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Jun 2

MedAgentBench: A Realistic Virtual EHR Environment to Benchmark Medical LLM Agents

Recent large language models (LLMs) have demonstrated significant advancements, particularly in their ability to serve as agents thereby surpassing their traditional role as chatbots. These agents can leverage their planning and tool utilization capabilities to address tasks specified at a high level. However, a standardized dataset to benchmark the agent capabilities of LLMs in medical applications is currently lacking, making the evaluation of LLMs on complex tasks in interactive healthcare environments challenging. To address this gap, we introduce MedAgentBench, a broad evaluation suite designed to assess the agent capabilities of large language models within medical records contexts. MedAgentBench encompasses 300 patient-specific clinically-derived tasks from 10 categories written by human physicians, realistic profiles of 100 patients with over 700,000 data elements, a FHIR-compliant interactive environment, and an accompanying codebase. The environment uses the standard APIs and communication infrastructure used in modern EMR systems, so it can be easily migrated into live EMR systems. MedAgentBench presents an unsaturated agent-oriented benchmark that current state-of-the-art LLMs exhibit some ability to succeed at. The best model (Claude 3.5 Sonnet v2) achieves a success rate of 69.67%. However, there is still substantial space for improvement which gives the community a next direction to optimize. Furthermore, there is significant variation in performance across task categories. MedAgentBench establishes this and is publicly available at https://github.com/stanfordmlgroup/MedAgentBench , offering a valuable framework for model developers to track progress and drive continuous improvements in the agent capabilities of large language models within the medical domain.

  • 7 authors
·
Jan 24, 2025

GRASP: Gated Regression-Aware Skill Proposer for Self-Improving LLM Agents

LLM agents acting in structured environments fail in operational rather than conversational ways, and reliability depends on procedural knowledge of the environment. Prior self-improvement methods accumulate natural-language guidance without checking that each new item preserves previously correct behavior, so a note that fixes one trajectory can silently regress another. We introduce GRASP (Gated Regression-Aware Skill Proposer), which treats agent improvement as a sequence of edits to a bounded skill library, admitting each candidate only if it produces a net improvement on a balanced held-out probe under a hard regression budget. We evaluate GRASP across five base models (gpt-oss-120b, DeepSeek V4 Flash, Gemini 3.1 Flash Lite, GPT-4.1, GPT-5.4) on two FHIR-based clinical benchmarks. On MedAgentBench, GRASP lifts gpt-oss-120b from 40.6% to 88.8%, exceeds the strongest of five self-improvement baselines by 21.0 points, and improves every other base model by 17.2 to 40.3 points. Ablations attribute the gain to comparative proposal generation, the acceptance gate, and the hard regression budget rather than to skill writing itself, which without validation is no better than using no skills. The mechanism generalizes beyond the clinical domain, improving agents on three of four non-clinical environments and remaining flat only where the action space is open-ended. Frozen libraries transfer across models, where skills from a stronger model improve weaker executors beyond what they learn for themselves while the reverse does not, an asymmetry that no ungated baseline reproduces.

  • 7 authors
·
May 27

Symbolic Guardrails for Domain-Specific Agents: Stronger Safety and Security Guarantees Without Sacrificing Utility

AI agents that interact with their environments through tools enable powerful applications, but in high-stakes business settings, unintended actions can cause unacceptable harm, such as privacy breaches and financial loss. Existing mitigations, such as training-based methods and neural guardrails, improve agent reliability but cannot provide guarantees. We study symbolic guardrails as a practical path toward strong safety and security guarantees for AI agents. Our three-part study includes a systematic review of 80 state-of-the-art agent safety and security benchmarks to identify the policies they evaluate, an analysis of which policy requirements can be guaranteed by symbolic guardrails, and an evaluation of how symbolic guardrails affect safety, security, and agent success on τ^2-Bench, CAR-bench, and MedAgentBench. We find that 85\% of benchmarks lack concrete policies, relying instead on underspecified high-level goals or common sense. Among the specified policies, 74\% of policy requirements can be enforced by symbolic guardrails, often using simple, low-cost mechanisms. These guardrails improve safety and security without sacrificing agent utility. Overall, our results suggest that symbolic guardrails are a practical and effective way to guarantee some safety and security requirements, especially for domain-specific AI agents. We release all codes and artifacts at https://github.com/hyn0027/agent-symbolic-guardrails.