Evidence map›Paper›PMID 41066364›Full record

ArticlePLOS digital health2025

Collaborative intelligence in AI: Evaluating the performance of a council of AIs on the USMLE.

Yahya Shaikh, Zainab Asiyah Jeelani-Shaikh, Muzamillah Mushtaq Jeelani, Aamir Javaid, Tauhid Mahmud, Shiv Gaglani, Michael Christopher Gibbons, Minahil Cheema, Amanda Cross, Denisa Livingston and 6 more

Abstract read
In one paragraph

Article in PLOS digital health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Yahya ShaikhDepartment of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.ORCID https://orcid.org/0009-0008-9254-844X
Zainab Asiyah Jeelani-ShaikhIndependent Researcher, Baltimore, Maryland, United States of America.
Muzamillah Mushtaq JeelaniInternational Institute of Islamic Thought and Civilization, International Islamic University of Malaysia, Gombak, Selangor, Malaysia.
Aamir JavaidDivision of Cardiology, University of California San Francisco, San Francisco, California, United States of America.
Tauhid MahmudDepartment of Biomedical Informatics, Stony Brook University Renaissance School of Medicine, Stony Brook, New York, United States of America.ORCID https://orcid.org/0009-0004-5804-0088
Shiv GaglaniGanglia Ventures, LLC, Melbourne Beach, Florida, United States of America.
Michael Christopher GibbonsThe Greystone Group Inc, Greenbelt, Maryland, United States of America.
Minahil CheemaUniversity of Maryland School of Medicine, Baltimore, Maryland, United States of America.ORCID https://orcid.org/0000-0002-6923-1494
Amanda CrossWahayenta Consulting LLC, Portland, Oregon, United States of America.
Denisa LivingstonMulti-Epistemic Researcher, Diné Community Advocacy Alliance, Navajo Nation, United States of America.
Morgan CheathamDivision of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.
Elahe NezamiPublic Health Sciences, University of Miami, Florida, United States of America.
Ronald DixonCareHive Health Inc, Austin, Texas, United States of America.
Ashwini Niranjan-AzadiJohns Hopkins School of Medicine, Department of Medicine, Baltimore, Maryland, United States of America.
Saad ZafarRiphah Institute of Systems Engineering, Riphah International University, Islamabad, Pakistan.
Zishan SiddiquiJohns Hopkins School of Medicine, Baltimore, Maryland, United States of America.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The stochastic nature of next-token generation and resulting response variability in Large Language Models (LLMs) outputs pose challenges in ensuring consistency and accuracy on knowledge assessments. This study introduces a novel multi-agent framework, referred to as a "Council of AIs", to enhance LLM performance through collaborative decision-making. The Council consists of multiple GPT-4 instances that iteratively discuss and reach consensus on answers facilitated by a designated "Facilitator AI." This methodology was applied to 325 United States Medical Licensing Exam (USMLE) questions across all three exam stages: Step 1, focusing on biomedical sciences; Step 2 evaluating clinical knowledge (CK)\; and Step 3, evaluating readiness for independent medical practice. The Council achieved consensus that were correct 97%, 93%, and 94% of the time for Step 1, Step 2 CK, and Step 3, respectively, outperforming single-instance GPT-4 models. In cases where there wasn't an initial unanimous response, the Council deliberations achieved a consensus that was the correct answer 83% of the time, with the Council correcting over half (53%) of the responses that majority vote had gotten incorrect. The odds of a majority voting response changing from incorrect to correct were 5 (95% CI: 1.1, 22.8) times higher than the odds of changing from correct to incorrect after discussion. This study provides the first evidence that the semantic entropy of the response space can consistently be reduced to zero-demonstrated here through Council deliberation, and suggesting the possibility of other mechanisms to achieve the same outcome.. This study revealed that in a Council model, response variability, often considered a limitation, can be transformed into a strength that supports adaptive reasoning and collaborative refinement of answers. These findings suggest new paradigms for AI implementation and reveal the heightened strength that emerges when AIs begin to collaborate as a collective rather than operate alone.

Identifiers

PMID41066364
PMCPMC12510544

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.