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Oct 2

RoboPhD: Evolving Diverse Complex Agents Under Tight Evaluation Budgets

2026 has brought an explosion of interest in LLM-guided evolution of agentic artifacts, with systems like GEPA and Autoresearch demonstrating that LLMs can iteratively improve prompts, code, and agent architectures across diverse domains. As adoption accelerates, a central question emerges: given the same information, the same seed agent, and the same objective, which optimization algorithm yields the best results under the same evaluation budget? This question becomes critical when evaluations are expensive, such as when they require human judgment or multiple LLM calls. We present the first systematic comparison of three optimization paradigms -- Elo tournament selection (RoboPhD), Pareto-based selection (GEPA), and greedy hill-climbing (Autoresearch) -- across four benchmarks spanning abstract reasoning, cloud scheduling, SQL generation, and financial QA, all under a fixed budget of 1,500 evaluations. RoboPhD introduces validation-free evolution: instead of splitting the budget between training and validation, it uses Elo competition on training data to simultaneously evaluate agents and drive evolution. All three systems receive seed agents with diagnostic print() statements that evolution can grow, enabling self-instrumenting agents that develop increasingly informative diagnostics for the benefit of their evolutionary successors. Using a single default configuration, RoboPhD outperforms both GEPA and Autoresearch on three of four benchmarks, losing only on the simplest task, where the winning solution (from our Autoresearch adaptation) required under 90 lines of code. On ARC-AGI, RoboPhD evolves a 22-line seed agent into a 1,013-line multi-strategy system, improving accuracy from 27.8% to 65.8% using Gemini 3.1 Flash Lite as the solver. We release RoboPhD as a versatile toolkit under the MIT license with a simple optimize_anything() API for evolving diverse complex agents.

  • 3 authors
·
Apr 5

Beyond Pixel Simulation: Pathology Image Generation via Diagnostic Semantic Tokens and Prototype Control

In computational pathology, understanding and generation have evolved along disparate paths: advanced understanding models already exhibit diagnostic-level competence, whereas generative models largely simulate pixels. Progress remains hindered by three coupled factors: the scarcity of large, high-quality image-text corpora; the lack of precise, fine-grained semantic control, which forces reliance on non-semantic cues; and terminological heterogeneity, where diverse phrasings for the same diagnostic concept impede reliable text conditioning. We introduce UniPath, a semantics-driven pathology image generation framework that leverages mature diagnostic understanding to enable controllable generation. UniPath implements Multi-Stream Control: a Raw-Text stream; a High-Level Semantics stream that uses learnable queries to a frozen pathology MLLM to distill paraphrase-robust Diagnostic Semantic Tokens and to expand prompts into diagnosis-aware attribute bundles; and a Prototype stream that affords component-level morphological control via a prototype bank. On the data front, we curate a 2.65M image-text corpus and a finely annotated, high-quality 68K subset to alleviate data scarcity. For a comprehensive assessment, we establish a four-tier evaluation hierarchy tailored to pathology. Extensive experiments demonstrate UniPath's SOTA performance, including a Patho-FID of 80.9 (51% better than the second-best) and fine-grained semantic control achieving 98.7% of the real-image. The meticulously curated datasets, complete source code, and pre-trained model weights developed in this study will be made openly accessible to the public.

  • 8 authors
·
Dec 24, 2025

LLM Guided Evolution -- The Automation of Models Advancing Models

In the realm of machine learning, traditional model development and automated approaches like AutoML typically rely on layers of abstraction, such as tree-based or Cartesian genetic programming. Our study introduces "Guided Evolution" (GE), a novel framework that diverges from these methods by utilizing Large Language Models (LLMs) to directly modify code. GE leverages LLMs for a more intelligent, supervised evolutionary process, guiding mutations and crossovers. Our unique "Evolution of Thought" (EoT) technique further enhances GE by enabling LLMs to reflect on and learn from the outcomes of previous mutations. This results in a self-sustaining feedback loop that augments decision-making in model evolution. GE maintains genetic diversity, crucial for evolutionary algorithms, by leveraging LLMs' capability to generate diverse responses from expertly crafted prompts and modulate model temperature. This not only accelerates the evolution process but also injects expert like creativity and insight into the process. Our application of GE in evolving the ExquisiteNetV2 model demonstrates its efficacy: the LLM-driven GE autonomously produced variants with improved accuracy, increasing from 92.52% to 93.34%, without compromising model compactness. This underscores the potential of LLMs to accelerate the traditional model design pipeline, enabling models to autonomously evolve and enhance their own designs.

  • 3 authors
·
Mar 17, 2024

Darwin Family: MRI-Trust-Weighted Evolutionary Merging for Training-Free Scaling of Language-Model Reasoning

We present Darwin Family, a framework for training-free evolutionary merging of large language models via gradient-free weight-space recombination. We ask whether frontier-level reasoning performance can be improved without additional training, by reorganizing latent capabilities already encoded in existing checkpoints. Darwin introduces three key ideas: (i) a 14-dimensional adaptive merge genome enabling fine-grained component- and block-level recombination; (ii) MRI-Trust Fusion, which adaptively balances diagnostic layer-importance signals with evolutionary search through a learnable trust parameter; and (iii) an Architecture Mapper that enables cross-architecture breeding between heterogeneous model families. Empirically, the flagship Darwin-27B-Opus achieves 86.9% on GPQA Diamond, ranking #6 among 1,252 evaluated models, and outperforming its fully trained foundation model without any gradient-based training. Across scales from 4B to 35B parameters, Darwin models consistently improve over their parents, support recursive multi-generation evolution, and enable a training-free evolutionary merge that combines Transformer- and Mamba-based components. Together, the Darwin Family demonstrates that diagnostic-guided evolutionary merging is a practical and reproducible alternative to costly post-training pipelines for reasoning-centric language models.

FINAL-Bench FINAL_Bench
·
May 13 5

PIE: Simulating Disease Progression via Progressive Image Editing

Disease progression simulation is a crucial area of research that has significant implications for clinical diagnosis, prognosis, and treatment. One major challenge in this field is the lack of continuous medical imaging monitoring of individual patients over time. To address this issue, we develop a novel framework termed Progressive Image Editing (PIE) that enables controlled manipulation of disease-related image features, facilitating precise and realistic disease progression simulation. Specifically, we leverage recent advancements in text-to-image generative models to simulate disease progression accurately and personalize it for each patient. We theoretically analyze the iterative refining process in our framework as a gradient descent with an exponentially decayed learning rate. To validate our framework, we conduct experiments in three medical imaging domains. Our results demonstrate the superiority of PIE over existing methods such as Stable Diffusion Walk and Style-Based Manifold Extrapolation based on CLIP score (Realism) and Disease Classification Confidence (Alignment). Our user study collected feedback from 35 veteran physicians to assess the generated progressions. Remarkably, 76.2% of the feedback agrees with the fidelity of the generated progressions. To our best knowledge, PIE is the first of its kind to generate disease progression images meeting real-world standards. It is a promising tool for medical research and clinical practice, potentially allowing healthcare providers to model disease trajectories over time, predict future treatment responses, and improve patient outcomes.

  • 6 authors
·
Sep 20, 2023 1

MEDDxAgent: A Unified Modular Agent Framework for Explainable Automatic Differential Diagnosis

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.

  • 6 authors
·
Feb 26, 2025

Sequential Diagnosis with Language Models

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.

  • 15 authors
·
Jun 27, 2025

Data Darwinism Part II: DataEvolve -- AI can Autonomously Evolve Pretraining Data Curation

Data Darwinism (Part I) established a ten-level hierarchy for data processing, showing that stronger processing can unlock greater data value. However, that work relied on manually designed strategies for a single category. Modern pretraining corpora comprise hundreds of heterogeneous categories spanning domains and content types, each demanding specialized treatment. At this scale, manual strategy design becomes prohibitive. This raises a key question: can strategies evolve in an automated way? We introduce DataEvolve, a framework that enables strategies to evolve through iterative optimization rather than manual design. For each data category, DataEvolve operates in a closed evolutionary loop: it identifies quality issues, generates candidate strategies, executes them on sampled data, evaluates results, and refines approaches across generations. The process accumulates knowledge through an experience pool of discovered issues and a strategy pool tracking performance across iterations. Applied to 8 categories spanning 672B tokens from Nemotron-CC, DataEvolve produces Darwin-CC, a 504B-token dataset with strategies evolved through 30 iterations per category. Training 3B models on 500B tokens, Darwin-CC outperforms raw data (+3.96 points) and achieves a 44.13 average score across 18 benchmarks, surpassing DCLM, Ultra-FineWeb, and FineWeb-Edu, with strong gains on knowledge-intensive tasks such as MMLU. Analysis shows evolved strategies converge on cleaning-focused approaches: targeted noise removal and format normalization with domain-aware preservation, echoing the L4 (Generative Refinement) principles from Part I. Ablation studies confirm iterative evolution is essential: optimized strategies outperform suboptimal ones by 2.93 points, establishing evolutionary strategy design as feasible and necessary for pretraining-scale data curation.

  • 9 authors
·
Mar 14

Harnessing Agentic Evolution

Agentic evolution has emerged as a powerful paradigm for improving programs, workflows, and scientific solutions by iteratively generating candidates, evaluating them, and using feedback to guide future search. However, existing methods are typically instantiated either as fixed hand-designed procedures that are modular but rigid, or as general-purpose agents that flexibly integrate feedback but can drift in long-horizon evolution. Both forms accumulate rich evidence over time, including candidates, feedback, traces, and failures, yet lack a stable interface for organizing this evidence and revising the mechanism that drives future evolution. We address this limitation by formulating agentic evolution as an interactive environment, where the accumulated evolution context serves as a process-level state. We introduce AEvo, a harnessed meta-editing framework in which a meta-agent observes this state and acts not by directly proposing the next candidate, but by editing the procedure or agent context that controls future evolution. This unified interface enables AEvo to steer both procedure-based and agent-based evolution, making accumulated evidence actionable for long-horizon search. Empirical evaluations on agentic and reasoning benchmarks show that AEvo outperforms five evolution baselines, achieving a 26 relative improvement over the strongest baseline. Across three open-ended optimization tasks, AEvo further outperforms four evolution baselines and achieves state-of-the-art performance under the same iteration budget.

  • 13 authors
·
May 12

EvoLattice: Persistent Internal-Population Evolution through Multi-Alternative Quality-Diversity Graph Representations for LLM-Guided Program Discovery

Large language models (LLMs) are increasingly used to evolve programs and multi-agent systems, yet most existing approaches rely on overwrite-based mutations that maintain only a single candidate at a time. Such methods discard useful variants, suffer from destructive edits, and explore a brittle search space prone to structural failure. We introduce EvoLattice, a framework that represents an entire population of candidate programs or agent behaviors within a single directed acyclic graph. Each node stores multiple persistent alternatives, and every valid path through the graph defines a distinct executable candidate, yielding a large combinatorial search space without duplicating structure. EvoLattice enables fine-grained alternative-level evaluation by scoring each alternative across all paths in which it appears, producing statistics that reveal how local design choices affect global performance. These statistics provide a dense, data-driven feedback signal for LLM-guided mutation, recombination, and pruning, while preserving successful components. Structural correctness is guaranteed by a deterministic self-repair mechanism that enforces acyclicity and dependency consistency independently of the LLM. EvoLattice naturally extends to agent evolution by interpreting alternatives as prompt fragments or sub-agent behaviors. Across program synthesis (proxy and optimizer meta-learning), EvoLattice yields more stable evolution, greater expressivity, and stronger improvement trajectories than prior LLM-guided methods. The resulting dynamics resemble quality-diversity optimization, emerging implicitly from EvoLattice's internal multi-alternative representation rather than an explicit external archive.

  • 1 authors
·
Dec 16, 2025

Learning to Be A Doctor: Searching for Effective Medical Agent Architectures

Large Language Model (LLM)-based agents have demonstrated strong capabilities across a wide range of tasks, and their application in the medical domain holds particular promise due to the demand for high generalizability and reliance on interdisciplinary knowledge. However, existing medical agent systems often rely on static, manually crafted workflows that lack the flexibility to accommodate diverse diagnostic requirements and adapt to emerging clinical scenarios. Motivated by the success of automated machine learning (AutoML), this paper introduces a novel framework for the automated design of medical agent architectures. Specifically, we define a hierarchical and expressive agent search space that enables dynamic workflow adaptation through structured modifications at the node, structural, and framework levels. Our framework conceptualizes medical agents as graph-based architectures composed of diverse, functional node types and supports iterative self-improvement guided by diagnostic feedback. Experimental results on skin disease diagnosis tasks demonstrate that the proposed method effectively evolves workflow structures and significantly enhances diagnostic accuracy over time. This work represents the first fully automated framework for medical agent architecture design and offers a scalable, adaptable foundation for deploying intelligent agents in real-world clinical environments.

