Wanshu Fan, Zheng Tong, Yang Liu, Jing Qin, Zhongbin Han, Haifan Gong, Congyu Liao, Xiaofeng Liu 等 9 位作者
Large language models and multimodal foundation models are enabling medical artificial intelligence (AI) systems to move beyond isolated prediction and undertake multistep clinical tasks that require planning, tool use, memory, iterative correction, and coordination among specialized agents. However, the scope of agentic AI in medicine remains unsettled, and current evaluation practices are not yet aligned with the requirements of clinical use. We conducted a scoping review with systematic evidence mapping across five electronic sources, screened 1,649 exportable records, and provisionally included 557 unique studies that met predefined criteria for goal-directed task execution, tool use, interaction with external resources, feedback-based refinement, or multi-agent collaboration. The included studies describe single agents that use external tools, workflows supported by retrieval and external knowledge, multimodal agents, and multi-agent systems applied to medical question answering, image interpretation, electronic health record analysis, drug safety, and clinical trial prediction. The evidence base remains dominated by public benchmarks, simulated settings, retrospective datasets, and small-scale expert evaluation. Process reliability, evidence traceability, uncertainty, safety, workflow impact, and external validity are evaluated less consistently. Clinical translation will depend on clearer definitions, reproducible evaluation, auditable oversight, interoperable system design, and prospective validation in real-world clinical workflows.
Shipeng Hu, Miaohui Wang, Jing Qin, Sukun Tian, Yuchun Sun
Medical image segmentation (MIS) remains challenging due to composite degradations and multi-scale geometric variations, which jointly impair lesion-background separability, structural consistency, and optimization stability. Existing single-stream frameworks entangle heterogeneous cues within a single representation pathway, while hybrid-stream approaches often rely on generic or static fusion, limiting effective coordination across domains and failing to explicitly address optimization instability. To overcome these limitations, we propose a new optimization-aware dual-domain framework for MIS (O2D-MedNet). First, a degradation-aware dualdomain interaction (DDI) module integrates Fourier - and Wavelet-domain features to suppress degradation-sensitive responses while preserving structural and fine-detail information. Second, a cross-backbone contour-guided fusion (CGF) module enables selective interaction between CNN-based local detail modeling and visual state-space-based global structure modeling, improving boundary accuracy and representation consistency. Third, a gradient-context optimization (GCO) strategy stabilizes training by adaptively adjusting learning dynamics based on loss trends and gradient statistics, mitigating instability caused by class imbalance and heterogeneous sample difficulty. Extensive experiments on six benchmarks demonstrate consistent improvements over state-of-the-art MIS methods across multiple imaging modalities. Further analyses confirm enhanced sensitivity, structural consistency, and optimization stability, validating the effectiveness of the proposed O2D-MedNet for robust MIS under heterogeneous conditions.
Xin Sun, Di Wu, Sijing Qin Hitotsubashi University, Isao Echizen National Institute of Informatics, Abdallah El Ali Utrecht University and Centrum voor Wiskunde en Informatica, Saku Sugawara University of Tokyo and National Institute of Informatics
Large language models (LLMs) are increasingly used as automated evaluators (LLM-as-a-Judge). This work challenges its reliability by showing that trust judgments by LLMs are biased by disclosed source labels. Using a counterfactual design, we find that both humans and LLM judges assign higher trust to information labeled as human-authored than to the same content labeled as AI-generated. Eye-tracking data reveal that humans rely heavily on source labels as heuristic cues for judgments. We analyze LLM internal states during judgment. Across label conditions, models allocate denser attention to the label region than the content region, and this label dominance is stronger under Human labels than AI labels, consistent with the human gaze patterns. Besides, decision uncertainty measured by logits is higher under AI labels than Human labels. These results indicate that the source label is a salient heuristic cue for both humans and LLMs. It raises validity concerns for label-sensitive LLM-as-a-Judge evaluation, and we cautiously raise that aligning models with human preferences may propagate human heuristic reliance into models, motivating debiased evaluation and alignment.
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cs.CL
Proceedings of the 64th Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers) · 2026 · 正式发表