MACD: Multi-Agent Clinical Diagnosis with Self-Learned Knowledge for LLM

• URL: http://arxiv.org/abs/2509.20067v3
• Date: Fri, 26 Sep 2025 02:33:31 GMT
• Title: MACD: Multi-Agent Clinical Diagnosis with Self-Learned Knowledge for LLM
• Authors: Wenliang Li, Rui Yan, Xu Zhang, Li Chen, Hongji Zhu, Jing Zhao, Junjun Li, Mengru Li, Wei Cao, Zihang Jiang, Wei Wei, Kun Zhang, Shaohua Kevin Zhou,
• Abstract summary: Large language models (LLMs) have demonstrated notable potential in medical applications.<n>This study proposes a novel Multi-Agent Clinical Diagnosis (MACD) framework.<n>It allows LLMs to self-learn clinical knowledge via a multi-agent pipeline.
• Score: 32.0716204095227
• License: http://creativecommons.org/licenses/by-nc-nd/4.0/
• Abstract: Large language models (LLMs) have demonstrated notable potential in medical applications, yet they face substantial challenges in handling complex real-world clinical diagnoses using conventional prompting methods. Current prompt engineering and multi-agent approaches typically optimize isolated inferences, neglecting the accumulation of reusable clinical experience. To address this, this study proposes a novel Multi-Agent Clinical Diagnosis (MACD) framework, which allows LLMs to self-learn clinical knowledge via a multi-agent pipeline that summarizes, refines, and applies diagnostic insights. It mirrors how physicians develop expertise through experience, enabling more focused and accurate diagnosis on key disease-specific cues. We further extend it to a MACD-human collaborative workflow, where multiple LLM-based diagnostician agents engage in iterative consultations, supported by an evaluator agent and human oversight for cases where agreement is not reached. Evaluated on 4,390 real-world patient cases across seven diseases using diverse open-source LLMs (Llama-3.1 8B/70B, DeepSeek-R1-Distill-Llama 70B), MACD significantly improves primary diagnostic accuracy, outperforming established clinical guidelines with gains up to 22.3% (MACD). In direct comparison with physician-only diagnosis under the same evaluation protocol, MACD achieves comparable or superior performance, with improvements up to 16%. Furthermore, the MACD-human workflow yields an 18.6% improvement over physician-only diagnosis, demonstrating the synergistic potential of human-AI collaboration. Notably, the self-learned clinical knowledge exhibits strong cross-model stability, transferability across LLMs, and capacity for model-specific personalization.This work thus presents a scalable self-learning paradigm that bridges the gap between the intrinsic knowledge of LLMs.

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