  • 6 authors
·
Apr 15, 2025

Evolving Diagnostic Agents in a Virtual Clinical Environment

In this paper, we present a framework for training large language models (LLMs) as diagnostic agents with reinforcement learning, enabling them to manage multi-turn diagnostic processes, adaptively select examinations, and commit to final diagnoses. Unlike instruction-tuned models trained on static case summaries, our method acquires diagnostic strategies through interactive exploration and outcome-based feedback. Our contributions are fourfold: (i) We present DiagGym, a diagnostics world model trained with electronic health records that emits examination outcomes conditioned on patient history and recommended examination, serving as a virtual clinical environment for realistic diagnosis training and evaluation; (ii) We train DiagAgent via end-to-end, multi-turn reinforcement learning to learn diagnostic policies that optimize both information yield and diagnostic accuracy; (iii) We introduce DiagBench, a diagnostic benchmark comprising 750 cases with physician-validated examination recommendations and 99 cases annotated with 973 physician-written rubrics on diagnosis process; (iv) we demonstrate superior performance across diverse diagnostic settings. DiagAgent significantly outperforms 10 state-of-the-art LLMs, including DeepSeek-v3 and GPT-4o, as well as two prompt-engineered agents. In single-turn settings, DiagAgent achieves 9.34% higher diagnostic accuracy and 44.03% improvement in examination recommendation hit ratio. In end-to-end settings, it delivers 15.12% increase in diagnostic accuracy and 23.09% boost in examination recommendation F1 score. In rubric-based evaluation, it surpasses the next-best model, Claude-sonnet-4, by 7.1% in weighted rubric score. These findings indicate that learning policies in interactive clinical environments confers dynamic and clinically meaningful diagnostic management abilities unattainable through passive training alone.

An Explainable Diagnostic Framework for Neurodegenerative Dementias via Reinforcement-Optimized LLM Reasoning

The differential diagnosis of neurodegenerative dementias is a challenging clinical task, mainly because of the overlap in symptom presentation and the similarity of patterns observed in structural neuroimaging. To improve diagnostic efficiency and accuracy, deep learning-based methods such as Convolutional Neural Networks and Vision Transformers have been proposed for the automatic classification of brain MRIs. However, despite their strong predictive performance, these models find limited clinical utility due to their opaque decision making. In this work, we propose a framework that integrates two core components to enhance diagnostic transparency. First, we introduce a modular pipeline for converting 3D T1-weighted brain MRIs into textual radiology reports. Second, we explore the potential of modern Large Language Models (LLMs) to assist clinicians in the differential diagnosis between Frontotemporal dementia subtypes, Alzheimer's disease, and normal aging based on the generated reports. To bridge the gap between predictive accuracy and explainability, we employ reinforcement learning to incentivize diagnostic reasoning in LLMs. Without requiring supervised reasoning traces or distillation from larger models, our approach enables the emergence of structured diagnostic rationales grounded in neuroimaging findings. Unlike post-hoc explainability methods that retrospectively justify model decisions, our framework generates diagnostic rationales as part of the inference process-producing causally grounded explanations that inform and guide the model's decision-making process. In doing so, our framework matches the diagnostic performance of existing deep learning methods while offering rationales that support its diagnostic conclusions.

  • 6 authors
·
May 26, 2025 2

SkillProx: Self-Evolving Agent Skills via Proximal Textual Gradient Descent

LLM agents increasingly adapt to recurring tasks by accumulating procedural knowledge in skills. These skills are lightweight, reusable textual artifacts that are loaded into the agent's context without weight updates. Recent methods refine skills through iterative task execution, failure diagnosis, and trajectory-guided text-space updates. However, existing frameworks lack explicit diagnosis--outcome feedback and treat deletion as a generic edit operation rather than a dedicated mechanism for consolidating accumulated knowledge. We introduce SkillProx, a proximal-gradient-inspired forward--backward framework that couples closed-loop diagnostic evolution with utility-aware proximal refinement. Motivated by a composite objective balancing task loss and skill complexity, the forward stage re-executes diagnosis-driven edits on the same task batch, rolls back regressions, and feeds measured outcomes into subsequent diagnoses. The backward stage decomposes the resulting skill into auditable knowledge units, estimates their contributions using a frozen leave-one-out utility audit, and applies validation-gated consolidation, demotion, or removal. Experiments on in-distribution and out-of-distribution benchmarks across multiple backbone LLMs show that SkillProx improves average accuracy by 3.0 percentage points over the strongest gradient-based baseline. Component ablations demonstrate the complementary effects of closed-loop diagnosis and proximal refinement.

  • 9 authors
·
Aug 6

Unimedvl: Unifying Medical Multimodal Understanding And Generation Through Observation-Knowledge-Analysis

Medical diagnostic applications require models that can process multimodal medical inputs (images, patient histories, lab results) and generate diverse outputs including both textual reports and visual content (annotations, segmentation masks, and images). Despite this need, existing medical AI systems disrupt this unified process: medical image understanding models interpret images but cannot generate visual outputs, while medical image generation models synthesize images but cannot provide textual explanations. This leads to gaps in data representation, feature integration, and task-level multimodal capabilities. To this end, we propose a multi-level framework that draws inspiration from diagnostic workflows through the Observation-Knowledge-Analysis (OKA) paradigm. Specifically, at the observation level, we construct UniMed-5M, a dataset comprising over 5.6M samples that reformat diverse unimodal data into multimodal pairs for foundational observation. At the knowledge level, we propose Progressive Curriculum Learning that systematically introduces medical multimodal knowledge. At the analysis level, we introduce UniMedVL, the first medical unified multimodal model for the simultaneous analysis of image understanding and generation tasks within a single architecture. UniMedVL achieves superior performance on five medical image understanding benchmarks, while matching specialized models in generation quality across eight medical imaging modalities. Crucially, our unified architecture enables bidirectional knowledge sharing: generation tasks enhance visual understanding features, demonstrating that integrating traditionally separate capabilities within a single medical framework unlocks improvements across diverse medical vision-language tasks. Code is available at https://github.com/uni-medical/UniMedVL.

General-Medical-AI General Medical AI
·
Oct 17, 2025 3

Progression as Latent Drift: Generative Forecasting of Slow-Evolving Pathologies

Forecasting the future anatomy of slow-evolving neurodegenerative diseases could enable earlier, more targeted intervention and improve clinical trial design, but it remains challenging because true progression signals are subtle in longitudinal MRI. In this low-signal regime, transferring modern generative sequence models directly is unreliable: training is dominated by stable baseline anatomy and confounded by dense, sample-specific nuisance variation. We first provide a theoretical analysis that explains these failures through two modes. Identity collapse occurs when optimization is driven toward reproducing the current anatomy, which prevents the model from learning faint temporal change. The continuous interpolation trap arises when standard smooth networks cannot separate localized biological drift from pervasive noise, which leads to spurious changes that diffuse across the volume. To address both issues, we propose Latent Drift, a progressive generative framework that learns change in a compressed semantic representation rather than synthesizing full-resolution anatomy. This design removes pixel-level identity from the prediction target and concentrates model capacity on progression-relevant dynamics. We further apply Finite Scalar Quantization to the learned change representation, which suppresses small, high-frequency nuisance fluctuations while preserving consistent structural drift. Experiments on longitudinal 3D brain MRI show that Latent Drift improves patient-specific neuro-forecasting over diffusion and autoregressive transformer baselines across generative fidelity and clinically relevant evaluation metrics. Project page: https://cutepkq.github.io/latent-drift{https://cutepkq.github.io/latent-drift}.

  • 10 authors
·
Jul 8

RAD: Towards Trustworthy Retrieval-Augmented Multi-modal Clinical Diagnosis

Clinical diagnosis is a highly specialized discipline requiring both domain expertise and strict adherence to rigorous guidelines. While current AI-driven medical research predominantly focuses on knowledge graphs or natural text pretraining paradigms to incorporate medical knowledge, these approaches primarily rely on implicitly encoded knowledge within model parameters, neglecting task-specific knowledge required by diverse downstream tasks. To address this limitation, we propose Retrieval-Augmented Diagnosis (RAD), a novel framework that explicitly injects external knowledge into multimodal models directly on downstream tasks. Specifically, RAD operates through three key mechanisms: retrieval and refinement of disease-centered knowledge from multiple medical sources, a guideline-enhanced contrastive loss that constrains the latent distance between multi-modal features and guideline knowledge, and the dual transformer decoder that employs guidelines as queries to steer cross-modal fusion, aligning the models with clinical diagnostic workflows from guideline acquisition to feature extraction and decision-making. Moreover, recognizing the lack of quantitative evaluation of interpretability for multimodal diagnostic models, we introduce a set of criteria to assess the interpretability from both image and text perspectives. Extensive evaluations across four datasets with different anatomies demonstrate RAD's generalizability, achieving state-of-the-art performance. Furthermore, RAD enables the model to concentrate more precisely on abnormal regions and critical indicators, ensuring evidence-based, trustworthy diagnosis. Our code is available at https://github.com/tdlhl/RAD.

Fudan-University Fudan University
·
Sep 24, 2025

MLEvolve: A Self-Evolving Framework for Automated Machine Learning Algorithm Discovery

Large language model (LLM) agents are increasingly applied to long-horizon tasks such as scientific discovery and machine learning engineering (MLE), where sustained self-evolution becomes a key capability. However, existing MLE agents suffer from inter-branch information isolation, memoryless search, and lack of hierarchical control, which together hinder long-horizon optimization. We present MLEvolve, an LLM-based self-evolving multi-agent framework for end-to-end machine learning algorithm discovery. By extending tree search to Progressive MCGS, MLEvolve enables cross-branch information flow through graph-based reference edges and gradually shifts the search from broad exploration to focused exploitation with an entropy-inspired progressive schedule. To allow the agent to evolve with accumulated experience, we introduce Retrospective Memory, which combines a cold-start domain knowledge base with a dynamic global memory for task-specific experience retrieval and reuse. For stable long-horizon iteration, we further decouple strategic planning from code generation with adaptive coding modes. Evaluation on MLE-Bench shows that MLEvolve achieves state-of-the-art performance across multiple dimensions including average medal rate and valid submission rate under a 12-hour budget (half the standard runtime). Moreover, MLEvolve also outperforms specialized algorithm discovery methods including AlphaEvolve on mathematical algorithm optimization tasks, demonstrating strong cross-domain generalization. Our code is available at https://github.com/InternScience/MLEvolve.

  • 14 authors
·
Jun 3 2

An Agentic System for Rare Disease Diagnosis with Traceable Reasoning

Rare diseases collectively affect over 300 million individuals worldwide, yet timely and accurate diagnosis remains a pervasive challenge. This is largely due to their clinical heterogeneity, low individual prevalence, and the limited familiarity most clinicians have with rare conditions. Here, we introduce DeepRare, the first rare disease diagnosis agentic system powered by a large language model (LLM), capable of processing heterogeneous clinical inputs. The system generates ranked diagnostic hypotheses for rare diseases, each accompanied by a transparent chain of reasoning that links intermediate analytic steps to verifiable medical evidence. DeepRare comprises three key components: a central host with a long-term memory module; specialized agent servers responsible for domain-specific analytical tasks integrating over 40 specialized tools and web-scale, up-to-date medical knowledge sources, ensuring access to the most current clinical information. This modular and scalable design enables complex diagnostic reasoning while maintaining traceability and adaptability. We evaluate DeepRare on eight datasets. The system demonstrates exceptional diagnostic performance among 2,919 diseases, achieving 100% accuracy for 1013 diseases. In HPO-based evaluations, DeepRare significantly outperforms other 15 methods, like traditional bioinformatics diagnostic tools, LLMs, and other agentic systems, achieving an average Recall@1 score of 57.18% and surpassing the second-best method (Reasoning LLM) by a substantial margin of 23.79 percentage points. For multi-modal input scenarios, DeepRare achieves 70.60% at Recall@1 compared to Exomiser's 53.20% in 109 cases. Manual verification of reasoning chains by clinical experts achieves 95.40% agreements. Furthermore, the DeepRare system has been implemented as a user-friendly web application http://raredx.cn/doctor.

