Evidence map›Paper›PMID 40894146›Full record

ArticlemedRxiv : the preprint server for health sciences2025

Orchestrated multi agents sustain accuracy under clinical-scale workloads compared to a single agent.

Eyal Klang, Mahmud Omar, Ganesh Raut, Reem Agbareia, Prem Timsina, Robert Freeman, Nicholas Gavin, Lisa Stump, Alexander W Charney, Benjamin S Glicksberg and 1 more

Abstract readPreprint
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Eyal KlangThe Windreich Department of Artificial Intelligence and Human Health, Mount Sinai Medical Center, NY, USA.ORCID 0000-0002-4567-3108
Mahmud OmarThe Windreich Department of Artificial Intelligence and Human Health, Mount Sinai Medical Center, NY, USA.ORCID 0009-0001-0438-0827
Ganesh RautThe Windreich Department of Artificial Intelligence and Human Health, Mount Sinai Medical Center, NY, USA.ORCID 0000-0002-4527-1264
Reem AgbareiaOphthalmology Department, Hadassah Medical Center, Jerusalem, Israel.ORCID 0009-0000-8030-9232
Prem TimsinaThe Windreich Department of Artificial Intelligence and Human Health, Mount Sinai Medical Center, NY, USA.
Robert FreemanThe Windreich Department of Artificial Intelligence and Human Health, Mount Sinai Medical Center, NY, USA.
Nicholas GavinThe Windreich Department of Artificial Intelligence and Human Health, Mount Sinai Medical Center, NY, USA.ORCID 0000-0001-6900-3953
Lisa StumpThe Windreich Department of Artificial Intelligence and Human Health, Mount Sinai Medical Center, NY, USA.ORCID 0000-0002-1327-4110
Alexander W CharneyThe Windreich Department of Artificial Intelligence and Human Health, Mount Sinai Medical Center, NY, USA.ORCID 0000-0001-8135-6858
Benjamin S GlicksbergThe Windreich Department of Artificial Intelligence and Human Health, Mount Sinai Medical Center, NY, USA.
Girish N NadkarniThe Windreich Department of Artificial Intelligence and Human Health, Mount Sinai Medical Center, NY, USA.

Funding

Conduits: Mount Sinai Health System Translational Science HubUL1TR004419 · NCATS · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Rosalind J Wright · 2022 to 2026
$46.4M
COVID and Translational Science supercomputer (CATS)S10OD030463 · OD · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KOVATCH, PATRICIA · 2021 to 2021
$2.0M
Big Omics Data Engine 2 SupercomputerS10OD026880 · OD · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KOVATCH, PATRICIA · 2019 to 2019
$2.0M
NCATS NIH HHS UL1 TR004419NIH HHS S10 OD026880NIH HHS S10 OD030463
6 · The paper itself

Abstract

We tested state-of-the-art large language models (LLMs) in two configurations for clinical-scale workloads: a single agent handling heterogeneous tasks versus an orchestrated multi-agent system assigning each task to a dedicated worker. Across retrieval, extraction, and dosing calculations, we varied batch sizes from 5 to 80 to simulate clinical traffic. Multi-agent runs maintained high accuracy under load (pooled accuracy 90.6% at 5 tasks, 65.3% at 80) while single-agent accuracy fell sharply (73.1% to 16.6%), with significant differences beyond 10 tasks (FDR-adjusted p < 0.01). Multi-agent execution reduced token usage up to 65-fold and limited latency growth compared with single-agent runs. The design's isolation of tasks prevented context interference and preserved performance across four diverse LLM checkpoints. This is the first evaluation of LLM agent architectures under sustained, mixed-task clinical workloads, showing that lightweight orchestration can deliver accuracy, efficiency, and auditability at operational scale.

Identifiers

PMID40894146
PMCPMC12393657

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.