LLM-guided MAP-Elites evolution improves medical decision pipelines at inference time
Researchers propose using LLM-guided MAP-Elites evolutionary search as an inference-time alternative to fine-tuning for adapting LLMs to clinical workflows, formulating triage, consultation, and image classification as evolutionary searches over executable artifacts. Across three medical settings, evolved programs substantially outperform manually designed baselines: triage accuracy improves from 77.3% to 87.1% and emergency recall from 0.60 to 0.97, with gains also shown on MIMIC-ESI, iCRAFTMD, and PneumoniaMNIST. The approach works across Llama-3, Qwen-3.5, and Gemma-4 backbones and produces interpretable program-level mechanisms rather than superficial prompt changes.
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ClaMPAPP: Hybrid LLM-ML system uses language models as interfaces for pediatric appendicitis diagnosis
Researchers introduce ClaMPAPP, a hybrid clinical decision support system that uses an LLM solely for structured feature extraction from free-text clinical notes, then passes validated features to an XGBoost classifier for final diagnosis. Evaluated on two independent German pediatric appendicitis cohorts, ClaMPAPP outperformed end-to-end LLM baselines on diagnostic performance and showed greater robustness to narrative reordering. The work formalizes an 'LLM-as-interface, ML-as-predictor' design pattern that separates natural-language usability from predictive inference, offering a more auditable pathway for clinical AI.
MLEvolve: Self-evolving multi-agent framework for automated ML algorithm discovery
MLEvolve is a new LLM-based multi-agent framework for end-to-end machine learning algorithm discovery, addressing limitations of existing MLE agents including information isolation and memoryless search. The system introduces Progressive MCGS (a graph-extended tree search), Retrospective Memory for experience accumulation, and decoupled strategic planning from code generation. Evaluated on MLE-Bench, it achieves state-of-the-art medal and valid submission rates within a 12-hour budget, and also outperforms AlphaEvolve on mathematical algorithm optimization tasks.
Systematic evaluation of LLM prompt sensitivity in healthcare settings reveals safety risks
Researchers conduct a sensitivity analysis of both general-purpose and medical-specific LLMs using the MedMCQA benchmark, testing robustness to lexical and syntactic prompt perturbations. The study finds that even minor phrasing changes can alter clinical advice, and adversarial prompts can produce dangerous outputs such as incorrect dosages or omitted critical findings. Both general-purpose models (GPT-3.5, Llama 3) and domain-specific models (ClinicalBERT, BioLlama3, BioBERT) exhibit this fragility, with syntactic reordering and misleading contextual cues proving more destabilizing than simple paraphrasing.
MedRLM: Recursive multimodal agent framework for long-context clinical decision support
MedRLM is a proposed framework for clinical decision support that uses recursive multi-agent reasoning over heterogeneous patient data including EHRs, medical images, physiological sensor streams, and clinical guidelines. Rather than single-step prompting, it decomposes patient cases into an inspectable external environment coordinated by specialized agents, with a Clinical Evidence Graph Memory and sensor-triggered deeper reasoning. The paper outlines an evaluation design using public and credentialed clinical datasets spanning radiology, ECG, ICU time series, and referral outcomes. The work targets a gap between static medical QA benchmarks and real-world longitudinal clinical workflows.
Clinically grounded privacy evaluation framework reveals high memorization risk in medical LMs
Researchers introduce a tiered adversarial framework for evaluating privacy leakage in medical language models, moving beyond simple training-text recovery to realistic clinical threat models. Applied to an LM pretrained on 378k clinical notes, the framework finds that routine encounter metadata (name, DOB, provider, visit date) elicits high verbatim memorization and sensitive-diagnosis recovery (AUROC 0.91 for abortion, 0.81 for HIV). The study also finds that exact-match memorization overstates disclosure risk because 36% of memorized tokens reflect templated documentation. The work provides a practical contextual privacy evaluation methodology for medical LMs trained on longitudinal patient data.
The Open Medical-LLM Leaderboard: Benchmarking Large Language Models in Healthcare
Hugging Face has launched the Open Medical-LLM Leaderboard, a public benchmark for evaluating large language models on healthcare and medical tasks. The leaderboard aggregates performance across multiple medical question-answering datasets to enable standardized comparison of open-weight models in clinical and biomedical domains. This initiative aims to accelerate progress in medical AI by providing transparent, reproducible evaluation infrastructure.
ClinEnv: Interactive Multi-Stage Long-Horizon EHR Benchmark for Clinical Agent Evaluation
ClinEnv is a new interactive benchmark that evaluates LLMs as attending physicians over real inpatient admissions using a Longitudinal Inpatient Simulation paradigm. Each case is decomposed into sequential decision stages where models must query four specialized agents before committing to medications, procedures, and diagnoses. Across seven evaluated models, the best achieves only 0.31 decision F1, with a sharp gap between diagnosis recovery (0.51 F1) and management actions (0.17 F1). The benchmark uniquely measures information-acquisition process quality alongside outcome quality, exposing a gap invisible to static or outcome-only evaluations.
Democratizing Large-Scale Re-Optimization with LLM-Guided Model Patches
This paper introduces an agentic framework where an LLM acts as an operations research expert, translating natural-language user prompts into structured updates ('patches') to deployed optimization models and selecting appropriate re-optimization techniques from a toolbox. The toolbox leverages primal information—historical solutions, valid inequalities, solver configurations, and metaheuristics—to accelerate re-optimization while preserving solution quality. Experiments on supply chain re-optimization and university exam scheduling demonstrate computational efficiency gains and improved interpretability through patch-based model modifications. The framework aims to reduce dependence on OR experts for maintaining dynamic decision-support systems.