  • 12 authors
·
Jun 25, 2025 1

Squeeze Evolve: Unified Multi-Model Orchestration for Verifier-Free Evolution

We show that verifier-free evolution is bottlenecked by both diversity and efficiency: without external correction, repeated evolution accelerates collapse toward narrow modes, while the uniform use of a high-cost model wastes compute and quickly becomes economically impractical. We introduce Squeeze Evolve, a unified multi-model orchestration framework for verifier-free evolutionary inference. Our approach is guided by a simple principle: allocate model capability where it has the highest marginal utility. Stronger models are reserved for high-impact stages, while cheaper models handle the other stages at much lower costs. This principle addresses diversity and cost-efficiency jointly while remaining lightweight. Squeeze Evolve naturally supports open-source, closed-source, and mixed-model deployments. Across AIME 2025, HMMT 2025, LiveCodeBench V6, GPQA-Diamond, ARC-AGI-V2, and multimodal vision benchmarks, such as MMMU-Pro and BabyVision, Squeeze Evolve consistently improves the cost-capability frontier over single-model evolution and achieves new state-of-the-art results on several tasks. Empirically, Squeeze Evolve reduces API cost by up to sim3times and increases fixed-budget serving throughput by up to sim10times. Moreover, on discovery tasks, Squeeze Evolve is the first verifier-free evolutionary method to match, and in some cases exceed, the performance of verifier-based evolutionary methods.

  • 19 authors
·
Apr 9

UGPL: Uncertainty-Guided Progressive Learning for Evidence-Based Classification in Computed Tomography

Accurate classification of computed tomography (CT) images is essential for diagnosis and treatment planning, but existing methods often struggle with the subtle and spatially diverse nature of pathological features. Current approaches typically process images uniformly, limiting their ability to detect localized abnormalities that require focused analysis. We introduce UGPL, an uncertainty-guided progressive learning framework that performs a global-to-local analysis by first identifying regions of diagnostic ambiguity and then conducting detailed examination of these critical areas. Our approach employs evidential deep learning to quantify predictive uncertainty, guiding the extraction of informative patches through a non-maximum suppression mechanism that maintains spatial diversity. This progressive refinement strategy, combined with an adaptive fusion mechanism, enables UGPL to integrate both contextual information and fine-grained details. Experiments across three CT datasets demonstrate that UGPL consistently outperforms state-of-the-art methods, achieving improvements of 3.29%, 2.46%, and 8.08% in accuracy for kidney abnormality, lung cancer, and COVID-19 detection, respectively. Our analysis shows that the uncertainty-guided component provides substantial benefits, with performance dramatically increasing when the full progressive learning pipeline is implemented. Our code is available at: https://github.com/shravan-18/UGPL

  • 4 authors
·
Jul 18, 2025 1

CytoSyn: a Foundation Diffusion Model for Histopathology -- Tech Report

Computational pathology has made significant progress in recent years, fueling advances in both fundamental disease understanding and clinically ready tools. This evolution is driven by the availability of large amounts of digitized slides and specialized deep learning methods and models. Multiple self-supervised foundation feature extractors have been developed, enabling downstream predictive applications from cell segmentation to tumor sub-typing and survival analysis. In contrast, generative foundation models designed specifically for histopathology remain scarce. Such models could address tasks that are beyond the capabilities of feature extractors, such as virtual staining. In this paper, we introduce CytoSyn, a state-of-the-art foundation latent diffusion model that enables the guided generation of highly realistic and diverse histopathology H&E-stained images, as shown in an extensive benchmark. We explored methodological improvements, training set scaling, sampling strategies and slide-level overfitting, culminating in the improved CytoSyn-v2, and compared our work to PixCell, a state-of-the-art model, in an in-depth manner. This comparison highlighted the strong sensitivity of both diffusion models and performance metrics to preprocessing-specific details such as JPEG compression. Our model has been trained on a dataset obtained from more than 10,000 TCGA diagnostic whole-slide images of 32 different cancer types. Despite being trained only on oncology slides, it maintains state-of-the-art performance generating inflammatory bowel disease images. To support the research community, we publicly release CytoSyn's weights, its training and validation datasets, and a sample of synthetic images in this repository: https://huggingface.co/Owkin-Bioptimus/CytoSyn.

  • 10 authors
·
Mar 18

GigaEvo: An Open Source Optimization Framework Powered By LLMs And Evolution Algorithms

Recent advances in LLM-guided evolutionary computation, particularly AlphaEvolve (Novikov et al., 2025; Georgiev et al., 2025), have demonstrated remarkable success in discovering novel mathematical constructions and solving challenging optimization problems. However, the high-level descriptions in published work leave many implementation details unspecified, hindering reproducibility and further research. In this report we present GigaEvo, an extensible open-source framework that enables researchers to study and experiment with hybrid LLM-evolution approaches inspired by AlphaEvolve. Our system provides modular implementations of key components: MAP-Elites quality-diversity algorithms, asynchronous DAG-based evaluation pipelines, LLM-driven mutation operators with insight generation and bidirectional lineage tracking, and flexible multi-island evolutionary strategies. In order to assess reproducibility and validate our implementation we evaluate GigaEvo on challenging problems from the AlphaEvolve paper: Heilbronn triangle placement, circle packing in squares, and high-dimensional kissing numbers. The framework emphasizes modularity, concurrency, and ease of experimentation, enabling rapid prototyping through declarative configuration. We provide detailed descriptions of system architecture, implementation decisions, and experimental methodology to support further research in LLM driven evolutionary methods. The GigaEvo framework and all experimental code are available at https://github.com/AIRI-Institute/gigaevo-core.

Towards Diverse Scientific Hypothesis Search with Large Language Models

Large language models (LLMs) are on the rise for accelerating scientific discovery, most recently in advanced tasks such as generating valid scientific hypotheses. Yet in many discovery settings, the goal is not to identify a single best hypothesis since validation can be noisy and expensive, and scientists benefit from a set of high-quality alternative hypotheses that hedge against downstream uncertainty for the best solutions. Nevertheless, commonly used evolutionary search recipes tend to prioritize optimization over exploration in hypothesis generation, and the resulting selection pressure during the search process leads to diversity collapse. Motivated by these limitations, we formulate hypothesis search as a sampling problem, where the objective is to efficiently produce diverse, high-quality hypotheses under a fixed validation budget. Building on this perspective, we propose \ours, an evolutionary framework inspired by the classical parallel tempering algorithm that searches hypotheses at multiple temperature levels and enables principled information exchange across temperatures to improve exploration without disrupting convergence. Across domains including molecular discovery, equation discovery, and algorithm discovery, our approach consistently improves both hypothesis quality and diversity under the same validation budget, and produces candidates that remain robust under more expensive downstream computational validations.

  • 10 authors
·
Jun 9 2

MetaDE: Evolving Differential Evolution by Differential Evolution

As a cornerstone in the Evolutionary Computation (EC) domain, Differential Evolution (DE) is known for its simplicity and effectiveness in handling challenging black-box optimization problems. While the advantages of DE are well-recognized, achieving peak performance heavily depends on its hyperparameters such as the mutation factor, crossover probability, and the selection of specific DE strategies. Traditional approaches to this hyperparameter dilemma have leaned towards parameter tuning or adaptive mechanisms. However, identifying the optimal settings tailored for specific problems remains a persistent challenge. In response, we introduce MetaDE, an approach that evolves DE's intrinsic hyperparameters and strategies using DE itself at a meta-level. A pivotal aspect of MetaDE is a specialized parameterization technique, which endows it with the capability to dynamically modify DE's parameters and strategies throughout the evolutionary process. To augment computational efficiency, MetaDE incorporates a design that leverages parallel processing through a GPU-accelerated computing framework. Within such a framework, DE is not just a solver but also an optimizer for its own configurations, thus streamlining the process of hyperparameter optimization and problem-solving into a cohesive and automated workflow. Extensive evaluations on the CEC2022 benchmark suite demonstrate MetaDE's promising performance. Moreover, when applied to robot control via evolutionary reinforcement learning, MetaDE also demonstrates promising performance. The source code of MetaDE is publicly accessible at: https://github.com/EMI-Group/metade.

  • 3 authors
·
Feb 13, 2025

Evolving Medical Imaging Agents via Experience-driven Self-skill Discovery

Clinical image interpretation is inherently multi-step and tool-centric: clinicians iteratively combine visual evidence with patient context, quantify findings, and refine their decisions through a sequence of specialized procedures. While LLM-based agents promise to orchestrate such heterogeneous medical tools, existing systems treat tool sets and invocation strategies as static after deployment. This design is brittle under real-world domain shifts, across tasks, and evolving diagnostic requirements, where predefined tool chains frequently degrade and demand costly manual re-design. We propose MACRO, a self-evolving, experience-augmented medical agent that shifts from static tool composition to experience-driven tool discovery. From verified execution trajectories, the agent autonomously identifies recurring effective multi-step tool sequences, synthesizes them into reusable composite tools, and registers these as new high-level primitives that continuously expand its behavioral repertoire. A lightweight image-feature memory grounds tool selection in a visual-clinical context, while a GRPO-like training loop reinforces reliable invocation of discovered composites, enabling closed-loop self-improvement with minimal supervision. Extensive experiments across diverse medical imaging datasets and tasks demonstrate that autonomous composite tool discovery consistently improves multi-step orchestration accuracy and cross-domain generalization over strong baselines and recent state-of-the-art agentic methods, bridging the gap between brittle static tool use and adaptive, context-aware clinical AI assistance. Code will be available upon acceptance.

  • 7 authors
·
Mar 5

Mathematical exploration and discovery at scale

AlphaEvolve is a generic evolutionary coding agent that combines the generative capabilities of LLMs with automated evaluation in an iterative evolutionary framework that proposes, tests, and refines algorithmic solutions to challenging scientific and practical problems. In this paper we showcase AlphaEvolve as a tool for autonomously discovering novel mathematical constructions and advancing our understanding of long-standing open problems. To demonstrate its breadth, we considered a list of 67 problems spanning mathematical analysis, combinatorics, geometry, and number theory. The system rediscovered the best known solutions in most of the cases and discovered improved solutions in several. In some instances, AlphaEvolve is also able to generalize results for a finite number of input values into a formula valid for all input values. Furthermore, we are able to combine this methodology with Deep Think and AlphaProof in a broader framework where the additional proof-assistants and reasoning systems provide automated proof generation and further mathematical insights. These results demonstrate that large language model-guided evolutionary search can autonomously discover mathematical constructions that complement human intuition, at times matching or even improving the best known results, highlighting the potential for significant new ways of interaction between mathematicians and AI systems. We present AlphaEvolve as a powerful new tool for mathematical discovery, capable of exploring vast search spaces to solve complex optimization problems at scale, often with significantly reduced requirements on preparation and computation time.

  • 4 authors
·
Nov 3, 2025 1

THE-Tree: Can Tracing Historical Evolution Enhance Scientific Verification and Reasoning?

Large Language Models (LLMs) are accelerating scientific idea generation, but rigorously evaluating these numerous, often superficial, AI-generated propositions for novelty and factual accuracy is a critical bottleneck; manual verification is too slow. Existing validation methods are inadequate: LLMs as standalone verifiers may hallucinate and lack domain knowledge (our findings show 60% unawareness of relevant papers in specific domains), while traditional citation networks lack explicit causality and narrative surveys are unstructured. This underscores a core challenge: the absence of structured, verifiable, and causally-linked historical data of scientific evolution.To address this,we introduce THE-Tree (Technology History Evolution Tree), a computational framework that constructs such domain-specific evolution trees from scientific literature. THE-Tree employs a search algorithm to explore evolutionary paths. During its node expansion, it utilizes a novel "Think-Verbalize-Cite-Verify" process: an LLM proposes potential advancements and cites supporting literature. Critically, each proposed evolutionary link is then validated for logical coherence and evidential support by a recovered natural language inference mechanism that interrogates the cited literature, ensuring that each step is grounded. We construct and validate 88 THE-Trees across diverse domains and release a benchmark dataset including up to 71k fact verifications covering 27k papers to foster further research. Experiments demonstrate that i) in graph completion, our THE-Tree improves hit@1 by 8% to 14% across multiple models compared to traditional citation networks; ii) for predicting future scientific developments, it improves hit@1 metric by nearly 10%; and iii) when combined with other methods, it boosts the performance of evaluating important scientific papers by almost 100%.

  • 8 authors
·
Jun 26, 2025

Autonomous Scientific Discovery via Iterative Meta-Reflection

Autonomous scientific discovery systems offer the potential to accelerate research by automating the process of hypothesis generation and validation. However, current systems operate within constrained search spaces or require predefined research questions, limiting their capacity for true open-ended inquiry. Furthermore, while they generate hypotheses iteratively, they largely lack the ability to explicitly synthesize their own accumulated findings to uncover complex, interconnected phenomena. We introduce DiscoPER, an autonomous large language model-powered framework that conducts open-ended research by dynamically generating and executing code to explore datasets without pre-specified research objectives. To ensure rigorous scientific validity, every proposed discovery must pass statistical testing. To overcome the limitations of isolated search, our framework introduces a second-order reasoning mechanism that periodically analyzes its own accumulated discoveries. By treating prior discoveries as empirical data, DiscoPER identifies structural patterns, confounds, and epistemic gaps, actively redirecting hypothesis exploration toward uncharted regions of the search space. The search space is further expanded by incorporating tool use, enabling the system to explore hypotheses beyond structured metadata by seamlessly processing and extracting useful information from multimodal sources like images. Evaluated on iNatDisco, a new multimodal ecological knowledge benchmark with pattern-level ground truth obtained from peer-reviewed literature, DiscoPER recovers 8 of 9 known patterns with a 72.7% hypothesis support rate, outperforming both classical causal discovery and LLM-guided baselines. Ablations show that DiscoPER scales with more data, and confirms the benefits of second-order meta-reflection.

