Papers › The Optimization Paradox in Clinical AI Multi-Agent Systems
The Optimization Paradox in Clinical AI Multi-Agent Systems
Suhana Bedi, Iddah Mlauzi, Daniel Shin, Sanmi Koyejo, Nigam H. Shah
Multi-agent artificial intelligence systems are increasingly deployed in clinical settings, yet the relationship between component-level optimization and system-wide performance remains poorly understood. We evaluated this relationship using 2,400 real patient cases from the MIMIC-CDM dataset across four abdominal pathologies (appendicitis, pancreatitis, cholecystitis, diverticulitis), decomposing clinical diagnosis into information gathering, interpretation, and differential diagnosis. We evaluated single agent systems (one model performing all tasks) against multi-agent systems (specialized models for each task) using comprehensive metrics spanning diagnostic outcomes, process adherence, and cost efficiency. Our results reveal a paradox: while multi-agent systems generally outperformed single agents, the component-optimized or Best of Breed system with superior components and excellent process metrics (85.5% information accuracy) significantly underperformed in diagnostic accuracy (67.7% vs. 77.4% for a top multi-agent system). This finding underscores that successful integration of AI in healthcare requires not just component level optimization but also attention to information flow and compatibility between agents. Our findings highlight the need for end to end system validation rather than relying on component metrics alone.
Code
Repository list and official/mentioned flags are the archive's, frozen 2025-07-28. Reachability, where shown, is from one Syntology probe window (2026-09-16 to 2026-09-18); repositories not probed show nothing. GitHub stars are not tracked.
Code Syntology ran Syntology
Not run by Syntology. Nothing on this page verifies that the listed code works.
Tasks
Results from the paper archive 2025-07-28
No leaderboard rows for this paper in the archive.
Methods
Report a problem or propose a change · a person checks every report against the paper or source before anything changes; decisions are listed on /corrections