamic DAG updates, and the Agent Interaction Protocol (AIP) provides persistent, low-latency channels for reliable task dispatch and result streaming. These designs dissolve the traditional boundaries between devices and platforms, allowing agents to collaborate seamlessly and amplify their collective intelligence. We evaluate UFO^3 on NebulaBench, a benchmark of 55 cross-device tasks across 5 machines and 10 categories. UFO^3 achieves 83.3% subtask completion, 70.9% task success, exposes parallelism with an average width of 1.72, and reduces end-to-end latency by 31% relative to a sequential baseline. Fault-injection experiments demonstrate graceful degradation and recovery under transient and permanent agent failures. These results show that UFO^3 achieves accurate, efficient, and resilient task orchestration across heterogeneous devices, uniting isolated agents into a coherent, adaptive computing fabric that extends across the landscape of ubiquitous computing.

Large language models are powerful generalists, yet solving deep and complex problems such as those of the Humanity's Last Exam (HLE) remains both conceptually challenging and computationally expensive. We show that small orchestrators managing other models and a variety of tools can both push the upper bound of intelligence and improve efficiency in solving difficult agentic tasks. We introduce ToolOrchestra, a method for training small orchestrators that coordinate intelligent tools. ToolOrchestra explicitly uses reinforcement learning with outcome-, efficiency-, and user-preference-aware rewards. Using ToolOrchestra, we produce Orchestrator, an 8B model that achieves higher accuracy at lower cost than previous tool-use agents while aligning with user preferences on which tools are to be used for a given query. On HLE, Orchestrator achieves a score of 37.1%, outperforming GPT-5 (35.1%) while being 2.5x more efficient. On tau2-Bench and FRAMES, Orchestrator surpasses GPT-5 by a wide margin while using only about 30% of the cost. Extensive analysis shows that Orchestrator achieves the best trade-off between performance and cost under multiple metrics, and generalizes robustly to unseen tools. These results demonstrate that composing diverse tools with a lightweight orchestration model is both more efficient and more effective than existing methods, paving the way for practical and scalable tool-augmented reasoning systems.

Medical imaging analysis faces challenges such as data scarcity, high annotation costs, and privacy concerns. This paper introduces the Medical AI for Synthetic Imaging (MAISI), an innovative approach using the diffusion model to generate synthetic 3D computed tomography (CT) images to address those challenges. MAISI leverages the foundation volume compression network and the latent diffusion model to produce high-resolution CT images (up to a landmark volume dimension of 512 x 512 x 768 ) with flexible volume dimensions and voxel spacing. By incorporating ControlNet, MAISI can process organ segmentation, including 127 anatomical structures, as additional conditions and enables the generation of accurately annotated synthetic images that can be used for various downstream tasks. Our experiment results show that MAISI's capabilities in generating realistic, anatomically accurate images for diverse regions and conditions reveal its promising potential to mitigate challenges using synthetic data.

Interpretability can improve the safety, transparency and trust of AI models, which is especially important in healthcare applications where decisions often carry significant consequences. Mechanistic interpretability, particularly through the use of sparse autoencoders (SAEs), offers a promising approach for uncovering human-interpretable features within large transformer-based models. In this study, we apply Matryoshka-SAE to the radiology-specialised multimodal large language model, MAIRA-2, to interpret its internal representations. Using large-scale automated interpretability of the SAE features, we identify a range of clinically relevant concepts - including medical devices (e.g., line and tube placements, pacemaker presence), pathologies such as pleural effusion and cardiomegaly, longitudinal changes and textual features. We further examine the influence of these features on model behaviour through steering, demonstrating directional control over generations with mixed success. Our results reveal practical and methodological challenges, yet they offer initial insights into the internal concepts learned by MAIRA-2 - marking a step toward deeper mechanistic understanding and interpretability of a radiology-adapted multimodal large language model, and paving the way for improved model transparency. We release the trained SAEs and interpretations: https://huggingface.co/microsoft/maira-2-sae.