  • 3 authors
·
Jun 30 2

End-to-End Agentic RAG System Training for Traceable Diagnostic Reasoning

Accurate diagnosis with medical large language models is hindered by knowledge gaps and hallucinations. Retrieval and tool-augmented methods help, but their impact is limited by weak use of external knowledge and poor feedback-reasoning traceability. To address these challenges, We introduce Deep-DxSearch, an agentic RAG system trained end-to-end with reinforcement learning (RL) that enables steer tracebale retrieval-augmented reasoning for medical diagnosis. In Deep-DxSearch, we first construct a large-scale medical retrieval corpus comprising patient records and reliable medical knowledge sources to support retrieval-aware reasoning across diagnostic scenarios. More crutially, we frame the LLM as the core agent and the retrieval corpus as its environment, using tailored rewards on format, retrieval, reasoning structure, and diagnostic accuracy, thereby evolving the agentic RAG policy from large-scale data through RL. Experiments demonstrate that our end-to-end agentic RL training framework consistently outperforms prompt-engineering and training-free RAG approaches across multiple data centers. After training, Deep-DxSearch achieves substantial gains in diagnostic accuracy, surpassing strong diagnostic baselines such as GPT-4o, DeepSeek-R1, and other medical-specific frameworks for both common and rare disease diagnosis under in-distribution and out-of-distribution settings. Moreover, ablation studies on reward design and retrieval corpus components confirm their critical roles, underscoring the uniqueness and effectiveness of our approach compared with traditional implementations. Finally, case studies and interpretability analyses highlight improvements in Deep-DxSearch's diagnostic policy, providing deeper insight into its performance gains and supporting clinicians in delivering more reliable and precise preliminary diagnoses. See https://github.com/MAGIC-AI4Med/Deep-DxSearch.

  • 10 authors
·
Aug 21, 2025 2

Intern-Atlas: A Methodological Evolution Graph as Research Infrastructure for AI Scientists

Existing research infrastructure is fundamentally document-centric, providing citation links between papers but lacking explicit representations of methodological evolution. In particular, it does not capture the structured relationships that explain how and why research methods emerge, adapt, and build upon one another. With the rise of AI-driven research agents as a new class of consumers of scientific knowledge, this limitation becomes increasingly consequential, as such agents cannot reliably reconstruct method evolution topologies from unstructured text. We introduce Intern-Atlas, a methodological evolution graph that automatically identifies method-level entities, infers lineage relationships among methodologies, and captures the bottlenecks that drive transitions between successive innovations. Built from 1,030,314 papers spanning AI conferences, journals, and arXiv preprints, the resulting graph comprises 9,410,201 semantically typed edges, each grounded in verbatim source evidence, forming a queryable causal network of methodological development. To operationalize this structure, we further propose a self-guided temporal tree search algorithm for constructing evolution chains that trace the progression of methods over time. We evaluate the quality of the resulting graph against expert-curated ground-truth evolution chains and observe strong alignment. In addition, we demonstrate that Intern-Atlas enables downstream applications in idea evaluation and automated idea generation. We position methodological evolution graphs as a foundational data layer for the emerging automated scientific discovery.

  • 13 authors
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Apr 29 4

RoboPhD: Self-Improving Text-to-SQL Through Autonomous Agent Evolution

We present RoboPhD, a system where AI agents autonomously conduct research to improve Text-to-SQL performance. RoboPhD implements a closed-loop evolution cycle with two coordinated components: a SQL Generation agent composed of a database analysis script and SQL generation instructions, and an Evolution agent that designs new versions based on performance feedback. Central to the framework is an ELO-based selection mechanism enabling survival-of-the-fittest dynamics while handling non-transitivity in performance. Starting from a naive 70-line baseline, RoboPhD evolves agents through iterative cross-pollination, discovering effective techniques without any external guidance on the Text-to-SQL domain. Our best agent, evolved to 1500 lines over 18 iterations, autonomously discovered strategies such as size-adaptive database analysis that adjusts depth based on schema complexity and SQL generation patterns for column selection, evidence interpretation, and aggregation. Evolution provides the largest gains on cheaper models: while we improve by 2.3 points over a strong Claude Opus 4.5 naive baseline, we show an improvement of 8.9 points over the weaker Claude Haiku model. This enables 'skip a tier' deployment: evolved Haiku exceeds naive Sonnet accuracy, and evolved Sonnet exceeds naive Opus, both at lower cost. The full system achieves 73.67% accuracy on the BIRD test set, demonstrating that AI can autonomously build a strong agentic system with only a trivial human-provided starting point.

  • 2 authors
·
Jan 25

Root-Cause Attribution Is a Search Problem: Continual Search for Long-Horizon Agent Failures

The increasing deployment of AI agents in long-horizon tasks yields massive execution logs. Diagnosing failures within these records is crucial for reliability, as it transforms outcome-level signals into actionable interventions. The sheer scale of the data renders human review impractical, driving the need for automated root-cause attribution (RCA). However, automated RCA methods using LLMs suffer from low diagnostic accuracy, especially as execution traces grow larger. They struggle because relevant information is often sparse, distributed across distant actions, and disconnected from the visible failure, reducing root-cause attribution to a massive search problem. Existing RCA methods typically rely on one-shot LLM judgments to diagnose failures from execution traces. While effective for shorter trajectories, these judges tend to settle on a plausible diagnosis early, leaving critical evidence in longer traces unexamined. We introduce Continual Search, an iterative framework that nudges the judge, over successive turns, to keep searching for unresolved diagnostic evidence. We evaluate Continual Search across four existing RCA benchmarks. Recognizing the lack of massive execution traces in current benchmarks, we introduce MegaRCA-Mix to evaluate RCA at scale. MegaRCA-Mix provides a challenging testbed of 50 human-annotated failure trials spanning long-horizon, execution-heavy tasks. Across multiple benchmark suites and model families, Continual Search consistently improves attribution performance. On MegaRCA-Mix, for example, it improves GPT-5.5's F1 score by more than 40\%, from 0.349 to 0.498. More interestingly, within the same model family, lower-tier models can even surpass their higher-tier counterparts, demonstrating that effective search supersedes raw model scale.

ScaleAI Scale AI
·
Sep 10 2

Pathology-CoT: Learning Visual Chain-of-Thought Agent from Expert Whole Slide Image Diagnosis Behavior

Diagnosing a whole-slide image is an interactive, multi-stage process involving changes in magnification and movement between fields. Although recent pathology foundation models are strong, practical agentic systems that decide what field to examine next, adjust magnification, and deliver explainable diagnoses are still lacking. The blocker is data: scalable, clinically aligned supervision of expert viewing behavior that is tacit and experience-based, not written in textbooks or online, and therefore absent from large language model training. We introduce the AI Session Recorder, which works with standard WSI viewers to unobtrusively record routine navigation and convert the viewer logs into standardized behavioral commands (inspect or peek at discrete magnifications) and bounding boxes. A lightweight human-in-the-loop review turns AI-drafted rationales into the Pathology-CoT dataset, a form of paired "where to look" and "why it matters" supervision produced at roughly six times lower labeling time. Using this behavioral data, we build Pathologist-o3, a two-stage agent that first proposes regions of interest and then performs behavior-guided reasoning. On gastrointestinal lymph-node metastasis detection, it achieved 84.5% precision, 100.0% recall, and 75.4% accuracy, exceeding the state-of-the-art OpenAI o3 model and generalizing across backbones. To our knowledge, this constitutes one of the first behavior-grounded agentic systems in pathology. Turning everyday viewer logs into scalable, expert-validated supervision, our framework makes agentic pathology practical and establishes a path to human-aligned, upgradeable clinical AI.

zhihuanglab Zhi Huang Lab
·
Oct 6, 2025 2

What Do Evolutionary Coding Agents Evolve?

Recent work pairs LLMs with evolutionary search to iteratively generate, modify, and select code using task-specific feedback. These systems have produced strong results in mathematical discovery and algorithm design, yet a fundamental question remains: what do they actually evolve? Progress is typically summarized by the best score a run reaches under a task-specific evaluator, but that score can reflect several different mechanisms: new algorithmic structure, re-tuning an existing strategy, recombining ideas already in the model's internal knowledge, or overfitting to the evaluator. Distinguishing these mechanisms requires inspecting the search process itself, not only its final outcome. We introduce EvoTrace, a dataset of evolutionary coding traces spanning four evolutionary frameworks, reasoning and non-reasoning models, and 16 tasks across mathematics and algorithm design. To analyze these traces, we develop EvoReplay, a replay-based methodology that reconstructs the local search states behind high-scoring solutions and tests controlled interventions, including adjusting constants, removing program components and substituting models or prompting contexts. We annotate every code edit in EvoTrace with one of nine recurring edit types using an LLM-as-judge pipeline validated against blind human re-annotation. Across EvoTrace, most score gains come from a small subset of these edit types. We further find a deterministic cycling pattern: about 30% of code lines added during search are byte-identical re-introductions of previously-deleted lines, present throughout nearly every run. These results show that benchmark gains in evolutionary coding agents can arise from qualitatively different mechanisms, only some of which correspond to new algorithmic structure. EvoTrace enables more diagnostic evaluation of evolutionary coding agents beyond final benchmark scores.

  • 7 authors
·
May 18

From Clinical Intent to Clinical Model: An Autonomous Coding-Agent Framework for Clinician-driven AI Development

Clinical AI development has traditionally followed a collaborative paradigm that depends on close interaction between clinicians and specialized AI teams. This paradigm imposes a practical challenge: clinicians must repeatedly communicate and refine their requirements with AI developers before those requirements can be translated into executable model development. This iterative process is time-consuming, and even after repeated discussion, misalignment may still exist because the two sides do not fully share each other's expertise. However, autonomous coding agents may change this paradigm, raising the possibility that clinicians could develop clinical AI models independently through natural-language interaction alone. In this study, we present such an autonomous prototype for clinician-driven clinical AI development. We evaluated the system on five clinical tasks spanning dermoscopic lesion classification, melanoma-versus-nevus triage, wrist-fracture detection (including a weakly supervised variant with only 5% bounding-box annotations), and debiased pneumothorax classification on chest radiographs. Across these settings, the system consistently developed models from clinician requests and achieved promising performance. Notably, in a debiased pneumothorax classification task on chest radiographs, where chest drains can act as a major confounder, the system successfully mitigated shortcut learning and nearly halved the model's reliance on chest drains. These findings provide proof of concept that autonomous coding agents may help shift clinical AI development toward a more clinician-driven paradigm, reducing the communication overhead and dependence on specialized AI developers. Although further validation and robustness assessment are needed, this study suggests a promising path toward making clinical AI development more accessible.

  • 6 authors
·
Apr 17

HypoEvolve: Genetic Algorithms Enable Multi-Agent LLMs to Discover Scientific Hypotheses

Scientific agents contribute to hypothesis discovery by synthesizing evidence, assessing proposals, and developing new explanations. Recent systems combine scientific agents with evolutionary search through critique, comparison, and revision. However, how different forms of agent collaboration affect hypothesis quality remains an open question. Answering this question requires separating the effects of agents' scientific capabilities from those of their collaboration. A framework must therefore preserve agents' scientific roles and support rules for combining, revising, and retaining hypotheses. Building on this view, we introduce HypoEvolve, which makes collaboration explicit through successive updates to a hypothesis population. Specifically, we propose a generational genetic algorithm to coordinate specialized large language model (LLM) agents that integrate mechanistic arguments, reconsider assumptions, and assess evidence and testability. Each generation specifies how scientific judgments and new proposals reshape the population, making collaboration effects on hypothesis quality directly testable. Moreover, we design our evaluation around scientifically meaningful hypotheses that explain how a proposed intervention could work. Drug repurposing links these explanations to target-level biological claims assessed against external evidence. Specifically, we adapt DepMap and Open Targets into complementary external measures grounded in experimental, genetic, and clinical evidence. Across 34 cancer types, HypoEvolve achieves the highest scores against six baselines on both measures. DepMap selectivity reaches 0.171, versus 0.115 for the strongest baseline. Gains over single-pass generation also generalize to held-out cancer types. HypoEvolve advances a vision of autonomous science in which AI research teams achieve a capacity for discovery beyond that of individual models.

