Eva McCord, Ernest Pedapati, Zag ElSayedcs.HC cs.AI cs.ET physics.med-ph q-bio.NC
Clinical biomarker workflows in translational research settings often rely on spreadsheet-driven tracking, manual quality control (QC) reconciliation, and loosely integrated systems, resulting in limited state visibility, delayed reporting, and increased operational risk. These challenges are particularly pronounced in multi-day assays such as Luminex-based quantification of Fragile X Messenger Ribonucleoprotein (FMRP), where HIPAA-compliant data governance, deterministic workflow progression, and coordinated communication across laboratory and clinical teams are required. This paper presents FMRP-LEAN, a HIPAA-compliant, AI-augmented Laboratory Information Management System (LIMS) architecture that formalizes biospecimen lifecycle management through a finite-state workflow model with explicit transition guards and dwell-time observability. The system integrates a self-hosted Supabase/PostgreSQL stack deployed within hospital-controlled infrastructure, hybrid edge-internal isolation with encrypted tunneling and loopback-only services, and bi-directional REDCap synchronization. A unified MRN-UUIDv7 identifier framework with QR-based tracking ensures traceable clinical-research linkage under PHI residency constraints. FMRP-LEAN incorporates automated statistical QC pre-screening and a governance-constrained AI operations module that operates exclusively on aggregate projections, with deterministic fallback guarantees. Deployment demonstrates improved workflow observability, reduced QC latency, and enhanced cross-role transparency between laboratory technicians, research coordinators, and patient-facing teams. The architecture provides a reproducible model for secure, state-explicit, and AI-augmented clinical research workflows in regulated healthcare environments.
Autonomous computational pathology (ACP) converts high-level pathology analysis goals into executable, traceable and clinically bounded workflows. Realizing this capability requires adapting general agentic harness systems to pathology-specific tasks, tools, evidence standards and clinical claim boundaries. We contribute ACP-Bench, a framework that adapts existing harness systems from computational pathology support toward ACP workflow capability. ACP-Bench evaluates 41 pathology workflow tasks, including 24 biomarker, 7 morphology and 10 prognosis tasks spanning 6 body-system groups and 9 endpoint families. The benchmark evaluates 9 models and 3 harness groups (Claude Code, Codex and Open Code), yielding 369 complete trajectories. ACP-Bench evaluates each trajectory across workflow execution, diagnostic performance and clinical-boundary alignment, combining expert-adjudicated process audits, diagnostic assessment and pathologist-validated safety review. Across evaluated systems, workflow initiation, task interpretation and diagnostic reporting were more mature than tool-bound execution, result binding and reflective workflow revision, and formal end-to-end completion remained rare. ACP-Bench provides a reusable standard for auditing whether agentic systems can operationalize pathology workflows before claims of reliable clinical autonomy.
As AI agents become increasingly capable of complex, long-horizon reasoning, rigorous and holistic evaluation is essential for measuring progress toward real-world healthcare applications. We introduce HealthAgentBench, a suite of 54 agentic healthcare tasks across 7 categories each with its unique environment. The benchmark suite spans diverse workflows throughout the patient journey and a broad range of modalities. Each task is designed to replicate an end-to-end clinical workflow: given minimal instructions, an agent must explore raw healthcare data, operate within a complex environment, and execute multi-step solutions that go beyond naive prompting. A final task success rate is reported to provide a single, interpretable metric for HealthAgentBench overall performance for each agent. Evaluating frontier agents on HealthAgentBench, we find that overall task success rate remains low, underscoring the difficulty of the suite. The strongest and the most cost effective agent, Codex GPT-5.5, achieves only approximately 42% success rate. Beyond aggregate performance, HealthAgentBench reveals nuanced strengths and weaknesses across task categories. Frontier agents show promise in automatically developing research modeling pipelines over EHR data, but medical imaging remains especially challenging, particularly for Claude Code models, while Codex GPT-5.5 shows emerging capability. Tasks that combine large search spaces with compositional reasoning requirements remain difficult for all current agents. Together, these results suggest that HealthAgentBench provides a challenging and realistic benchmark with substantial room for future progress. We release our benchmark at https://github.com/microsoft/HealthAgentBench.
Ivan Sviridov, Artem Oskin, Ivan Panin +4cs.CL cs.NE
Adapting large language models (LLMs) to clinical workflows often requires costly fine-tuning or manual prompt and pipeline engineering. We study LLM-guided MAP-Elites evolution as an inference-time alternative for discovering medical decision strategies and provide an implementation repository at https://github.com/univanxx/llm_guided_evo_medical. We formulate urgency triage, interactive consultation, and medical image classification as evolutionary searches over executable artifacts optimized by task-specific fitness functions. Across all three settings, evolution improves over manually designed baselines under practical constraints. In triage, evolved programs increase Semigran accuracy from $77.3\%$ to $87.1\%$ and emergency recall from $0.60$ to $0.97$, while improving safety-weighted held-out MIMIC-ESI performance. In interactive consultation, evolved policies improve the accuracy--cost frontier across Llama-3, Qwen-3.5, and Gemma-4 and transfer to held-out iCRAFTMD. In PneumoniaMNIST, prompt-only evolution improves frozen MedGemma VLMs while preserving strict JSON outputs. Qualitative analysis shows that the gains come from interpretable program-level mechanisms, calibrated triage boundaries, targeted evidence acquisition, selective commitment, and finding-oriented visual decision rules, rather than superficial prompt rewording alone.