At the heart of medicine lies the physician-patient dialogue, where skillful history-taking paves the way for accurate diagnosis, effective management, and enduring trust. Artificial Intelligence (AI) systems capable of diagnostic dialogue could increase accessibility, consistency, and quality of care. However, approximating clinicians' expertise is an outstanding grand challenge. Here, we introduce AMIE (Articulate Medical Intelligence Explorer), a Large Language Model (LLM) based AI system optimized for diagnostic dialogue. AMIE uses a novel self-play based simulated environment with automated feedback mechanisms for scaling learning across diverse disease conditions, specialties, and contexts. We designed a framework for evaluating clinically-meaningful axes of performance including history-taking, diagnostic accuracy, management reasoning, communication skills, and empathy. We compared AMIE's performance to that of primary care physicians (PCPs) in a randomized, double-blind crossover study of text-based consultations with validated patient actors in the style of an Objective Structured Clinical Examination (OSCE). The study included 149 case scenarios from clinical providers in Canada, the UK, and India, 20 PCPs for comparison with AMIE, and evaluations by specialist physicians and patient actors. AMIE demonstrated greater diagnostic accuracy and superior performance on 28 of 32 axes according to specialist physicians and 24 of 26 axes according to patient actors. Our research has several limitations and should be interpreted with appropriate caution. Clinicians were limited to unfamiliar synchronous text-chat which permits large-scale LLM-patient interactions but is not representative of usual clinical practice. While further research is required before AMIE could be translated to real-world settings, the results represent a milestone towards conversational diagnostic AI.

Multi-agent large language model frameworks are promising for complex multi step reasoning, yet existing systems remain weak for scientific and knowledge intensive domains due to static prompts and agent roles, rigid workflows, and homogeneous model reliance, leading to poor domain adaptation, limited reasoning flexibility, and high latency on heterogeneous or long-horizon scientific tasks. They also struggle to revise earlier decisions when intermediate reasoning diverges, reducing reliability in structured and calculation heavy settings. To address these limitations, we propose a scientific domain oriented interactive two tier multi model orchestration framework. A dedicated orchestration model analyzes each task, dynamically constructs a domain aware reasoning pipeline, and instantiates specialized expert agents with tailored prompts, while an execution model performs each step under generated role and instruction specifications. The orchestrator iteratively updates the pipeline based on intermediate feedback, enabling dynamic replanning, role reallocation, and prompt refinement across multi turn interactions, strengthening robustness and specialization for scientific reasoning through structured heterogeneous model collaboration. The framework is model agnostic and supports heterogeneous LLM integration with different capacities or costs, enabling flexible performance efficiency trade offs in practical scientific deployments. Experiments show consistent improvements over existing multi agent systems and strong baselines across diverse reasoning and scientific style benchmarks.

Autonomous AI research has advanced rapidly, but long-horizon ML research engineering remains difficult: agents must sustain coherent progress across task comprehension, environment setup, implementation, experimentation, and debugging over hours or days. We introduce AiScientist, a system for autonomous long-horizon engineering for ML research built on a simple principle: strong long-horizon performance requires both structured orchestration and durable state continuity. To this end, AiScientist combines hierarchical orchestration with a permission-scoped File-as-Bus workspace: a top-level Orchestrator maintains stage-level control through concise summaries and a workspace map, while specialized agents repeatedly re-ground on durable artifacts such as analyses, plans, code, and experimental evidence rather than relying primarily on conversational handoffs, yielding thin control over thick state. Across two complementary benchmarks, AiScientist improves PaperBench score by 10.54 points on average over the best matched baseline and achieves 81.82 Any Medal% on MLE-Bench Lite. Ablation studies further show that File-as-Bus protocol is a key driver of performance, reducing PaperBench by 6.41 points and MLE-Bench Lite by 31.82 points when removed. These results suggest that long-horizon ML research engineering is a systems problem of coordinating specialized work over durable project state, rather than a purely local reasoning problem.