  • 13 authors
·
Sep 13 2

The World Won't Stay Still: Programmable Evolution for Agent Benchmarks

LLM-powered tool-calling agents fulfill user requests by interacting with environments, querying data, and invoking tools in a multi-turn process. Yet, most existing benchmarks evaluate these systems under static environment interfaces, with fixed schemas and toolsets, making it difficult to assess how agents behave as environments evolves -- when capabilities are added, reorganized, or deprecated across successive environment versions. In this paper, we study structured environment evolution as a benchmark-construction problem for tool-calling agents. We propose ProEvolve, a graph-based framework that makes environment evolution programmable. At its core, a typed relational graph provides a unified, explicit representation of the environment - data, tools, and schema. Under this formalism, adding, removing, or modifying capabilities are expressed as graph transformations that coherently propagate updates across tools, schemas, and data access. Building on this, ProEvolve supports (1) automatic generation of evolved executable environments through explicit graph transformations, and (2) graph-grounded construction of task sandboxes via subgraph sampling and instantiation. We validate ProEvolve in two tool-calling domains, e-commerce and airline booking, in terms of quality, implementation validity, and failure modes. Finally, we use the generated benchmark as a downstream diagnostic to study how representative agents behave under structured environment evolution.

  • 14 authors
·
May 18

MedS^3: Towards Medical Small Language Models with Self-Evolved Slow Thinking

Medical language models (MLMs) have become pivotal in advancing medical natural language processing. However, prior models that rely on pre-training or supervised fine-tuning often exhibit low data efficiency and limited practicality in real-world clinical applications. While OpenAIs O1 highlights test-time scaling in mathematics, attempts to replicate this approach in medicine typically distill responses from GPT-series models to open-source models, focusing primarily on multiple-choice tasks. This strategy, though straightforward, neglects critical concerns like data privacy and realistic deployment in clinical settings. In this work, we present a deployable, small-scale medical language model, \mone, designed for long-chain reasoning in clinical tasks using a self-evolution paradigm. Starting with a seed dataset of around 8,000 instances spanning five domains and 16 datasets, we prompt a base policy model to perform Monte Carlo Tree Search (MCTS) to construct verifiable reasoning chains. Each reasoning step is assigned an evolution rollout value, allowing verified trajectories to train the policy model and the reward model. During inference, the policy model generates multiple responses, and the reward model selects the one with the highest reward score. Experiments on eleven evaluation datasets demonstrate that \mone outperforms prior open-source models by 2 points, with the addition of the reward model further boosting performance (sim13 points), surpassing GPT-4o-mini. Code and data are available at https://github.com/pixas/MedSSS.

  • 6 authors
·
Jan 21, 2025

Trustworthy and Fair SkinGPT-R1 for Democratizing Dermatological Reasoning across Diverse Ethnicities

The clinical translation of dermatological AI is hindered by opaque reasoning and systematic performance disparities across skin tones. Here we present SkinGPT-R1, a multimodal large language model that integrates chain-of-thought diagnostic reasoning with a fairness-aware mixture-of-experts architecture for interpretable and equitable skin disease diagnosis. Through parameter-efficient adaptation of a frozen reasoning backbone, SkinGPT-R1 generates structured diagnostic reports comprising visual findings, differential reasoning, and final diagnosis. Across seven external datasets spanning diverse pathologies and imaging conditions, SkinGPT-R1 achieves state-of-the-art accuracy on six benchmarks, including 82.50\% on a challenging 40-class long-tail classification task (+19.30\% over leading baselines). Blinded evaluation by five board-certified dermatologists on 1,000 phenotypically balanced cases yields a mean score of 3.6 out of 5, with the highest ratings in safety (3.8) and reasoning coherence (3.6), indicating that the generated rationales are clinically safe, logically grounded, and suitable for supporting diagnostic decision-making. Critically, SkinGPT-R1 mitigates algorithmic bias across the full Fitzpatrick spectrum, achieving a robust worst-group performance of 41.40\% on the Fitz17k benchmark and a five-fold relative improvement in lower-bound accuracy on the DDI dataset compared to standard multimodal baselines. These results establish a framework for trustworthy, fair, and explainable AI-assisted dermatological diagnosis.

  • 17 authors
·
Nov 19, 2025

AlphaEvolve: A coding agent for scientific and algorithmic discovery

In this white paper, we present AlphaEvolve, an evolutionary coding agent that substantially enhances capabilities of state-of-the-art LLMs on highly challenging tasks such as tackling open scientific problems or optimizing critical pieces of computational infrastructure. AlphaEvolve orchestrates an autonomous pipeline of LLMs, whose task is to improve an algorithm by making direct changes to the code. Using an evolutionary approach, continuously receiving feedback from one or more evaluators, AlphaEvolve iteratively improves the algorithm, potentially leading to new scientific and practical discoveries. We demonstrate the broad applicability of this approach by applying it to a number of important computational problems. When applied to optimizing critical components of large-scale computational stacks at Google, AlphaEvolve developed a more efficient scheduling algorithm for data centers, found a functionally equivalent simplification in the circuit design of hardware accelerators, and accelerated the training of the LLM underpinning AlphaEvolve itself. Furthermore, AlphaEvolve discovered novel, provably correct algorithms that surpass state-of-the-art solutions on a spectrum of problems in mathematics and computer science, significantly expanding the scope of prior automated discovery methods (Romera-Paredes et al., 2023). Notably, AlphaEvolve developed a search algorithm that found a procedure to multiply two 4 times 4 complex-valued matrices using 48 scalar multiplications; offering the first improvement, after 56 years, over Strassen's algorithm in this setting. We believe AlphaEvolve and coding agents like it can have a significant impact in improving solutions of problems across many areas of science and computation.

  • 18 authors
·
Jun 16, 2025

EvoGen-Harness: Learning Where and How to Evolve Image-Generation Harnesses

Modern text-to-image (T2I) systems can be improved without modifying generator parameters by adapting the external system around frozen generators. However, existing approaches typically optimize a predefined dimension, such as prompts, routing, or workflows, restricting the space in which generation failures can be corrected. Allowing multiple generator-external responsibilities to evolve provides a broader adaptation space, but introduces a new challenge: visual feedback reveals what failed, but not where persistent evolution should occur or how this space should be explored efficiently. We introduce EvoGen-Harness, a generator-agnostic framework for multi-responsibility image-generation harness evolution, together with Trace (Trajectory-Relative Attribution and Coordinated Evolution). Trace aggregates evidence across stochastic executions, uses failure attribution as a search prior to focus candidate updates, and progressively re-attributes residual failures to coordinate evolution across responsibilities, while No-Patch and held-out validation prevent unnecessary or harmful updates. Across GenEval2, T2I-CompBench++, and WISE, EvoGen-Harness improves over the strongest evaluated baselines by +0.2633, +0.0720, and +0.0752, respectively, while achieving 87.9-91.4% attribution recall, 94.8% No-Patch accuracy, and only 1.9% regression. These results demonstrate that attribution-guided multi-responsibility evolution can substantially enhance frozen T2I systems beyond single-dimension adaptation.

  • 4 authors
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Sep 29

LEVI: Stronger Search Architectures Can Substitute for Larger LLMs in Evolutionary Search

LLM-guided evolutionary methods such as AlphaEvolve have proven effective in domains like math, systems research, and algorithmic discovery, but their reliance on frontier models makes each run expensive. We argue this is largely an artifact of how existing frameworks allocate search: archives that fail to preserve solution diversity force compensation through stronger mutation models; blind model use spends frontier dollars on local edits a smaller model could handle; and full-set evaluation wastes rollouts on redundant examples. We introduce LEVI, a harness-first evolutionary framework built on the bet that stronger search architectures can substitute for or even outperform larger LLMs in evolutionary search. LEVI improves on three core components of evolutionary search: a solution database that establishes diversity from the beginning, and then maintains it throughout the run; a smarter mutation router that plays into the strengths of large and small LLMs; and a rank-preserving proxy benchmark for rollout-heavy settings. Across systems-research benchmarks LEVI attains the highest score on a budget 3.3-6.7x smaller than the published frontier-model runs of existing frameworks like ShinkaEvolve, GEPA, and AdaEvolve; on one problem, LEVI matches the existing best at a 35x lower cost. On prompt optimization, LEVI matches or exceeds GEPA at less than half of its rollout budget on four different benchmarks. LEVI is available as an open-source framework at https://github.com/ttanv/levi.

  • 1 authors
·
May 9

PACE: Two-Timescale Self-Evolution for Small Language Model Agents

Deploying language-model agents in production often requires substantial compute and human effort to tune prompts, parsers, validators, and other components of the agent pipeline. Self-evolution offers a promising alternative, but most existing frameworks assume access to frontier models that can reliably diagnose failures, propose revisions, and judge their own updates. We study whether frozen small language models (SLMs) can serve as effective self-evolving agents under resource constraints. We propose PACE (Prompt And Control Logic Evolution), a two-timescale framework that coordinates low-risk prompt refinement with higher-risk control-logic updates. PACE evolves prompts under fixed control logic until prompt-level gains saturate, then considers constrained control-logic updates that are accepted through held-out validation. Across three frozen SLM backbones ranging from 4B to 14B parameters and four controlled benchmarks, PACE achieves the best performance on all 12 backbone--benchmark combinations, improving over vanilla SLM agents by up to +9.2% relative improvement and over the stronger single-mode evolution baseline by up to +5.4% relative improvement. A tau-bench case study further shows that PACE improves multi-turn tool-use success over vanilla and prompt-only evolution. These results suggest that reliable SLM agent self-evolution is possible without updating model weights or relying on frontier-model teachers, and that the key benefit is not any single final solver pattern but autonomous, validated discovery of task-appropriate inference strategies.

  • 7 authors
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May 20

Steve-Evolving: Open-World Embodied Self-Evolution via Fine-Grained Diagnosis and Dual-Track Knowledge Distillation

Open-world embodied agents must solve long-horizon tasks where the main bottleneck is not single-step planning quality but how interaction experience is organized and evolved. To this end, we present Steve-Evolving, a non-parametric self-evolving framework that tightly couples fine-grained execution diagnosis with dual-track knowledge distillation in a closed loop. The method follows three phases: Experience Anchoring, Experience Distillation, and Knowledge-Driven Closed-Loop Control. In detail, Experience Anchoring solidifies each subgoal attempt into a structured experience tuple with a fixed schema (pre-state, action, diagnosis-result, and post-state) and organizes it in a three-tier experience space with multi-dimensional indices (e.g., condition signatures, spatial hashing, and semantic tags) plus rolling summarization for efficient and auditable recall. To ensure sufficient information density for attribution, the execution layer provides compositional diagnosis signals beyond binary outcomes, including state-difference summaries, enumerated failure causes, continuous indicators, and stagnation/loop detection. Moreover, successful trajectories of Experience Distillation are generalized into reusable skills with explicit preconditions and verification criteria, while failures are distilled into executable guardrails that capture root causes and forbid risky operations at both subgoal and task granularities. Besides, Knowledge-Driven Closed-Loop Control retrieved skills and guardrails are injected into an LLM planner, and diagnosis-triggered local replanning updates the active constraints online, forming a continual evolution process without any model parameter updates. Experiments on the long-horizon suite of Minecraft MCU demonstrate consistent improvements over static-retrieval baselines.

  • 7 authors
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Mar 13 2

Harnessing Pre-Resolution Signals for Future Prediction Agents

Many high-stakes decisions depend on forecasts made before outcomes are known. In this future prediction setting, the central challenge is that public evidence evolves over time, while the main supervision signal arrives only after resolution: the realized outcome mainly assesses final correctness, offering only coarse guidance on what to track, what to verify, and which judgments to leave uncertain along the way. Our key observation is that revisiting the same unresolved question over time creates informative temporal contrasts across evolving evidence and repeated forecasts, exposing what earlier attempts missed before resolution and yielding a diagnostic signal we call the pre-resolution signal. We instantiate this idea in Milkyway, a future prediction agent with a persistent future prediction harness, an editable external state that stores reusable procedural guidance across revisits to the same unresolved question. As the same unresolved question is revisited, Milkyway extracts pre-resolution signals from evolving evidence and repeated forecasts, uses them to update the harness, and improves later forecasts on that question before resolution. After resolution, the realized outcome serves as a post-resolution check of provisional updates. On the FutureX and FutureWorld benchmarks, Milkyway achieves strong performance against competitive baselines, and a mechanism study suggests that the gains stem from harness evolution driven by pre-resolution signals rather than repeated prediction alone.

  • 15 authors
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May 7

A specialized reasoning large language model for accelerating rare disease diagnosis: a randomized AI physician assistance trial

Rare diseases affect millions of individuals worldwide, yet timely diagnosis remains a major public health challenge due to scarcity of specialized clinical expertise. While large language models (LLMs) show promise to support rare disease diagnosis, current models are constrained by insufficient clinical deployability, limited clinically grounded evidence, and scarcity of training data. Here we present RaDaR (Rare Disease navigatoR), an open-source, compact reasoning LLM (32B parameters) for rare disease diagnosis. RaDaR was trained with 49,170 publicly available free-text cases and 104,666 synthetic cases with reasoning-enhanced training. RaDaR showed the strongest performance among evaluated open-source models, including the 671B DeepSeek-R1, across public benchmarks and four external validation centers. In a retrospective cohort, RaDaR prioritized the final diagnosis before documented clinical suspicion in 61.06 percent of cases, corresponding to a potential lead time of 1.87 months and 50.18 percent of the within-center interval. In a randomized physician-assistance trial, RaDaR assistance improved physicians' rare-disease diagnostic accuracy by 21.44 percentage points compared with internet search alone. Synthetic-data ablations suggested that phenotype-anchored narratives provide useful training signal for long-tail rare diseases, with a monotonic scaling trend within the tested data range. Together, RaDaR and its development and validation framework provide a deployable rare-disease reasoning model and a reproducible development framework for diagnostic AI under data scarcity.

  • 31 authors
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Jun 22

DemoEvolve: Overcoming Sparse Feedback in Agentic Harness Evolution with Demonstrations

Agent harness evolution improves frozen language-model agents by modifying the executable structures around them. We study this paradigm as a form of sample-efficient fast adaptation: instead of updating model weights, an agent can acquire task-specific competence by changing its external harness, while leaving the base model's general capabilities intact. Prior work shows that self-generated rollouts can support harness search, suggesting that agents may acquire new task competence through practice. Yet in long-horizon stochastic environments, self-practice becomes fragile: rewards are sparse, outcomes are high-variance, and failures are hard to attribute to concrete harness mechanisms. We introduce DemoEvolve, a demonstration-bootstrapped approach to harness evolution. When reward-only search is too broad and noisy, competent human trajectories serve as expert reference experience for the coding proposer, guiding harness-level diagnosis and editing. Experiments on Liar's Dice show that self-rollout evolution can work when episodes are short and failures are attributable. In contrast, Balatro exposes a harder long-horizon stochastic regime, where self-rollout evolution is misled by sparse feedback and candidate-selection noise, while tutorial-like textual knowledge alone does not yield stable improvement. Under the same limited budget, DemoEvolve produces more effective and auditable harness edits and achieves better performance. Overall, demonstrations make sparse-feedback harness evolution more diagnosable, localizable, and stable.

  • 6 authors
·
May 22

HarnessCompass: Guiding Automatic Harness Evolution toward Generalizable and Effective Agent Harnesses

Harness design plays a critical role in agent performance by shaping how large language models (LLMs) perceive, reason over, and act within executable environments. Recent work has proposed automatic harness evolution, which iteratively improves the harness from agent--environment interactions. However, existing methods often overfit to the evolution tasks, rely exclusively on trajectory-derived signals, and optimize harness components jointly, causing interference across components. We propose HarnessCompass, a novel automatic harness evolution framework built around constrained evolution, proactive feedback, and component-wise optimization. HarnessCompass first enforces global constraints on evolution, restricting modifications to task-agnostic harness changes that generalize beyond the evolution tasks. It then augments trajectory-derived evidence with proactive first-person feedback from the agent about harness usage, yielding richer signals for evolution. Finally, it decouples the optimization of different harness components before consolidating them into a unified harness, reducing cross-component interference while preserving component synergy. On SWE-bench Verified with GPT-5.4, HarnessCompass improves Pass@1 from 54\% to 66\% in only 5 evolution iterations, outperforming AHE in both effectiveness and evolution efficiency. In addition, the evolved harness transfers effectively to held-out tasks and other models, demonstrating substantially stronger generalization than prior automatic harness evolution methods.

  • 12 authors
·
Aug 2

SkinFlow: Efficient Information Transmission for Open Dermatological Diagnosis via Dynamic Visual Encoding and Staged RL

General-purpose Large Vision-Language Models (LVLMs), despite their massive scale, often falter in dermatology due to "diffuse attention" - the inability to disentangle subtle pathological lesions from background noise. In this paper, we challenge the assumption that parameter scaling is the only path to medical precision. We introduce SkinFlow, a framework that treats diagnosis as an optimization of visual information transmission efficiency. Our approach utilizes a Virtual-Width Dynamic Vision Encoder (DVE) to "unfold" complex pathological manifolds without physical parameter expansion, coupled with a two-stage Reinforcement Learning strategy. This strategy sequentially aligns explicit medical descriptions (Stage I) and reconstructs implicit diagnostic textures (Stage II) within a constrained semantic space. Furthermore, we propose a clinically grounded evaluation protocol that prioritizes diagnostic safety and hierarchical relevance over rigid label matching. Empirical results are compelling: our 7B model establishes a new state-of-the-art on the Fitzpatrick17k benchmark, achieving a +12.06% gain in Top-1 accuracy and a +28.57% boost in Top-6 accuracy over the massive general-purpose models (e.g., Qwen3VL-235B and GPT-5.2). These findings demonstrate that optimizing geometric capacity and information flow yields superior diagnostic reasoning compared to raw parameter scaling.

BenchEvolver: Frontier Task Synthesis via Solution-Centric Evolution

The rapid progress of frontier large language models has led to widespread benchmark saturation, limiting the ability of existing datasets to differentiate model capabilities or provide useful training signal. For instance, on LiveCodeBench, frontier models achieve over 99% Pass@1 on easy splits and exceed 90% Pass@1 on average across difficulty levels. Constructing new, challenging datasets typically requires substantial human effort, creating a bottleneck for progress. We introduce BenchEvolver, a solution-centric evolutionary framework that automatically transforms existing coding problems into harder variants. Rather than generating problems from scratch, BenchEvolver evolves reference solutions through structured transformations and derives corresponding statements and tests from the evolved solutions. This design grounds generation in executable semantics, enabling scalable construction of high-quality, diverse, and difficult tasks with verifiable correctness. Applying BenchEvolver to LiveCodeBench and SciCode, we obtain evolved tasks that are substantially harder while maintaining validity, reference correctness, and diversity. We further curate LiveCodeBench-Plus, a 91-problem benchmark combining evolved and difficult original LCB-v6 tasks, where frontier-model Pass@1 ranges from 27.5% to 62.6%, restoring clear discrimination among strong coding models. Importantly, evolved tasks remain challenging even for the model that generates them, enabling self-improvement. We further show that RL on evolved LCB tasks improves held-out coding performance: for gpt-oss-20b, seed+evolved training achieves +8.7 and +8.3 Pass@1 gains on LCB v6 Hard and LCB-Pro Easy, exceeding seed-only gains by 70.7% and 34.8%, respectively. Our results show that BenchEvolver can convert saturated benchmarks into frontier-level evaluation suites and reusable training signal.

Ecdysis: Efficient and Effective Training of Runtime Harnesses for LLM Agents

Self-evolving runtime harnesses can substantially improve the capabilities of large language model (LLM) agents and provide a promising paradigm for optimizing agent execution. Existing failure-driven approaches often treat observed agent failures as direct evidence for harness modification. A key challenge in failure-driven harness evolution is that observed failures can reflect either limitations of the underlying model or systematic deficiencies of the harness. Directly optimizing against individual failures can therefore induce model-specific accommodation and impair generalization across tasks and models. We study whether failure evidence accumulated across task instances can provide a more reliable signal for harness training. Our key insight is that failures recurring across distinct tasks provide stronger inductive evidence for systematic harness deficiencies than isolated failures. Based on this insight, we propose Ecdysis, which aggregates failure evidence across task instances before promoting recurring failure patterns into persistent harness evolution, biasing evolution toward repairs that are more likely to generalize beyond individual model behaviors. Ecdysis further employs collaborative failure analysis to refine modification specifications, trading additional evolution-time reasoning for improved modification quality. Across multiple LLMs and benchmarks, Ecdysis improves the reasoning accuracy of evolved harnesses by 18.56% over existing harness evolution while achieving up to 1.84x faster harness training. Ecdysis also enables more data-efficient training. Fine-grained analysis shows that Ecdysis reduces model-specific accommodation during evolution, while the resulting harnesses exhibit stronger cross-LLM generalization and lower inference-time token consumption.

  • 14 authors
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Sep 19

PathReasoner-R1: Instilling Structured Reasoning into Pathology Vision-Language Model via Knowledge-Guided Policy Optimization

Vision-Language Models (VLMs) are advancing computational pathology with superior visual understanding capabilities. However, current systems often reduce diagnosis to directly output conclusions without verifiable evidence-linked reasoning, which severely limits clinical trust and hinders expert error rectification. To address these barriers, we construct PathReasoner, the first large-scale dataset of whole-slide image (WSI) reasoning. Unlike previous work reliant on unverified distillation, we develop a rigorous knowledge-guided generation pipeline. By leveraging medical knowledge graphs, we explicitly align structured pathological findings and clinical reasoning with diagnoses, generating over 20K high-quality instructional samples. Based on the database, we propose PathReasoner-R1, which synergizes trajectory-masked supervised fine-tuning with reasoning-oriented reinforcement learning to instill structured chain-of-thought capabilities. To ensure medical rigor, we engineer a knowledge-aware multi-granular reward function incorporating an Entity Reward mechanism strictly aligned with knowledge graphs. This effectively guides the model to optimize for logical consistency rather than mere outcome matching, thereby enhancing robustness. Extensive experiments demonstrate that PathReasoner-R1 achieves state-of-the-art performance on both PathReasoner and public benchmarks across various image scales, equipping pathology models with transparent, clinically grounded reasoning capabilities. Dataset and code are available at https://github.com/cyclexfy/PathReasoner-R1.

  • 5 authors
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Jan 29

Evidence-Informed LLM Beliefs for Continual Scientific Discovery

Open-ended scientific discovery with large language models (LLMs) increasingly operates as a long-horizon loop of hypothesis search and verification, where a reward signal guides which hypotheses to test next. A notable recent example is AutoDiscovery, which uses "Bayesian surprise" - the belief shift an LLM undergoes after observing evidence for a hypothesis - as both a discovery metric and a reward for search. We first observe that AutoDiscovery treats surprisal as a static quantity, while surprisal in human reasoning is non-stationary - it is defined relative to beliefs that evolve with experience, a prerequisite for continual scientific discovery. We address this mismatch with evidence-informed LLM beliefs: priors updated with evidence from previous hypotheses to compute non-stationary surprisal for new hypotheses. We compare in-context belief-updating mechanisms and find that embedding-based retrieval-augmented generation over prior discoveries best anticipates eventual posteriors, identifying 37.5% of static surprisals as spurious. We then modify search to avoid these spurious rewards and prioritize hypotheses that remain surprising under non-stationary beliefs. Concretely, we introduce two complementary changes to the original search procedure: belief-update filtering and diversity maximization. Across five discovery domains, our method increases accumulated non-stationary surprisal by 30.62% on average compared to the original search procedure, demonstrating that continual scientific discovery with LLMs requires not only better belief measurement but also search procedures that avoid redundancy and encourage diversity.

  • 6 authors
·
Jun 27

Automated Discovery Has No Universally Superior Harness

Autonomous discovery systems such as OpenEvolve and TTT-Discover are often used as general-purpose harnesses. However, in practice these are composite systems combining several design choices about archives, parent selection, exploration, and budget allocation into a single recipe. Because discovery runs are expensive and inherently stochastic, existing harnesses are often compared using too few independent trials to distinguish key methodological improvements from run-to-run variance. We systematically decompose OpenEvolve-style evolutionary search and the TTT-Discover search harness into its constituent components and systematically evaluate 30 budget-matched harnesses across 12 model-problem pairs using more than 3.1 million LLM rollouts and repeated-trial statistical analysis. Our results show that discovery harnesses have a generalization problem: No fixed harness is reliably superior across the evaluated model-problem pairs, and variants of OpenEvolve generally underperform simpler alternatives. Thus, harness choice is better viewed as a hyperparameter rather than as a universal recipe, and should be tailored to the specific problem and underlying model. We also find that early discovery progress predicts final performance, and use this property to present a budget-matched adaptive-allocation experiment that starts multiple harnesses, prunes weak partial runs, and reallocates compute to stronger survivors, outperforming both commitment to a randomly sampled fixed harness and a non-adaptive harness ensemble. Together, these results motivate shifting from fixed harness selection to online adaptation guided by early performance. We release all run pools including baseline null distributions for every model-problem pair as reusable statistical infrastructure against for future harness proposals.

  • 5 authors
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Jul 19

HyperWalker: Dynamic Hypergraph-Based Deep Diagnosis for Multi-Hop Clinical Modeling across EHR and X-Ray in Medical VLMs

Automated clinical diagnosis remains a core challenge in medical AI, which usually requires models to integrate multi-modal data and reason across complex, case-specific contexts. Although recent methods have advanced medical report generation (MRG) and visual question answering (VQA) with medical vision-language models (VLMs), these methods, however, predominantly operate under a sample-isolated inference paradigm, as such processing cases independently without access to longitudinal electronic health records (EHRs) or structurally related patient examples. This paradigm limits reasoning to image-derived information alone, which ignores external complementary medical evidence for potentially more accurate diagnosis. To overcome this limitation, we propose HyperWalker, a Deep Diagnosis framework that reformulates clinical reasoning via dynamic hypergraphs and test-time training. First, we construct a dynamic hypergraph, termed iBrochure, to model the structural heterogeneity of EHR data and implicit high-order associations among multimodal clinical information. Within this hypergraph, a reinforcement learning agent, Walker, navigates to and identifies optimal diagnostic paths. To ensure comprehensive coverage of diverse clinical characteristics in test samples, we incorporate a linger mechanism, a multi-hop orthogonal retrieval strategy that iteratively selects clinically complementary neighborhood cases reflecting distinct clinical attributes. Experiments on MRG with MIMIC and medical VQA on EHRXQA demonstrate that HyperWalker achieves state-of-the-art performance. Code is available at: https://github.com/Bean-Young/HyperWalker

  • 5 authors
·
Jan 19

PulseMind: A Multi-Modal Medical Model for Real-World Clinical Diagnosis

Recent advances in medical multi-modal models focus on specialized image analysis like dermatology, pathology, or radiology. However, they do not fully capture the complexity of real-world clinical diagnostics, which involve heterogeneous inputs and require ongoing contextual understanding during patient-physician interactions. To bridge this gap, we introduce PulseMind, a new family of multi-modal diagnostic models that integrates a systematically curated dataset, a comprehensive evaluation benchmark, and a tailored training framework. Specifically, we first construct a diagnostic dataset, MediScope, which comprises 98,000 real-world multi-turn consultations and 601,500 medical images, spanning over 10 major clinical departments and more than 200 sub-specialties. Then, to better reflect the requirements of real-world clinical diagnosis, we develop the PulseMind Benchmark, a multi-turn diagnostic consultation benchmark with a four-dimensional evaluation protocol comprising proactiveness, accuracy, usefulness, and language quality. Finally, we design a training framework tailored for multi-modal clinical diagnostics, centered around a core component named Comparison-based Reinforcement Policy Optimization (CRPO). Compared to absolute score rewards, CRPO uses relative preference signals from multi-dimensional com-parisons to provide stable and human-aligned training guidance. Extensive experiments demonstrate that PulseMind achieves competitive performance on both the diagnostic consultation benchmark and public medical benchmarks.

  • 12 authors
·
Jan 12

Inverse Bayesian Inference for Extracting Lesion Dynamics from Longitudinal Spectral CT

Longitudinal medical imaging captures temporal evolution of lesions, yet extracting the underlying dynamical parameters governing this evolution remains challenging. We propose an inverse Bayesian framework for inferring lesion dynamics from longitudinal spectral CT. We decompose spectral feature (x) evolution into three components: equation* dx_i{dt} = A_i x_i + B \cdot n + C \cdot Δx_{sat} equation* where A_i captures intrinsic dynamics (lesion-autonomous evolution), B captures local environment tumour burden (organ tumour burden through satellite count coupling), and C captures environment/satellite state change (i.e., whether surrounding lesions move similarly or not). We demonstrate the framework on photon-counting NSCLC CT data from metastases, recovering distinct dynamical regimes: lung lesions exhibit significant satellite count coupling (B=-0.34, p<0.05) suggesting competitive dynamics, while liver lesions show synergistic satellite behaviour coupling (Capprox+1.0, p<0.05). Synthetic validation confirms parameter recovery, and cross-coupling analysis validates that our method detects non-zero coupling when present. This work establishes inverse dynamical inference as a principled methodology for extracting interpretable parameters from longitudinal imaging, moving beyond static feature extraction toward mechanistic characterisation of lesion behaviour. The code and data are available at: https://github.com/lukasf98/inverse-bayesian-inference

  • 9 authors
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Jul 24

Integrating Clinical Knowledge Graphs and Gradient-Based Neural Systems for Enhanced Melanoma Diagnosis via the 7-Point Checklist

The 7-point checklist (7PCL) is a widely used diagnostic tool in dermoscopy for identifying malignant melanoma by assigning point values to seven specific attributes. However, the traditional 7PCL is limited to distinguishing between malignant melanoma and melanocytic Nevi, and falls short in scenarios where multiple skin diseases with appearances similar to melanoma coexist. To address this limitation, we propose a novel diagnostic framework that integrates a clinical knowledge-based topological graph (CKTG) with a gradient diagnostic strategy featuring a data-driven weighting system (GD-DDW). The CKTG captures both the internal and external relationships among the 7PCL attributes, while the GD-DDW emulates dermatologists' diagnostic processes, prioritizing visual observation before making predictions. Additionally, we introduce a multimodal feature extraction approach leveraging a dual-attention mechanism to enhance feature extraction through cross-modal interaction and unimodal collaboration. This method incorporates meta-information to uncover interactions between clinical data and image features, ensuring more accurate and robust predictions. Our approach, evaluated on the EDRA dataset, achieved an average AUC of 88.6%, demonstrating superior performance in melanoma detection and feature prediction. This integrated system provides data-driven benchmarks for clinicians, significantly enhancing the precision of melanoma diagnosis.

  • 7 authors
·
Jul 23, 2024

Ouroboros: A Self-Developing Frontier Coding Agent with Reviewed Core Evolution

We present Ouroboros, a self-developing agent harness whose tools, prompts, context assembly, and core implementation improve through reviewed commits that become the runtime for later work. Core evolution proceeds in two modes. In recursive free evolution, improvement is itself a task, and completing one evolution cycle can schedule the next. In experience-driven core evolution, ordinary work and social interaction expose bugs, rough edges, and inefficient context construction that lead to reviewed structural changes. On Terminal-Bench 2.1, an Opus 5 run scores 86.74%, the best result reported on the benchmark. On OSWorld-Verified, an Opus 5 run reaches 90.69%, exceeding the best previously reported score. A five-rollout CL-Bench campaign achieves a normalized reward of 0.2301, setting a new state of the art. Hope is the longest-running publicly documented Ouroboros deployment. It is a 161-day living agent experiment in free evolution under governed human communication across seven surfaces. Human interaction surfaces faults and generates proposals, but the agent decides which changes to pursue. Because a self-developing agent may rewrite its own code and select new model APIs, operational safety becomes a primary design problem: guardrails must remain authoritative under evolutionary and public social pressure. Benchmark campaigns use frozen system snapshots, while Hope continues live evolution on a separate lineage.

  • 6 authors
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Aug 7 4

MedAgent-Pro: Towards Multi-modal Evidence-based Medical Diagnosis via Reasoning Agentic Workflow

Developing reliable AI systems to assist human clinicians in multi-modal medical diagnosis has long been a key objective for researchers. Recently, Multi-modal Large Language Models (MLLMs) have gained significant attention and achieved success across various domains. With strong reasoning capabilities and the ability to perform diverse tasks based on user instructions, they hold great potential for enhancing medical diagnosis. However, directly applying MLLMs to the medical domain still presents challenges. They lack detailed perception of visual inputs, limiting their ability to perform quantitative image analysis, which is crucial for medical diagnostics. Additionally, MLLMs often exhibit hallucinations and inconsistencies in reasoning, whereas clinical diagnoses must adhere strictly to established criteria. To address these challenges, we propose MedAgent-Pro, an evidence-based reasoning agentic system designed to achieve reliable, explainable, and precise medical diagnoses. This is accomplished through a hierarchical workflow: at the task level, knowledge-based reasoning generate reliable diagnostic plans for specific diseases following retrieved clinical criteria. While at the case level, multiple tool agents process multi-modal inputs, analyze different indicators according to the plan, and provide a final diagnosis based on both quantitative and qualitative evidence. Comprehensive experiments on both 2D and 3D medical diagnosis tasks demonstrate the superiority and effectiveness of MedAgent-Pro, while case studies further highlight its reliability and interpretability. The code is available at https://github.com/jinlab-imvr/MedAgent-Pro.

  • 4 authors
·
Mar 21, 2025 2

ShinkaEvolve: Towards Open-Ended And Sample-Efficient Program Evolution

We introduce ShinkaEvolve: a new open-source framework leveraging large language models (LLMs) to advance scientific discovery with state-of-the-art performance and unprecedented efficiency. Recent advances in scaling inference time compute of LLMs have enabled significant progress in generalized scientific discovery. These approaches rely on evolutionary agentic harnesses that leverage LLMs as mutation operators to generate candidate solutions. However, current code evolution methods suffer from critical limitations: they are sample inefficient, requiring thousands of samples to identify effective solutions, and remain closed-source, hindering broad adoption and extension. ShinkaEvolve addresses these limitations, introducing three key innovations: a parent sampling technique balancing exploration and exploitation, code novelty rejection-sampling for efficient search space exploration, and a bandit-based LLM ensemble selection strategy. We evaluate ShinkaEvolve across diverse tasks, demonstrating consistent improvements in sample efficiency and solution quality. ShinkaEvolve discovers a new state-of-the-art circle packing solution using only 150 samples, designs high-performing agentic harnesses for AIME mathematical reasoning tasks, identifies improvements to ALE-Bench competitive programming solutions, and discovers novel mixture-of-expert load balancing loss functions that illuminate the space of optimization strategies. Our results demonstrate that ShinkaEvolve achieves broad applicability with exceptional sample efficiency. By providing open-source accessibility and cost-efficiency, this work democratizes open-ended discovery across diverse computational problems.

  • 3 authors
·
Sep 17, 2025

A Comprehensive Survey of Self-Evolving AI Agents: A New Paradigm Bridging Foundation Models and Lifelong Agentic Systems

Recent advances in large language models have sparked growing interest in AI agents capable of solving complex, real-world tasks. However, most existing agent systems rely on manually crafted configurations that remain static after deployment, limiting their ability to adapt to dynamic and evolving environments. To this end, recent research has explored agent evolution techniques that aim to automatically enhance agent systems based on interaction data and environmental feedback. This emerging direction lays the foundation for self-evolving AI agents, which bridge the static capabilities of foundation models with the continuous adaptability required by lifelong agentic systems. In this survey, we provide a comprehensive review of existing techniques for self-evolving agentic systems. Specifically, we first introduce a unified conceptual framework that abstracts the feedback loop underlying the design of self-evolving agentic systems. The framework highlights four key components: System Inputs, Agent System, Environment, and Optimisers, serving as a foundation for understanding and comparing different strategies. Based on this framework, we systematically review a wide range of self-evolving techniques that target different components of the agent system. We also investigate domain-specific evolution strategies developed for specialised fields such as biomedicine, programming, and finance, where optimisation objectives are tightly coupled with domain constraints. In addition, we provide a dedicated discussion on the evaluation, safety, and ethical considerations for self-evolving agentic systems, which are critical to ensuring their effectiveness and reliability. This survey aims to provide researchers and practitioners with a systematic understanding of self-evolving AI agents, laying the foundation for the development of more adaptive, autonomous, and lifelong agentic systems.

  • 15 authors
·
Aug 10, 2025 2

SE-Bench: Benchmarking Self-Evolution with Knowledge Internalization

True self-evolution requires agents to act as lifelong learners that internalize novel experiences to solve future problems. However, rigorously measuring this foundational capability is hindered by two obstacles: the entanglement of prior knowledge, where ``new'' knowledge may appear in pre-training data, and the entanglement of reasoning complexity, where failures may stem from problem difficulty rather than an inability to recall learned knowledge. We introduce SE-Bench, a diagnostic environment that obfuscates the NumPy library and its API doc into a pseudo-novel package with randomized identifiers. Agents are trained to internalize this package and evaluated on simple coding tasks without access to documentation, yielding a clean setting where tasks are trivial with the new API doc but impossible for base models without it. Our investigation reveals three insights: (1) the Open-Book Paradox, where training with reference documentation inhibits retention, requiring "Closed-Book Training" to force knowledge compression into weights; (2) the RL Gap, where standard RL fails to internalize new knowledge completely due to PPO clipping and negative gradients; and (3) the viability of Self-Play for internalization, proving models can learn from self-generated, noisy tasks when coupled with SFT, but not RL. Overall, SE-Bench establishes a rigorous diagnostic platform for self-evolution with knowledge internalization. Our code and dataset can be found at https://github.com/thunlp/SE-Bench.

  • 6 authors
·
Feb 4 2

Understanding Evolution Strategies for LLM Reasoning: Broader Reasoning Coverage than GRPO

Evolution Strategies (ES) have recently emerged as a memory-efficient post-training paradigm for LLM reasoning. However, the optimization behavior of ES remains understudied, making it hard to define its advantage scope compared to mainstream post-training paradigms (e.g., Group Relative Policy Optimization (GRPO)). By systematically investigating ES dynamics and mechanisms, this paper first identifies a performance advantage of ES over GRPO, theoretically and empirically showing that ES can lead to broader reasoning coverage, thereby better exploiting the reasoning capabilities of pretrained LLMs. Theoretically, we show that verifier-projected Jensen-Shannon diversity across the ES population is helpful to higher Pass@K performances. Empirically, unlike GRPO, which exhibits entropy collapse, ES improves Pass@1 while attaining higher Pass@K than GRPO. We further develop a sequential GRPO-ES training strategy that combines GRPO's strength in Pass@1 with ES's gains in Pass@K. Second, we find that despite substantial whole-model parameter drift, the task-performance gains of ES are only contributed to a sparse subset of larger-magnitude updates. This functional sparsity suggests that large parameter movement need not imply widespread functional change, and held-out evaluations further show that it does not necessarily lead to catastrophic forgetting. Finally, we study how hyperparameter design affects the effectiveness of ES, demonstrating that ES requires a smaller population size in a larger LLM. These findings position ES as a distinct reasoning post-training paradigm rather than a less effective, memory-efficient alternative to GRPO.

  • 10 authors
·
Aug 26 3

Bucketing the Good Apples: A Method for Diagnosing and Improving Causal Abstraction

We present a method for diagnosing interpretation in neural networks by identifying an input subspace where a proposed interpretation is highly faithful. Our method is particularly useful for causal-abstraction-style interpretability, where a high-level causal hypothesis is evaluated by interchange interventions. Rather than treating interchange intervention accuracy as a single global summary, we refine this framework by partitioning the input space into well-interpreted and under-interpreted regions according to pairwise interchange-intervention behavior. This turns causal abstraction from a purely global evaluation into a more diagnostic tool: it not only measures whether an interpretation works, but also reveals where it works, where it fails, and what distinguishes the two cases. This diagnostic view also provides practical heuristics for improving interpretations. By analyzing the structure of the well-interpreted and under-interpreted regions, we can identify missing distinctions in a high-level hypothesis, discover previously unmodeled intermediate variables, and combine complementary partial interpretations into a stronger one. We instantiate this idea as a simple four-step recipe and show that it yields informative error analyses across multiple causal abstraction settings. In a toy logic task, recursively applying the recipe recovers a high-level hypothesis from scratch. More broadly, our results suggest that partitioning the input space is a useful step toward more precise, constructive, and scalable mechanistic interpretability.

  • 5 authors
·
May 3

TRAJEVAL: Decomposing Code Agent Trajectories for Fine-Grained Diagnosis

Code agents can autonomously resolve GitHub issues, yet when they fail, current evaluation provides no visibility into where or why. Metrics such as Pass@1 collapse an entire execution into a single binary outcome, making it difficult to identify where and why the agent went wrong. To address this limitation, we introduce TRAJEVAL, a diagnostic framework that decomposes agent trajectories into three interpretable stages: search (file localization), read (function comprehension), and edit (modification targeting). For each stage, we compute precision and recall by comparing against reference patches. Analyzing 16,758 trajectories across three agent architectures and seven models, we find universal inefficiencies (all agents examine approximately 22x more functions than necessary) yet distinct failure modes: GPT-5 locates relevant code but targets edits incorrectly, while Qwen-32B fails at file discovery entirely. We validate that these diagnostics are predictive, achieving model-level Pass@1 prediction within 0.87-2.1% MAE, and actionable: real-time feedback based on trajectory signals improves two state-of-the-art models by 2.2-4.6 percentage points while reducing costs by 20-31%. These results demonstrate that our framework not only provides a more fine-grained analysis of agent behavior, but also translates diagnostic signals into tangible performance gains. More broadly, TRAJEVAL transforms agent evaluation beyond outcome-based benchmarking toward mechanism-driven diagnosis of agent success and failure.

  • 9 authors
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Mar 24

CORAL: Towards Autonomous Multi-Agent Evolution for Open-Ended Discovery

Large language model (LLM)-based evolution is a promising approach for open-ended discovery, where progress requires sustained search and knowledge accumulation. Existing methods still rely heavily on fixed heuristics and hard-coded exploration rules, which limit the autonomy of LLM agents. We present CORAL, the first framework for autonomous multi-agent evolution on open-ended problems. CORAL replaces rigid control with long-running agents that explore, reflect, and collaborate through shared persistent memory, asynchronous multi-agent execution, and heartbeat-based interventions. It also provides practical safeguards, including isolated workspaces, evaluator separation, resource management, and agent session and health management. Evaluated on diverse mathematical, algorithmic, and systems optimization tasks, CORAL sets new state-of-the-art results on 10 tasks, achieving 3-10 times higher improvement rates with far fewer evaluations than fixed evolutionary search baselines across tasks. On Anthropic's kernel engineering task, four co-evolving agents improve the best known score from 1363 to 1103 cycles. Mechanistic analyses further show how these gains arise from knowledge reuse and multi-agent exploration and communication. Together, these results suggest that greater agent autonomy and multi-agent evolution can substantially improve open-ended discovery. Code is available at https://github.com/Human-Agent-Society/CORAL.

EvoForest: A Novel Machine-Learning Paradigm via Open-Ended Evolution of Computational Graphs

Modern machine learning is still largely organized around a single recipe: choose a parameterized model family and optimize its weights. Although highly successful, this paradigm is too narrow for many structured prediction problems, where the main bottleneck is not parameter fitting but discovering what should be computed from the data. Success often depends on identifying the right transformations, statistics, invariances, interaction structures, temporal summaries, gates, or nonlinear compositions, especially when objectives are non-differentiable, evaluation is cross-validation-based, interpretability matters, or continual adaptation is required. We present EvoForest, a hybrid neuro-symbolic system for end-to-end open-ended evolution of computation. Rather than merely generating features, EvoForest jointly evolves reusable computational structure, callable function families, and trainable low-dimensional continuous components inside a shared directed acyclic graph. Intermediate nodes store alternative implementations, callable nodes encode reusable transformation families such as projections, gates, and activations, output nodes define candidate predictive computations, and persistent global parameters can be refined by gradient descent. For each graph configuration, EvoForest evaluates the discovered computation and uses a lightweight Ridge-based readout to score the resulting representation against a non-differentiable cross-validation target. The evaluator also produces structured feedback that guides future LLM-driven mutations. In the 2025 ADIA Lab Structural Break Challenge, EvoForest reached 94.13% ROC-AUC after 600 evolution steps, exceeding the publicly reported winning score of 90.14% under the same evaluation protocol.

  • 2 authors
·
Mar 25

ASI-Evolve: AI Accelerates AI

Can AI accelerate the development of AI itself? While recent agentic systems have shown strong performance on well-scoped tasks with rapid feedback, it remains unclear whether they can tackle the costly, long-horizon, and weakly supervised research loops that drive real AI progress. We present ASI-Evolve, an agentic framework for AI-for-AI research that closes this loop through a learn-design-experiment-analyze cycle. ASI-Evolve augments standard evolutionary agents with two key components: a cognition base that injects accumulated human priors into each round of exploration, and a dedicated analyzer that distills complex experimental outcomes into reusable insights for future iterations. To our knowledge, ASI-Evolve is the first unified framework to demonstrate AI-driven discovery across three central components of AI development: data, architectures, and learning algorithms. In neural architecture design, it discovered 105 SOTA linear attention architectures, with the best discovered model surpassing DeltaNet by +0.97 points, nearly 3x the gain of recent human-designed improvements. In pretraining data curation, the evolved pipeline improves average benchmark performance by +3.96 points, with gains exceeding 18 points on MMLU. In reinforcement learning algorithm design, discovered algorithms outperform GRPO by up to +12.5 points on AMC32, +11.67 points on AIME24, and +5.04 points on OlympiadBench. We further provide initial evidence that this AI-for-AI paradigm can transfer beyond the AI stack through experiments in mathematics and biomedicine. Together, these results suggest that ASI-Evolve represents a promising step toward enabling AI to accelerate AI across the foundational stages of development, offering early evidence for the feasibility of closed-loop AI research.

GAIR SII - GAIR
·
Mar 30 2

RareLens: Towards End-to-End Rare Disease Care via Aligning Divergent Large Language Model Reasoning

Rare diseases collectively affect an estimated 3.5% to 5.9% of the population, yet more than 70% of patients are misdiagnosed and many endure years of evaluation before a diagnosis is reached, because early presentations are nonspecific and relevant expertise is scarce and unevenly distributed. Artificial intelligence could provide support, but existing systems address isolated stages of care, overwhelmingly diagnosis. They typically depend on the results of downstream investigations, and they treat the variability between models as noise to be eliminated. Here we present RareLens, a system that supports clinical decision-making across the entire rare disease trajectory by exploiting this variability. When heterogeneous large language models evaluate the same case, they generate divergent but complementary reasoning, which RareLens aligns and calibrates into a single convergent, actionable decision at each stage. Four coordinated modules perform primary-visit risk screening, diagnosis, treatment planning and prognosis. Developed and evaluated on RareBench, a real-world dataset of 157,525 cases spanning all 33 Orphanet categories and more than 7,000 conditions, RareLens outperformed every frontier model tested, including GPT-5, DeepSeek-R1, Claude-3.7-Sonnet and Gemini-2.5-Pro, at each stage. It achieved an area under the curve of 0.917 for screening and top-1 accuracies of 65.5% and 89.8% for diagnosis and treatment. In an external study spanning 1,287 cases and 23 physicians, autonomous RareLens and physicians assisted by RareLens both substantially outperformed unaided physicians. These findings indicate that aligning divergent model reasoning, rather than scaling a single model, offers a generalizable strategy for high-uncertainty clinical decision-making.

  • 27 authors
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Jul 24

MedExAgent: Training LLM Agents to Ask, Examine, and Diagnose in Noisy Clinical Environments

Real-world clinical diagnosis is a complex process in which the doctor is required to obtain information from both interaction with the patient and conducting medical exams. Additionally, the doctor needs to adapt to different patient personas, as well as noisy and incomplete information that can happen at any time during the process. However, existing benchmarks for medical LLMs and methods for automatic diagnosis largely simplify this process by reducing it to single-turn question answering, noise-free conversations, or sequential exam making, etc., ignoring the interactive and uncertain nature of clinical diagnosis. In this paper, we aim to address this gap by formalizing clinical diagnosis as a Partially Observable Markov Decision Process (POMDP) with three action types: questioning the patient, ordering medical exams as tool calls, and issuing a diagnosis. We also introduce a systematic noise model comprising seven patient noise types and three exam noise types. Using our proposed environment, we train an effective diagnosis agent, MedExAgent, through a two-stage pipeline that first performs supervised finetuning on synthetic conversations structured after the Calgary-Cambridge model for clinical interviews, and then applies DAPO to optimize a composite reward capturing diagnostic accuracy, tool call quality, and exam cost including financial cost and patient discomfort. Through extensive experiments and ablation studies, we demonstrate that MedExAgent achieves diagnostic performance comparable to larger models while maintaining cost-efficient examination strategies.

  • 5 authors
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May 7

CLARITY: Medical World Model for Guiding Treatment Decisions by Modeling Context-Aware Disease Trajectories in Latent Space

Clinical decision-making in oncology requires predicting dynamic disease evolution, a task current static AI predictors cannot perform. While world models (WMs) offer a paradigm for generative prediction, existing medical applications remain limited. Existing methods often rely on stochastic diffusion models, focusing on visual reconstruction rather than causal, physiological transitions. Furthermore, in medical domain, models like MeWM typically ignore patient-specific temporal and clinical contexts and lack a feedback mechanism to link predictions to treatment decisions. To address these gaps, we introduce CLARITY, a medical world model that forecasts disease evolution directly within a structured latent space. It explicitly integrates time intervals (temporal context) and patient-specific data (clinical context) to model treatment-conditioned progression as a smooth, interpretable trajectory, and thus generate physiologically faithful, individualized treatment plans. Finally, CLARITY introduces a novel prediction-to-decision framework, translating latent rollouts into transparent, actionable recommendations. CLARITY demonstrates state-of-the-art performance in treatment planning. On the MU-Glioma-Post dataset, our approach outperforms recent MeWM by 12\%, and significantly surpasses all other medical-specific large language models.