ENTAgents: AI Agents for Complex Knowledge Otolaryngology
Open accessAbstract
Various healthcare applications based on large language models (LLMs) have emerged as LLMs show improved efficiency and error reduction. Recently, retrieval augmented generation (RAG) has been adopted frequently for LLM applications to solve the problem of hallucinations. Despite the success of RAG, it has its drawbacks, including incomplete semantic meanings, and large-scale dataset requirements. AI Agents have shown great potential in medicine and healthcare applications by leveraging their rich background knowledge and reasoning capabilities. In this paper, we introduce ENTAgents, a framework that utilizes both the RAG and multi-agent systems. To achieve better decision-making and enhanced explainability, we use the verbal reinforcement learning framework, Reflexion, as a reference for the task planning of ENTAgents. With the verbal feedback received from the last agent node, the agentic system can decide the best agent to utilize to improve the response of ENTAgents. We tested ENTAgents with various types of questions, including short questions, essay questions, and multiple-choice questions. ENTAgents improve accuracy by over 11.3% in handling short questions, with 2.78 folds in the length of the text and explaining clearly. ENTAgents shows higher accuracy and is more comprehensive in its answer compared to other LLM models. ENTAgents also demonstrates its ability to refine its answer with additional information to make it more thorough and educational. It also presents the capability to change its response to the correct answer in multiple-choice questions according to its self-reflection. Overall, ENTAgents is easy to use, can self-correct, and can provide detailed information in complex knowledge to users. We look forward to integrating ENTAgents into various healthcare scenarios, such as medical education and clinical decision support, particularly otolaryngology.
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Primary clinical and biomedical tasks addressed included CDSSs, question answering, mental health screening and assessment, diagnostic and report generation or summarization, drug-target interaction prediction, biomarker discovery, and single-cell annotation.
“The primary clinical and biomedical tasks addressed included clinical decision support systems (CDSSs) [20,21,22,24,27], question answering (QA) [27], mental health screening and assessment [24], diagnostic and report generation or summarization [20,22,23], drug–target interaction prediction [19], biomarker discovery [25], and single-cell annotation [26].”
From Explainable Agentic Artificial Intelligence in Healthcare: A Scoping Review (2026) · cites this paper as [27]
The Abstract and Discussion describe ENTAgents answering clinical questions, supporting the question-answering task attributed to this source. The Abstract describes clinical decision support as a future integration, and the Discussion presents it as a potential application; neither establishes that ENTAgents addressed a clinical decision support system task. The other listed tasks have separate citations in the citing sentence and are not attributed to this paper. (LLM, conf=0.86)
Experimental — accuracy not yet measuredNine studies met all inclusion criteria and were included in the final synthesis.
“Nine studies met the inclusion criteria.”
From Explainable Agentic Artificial Intelligence in Healthcare: A Scoping Review (2026) · cites this paper as [27]
Multi-agent systems were predominantly role-based, with agents assigned to cognitively separable subtasks such as drafting, verification, retrieval, synthesis, supervision, or reporting.
“Multi-agent systems were predominantly role-based, with agents assigned to cognitively separable subtasks such as drafting, verification, retrieval, synthesis, supervision, or reporting [22,26,27].”
From Explainable Agentic Artificial Intelligence in Healthcare: A Scoping Review (2026) · cites this paper as [27]
Several included studies were proof-of-concept implementations (CBM-RAG, ENTAgents, ArgMed-AgentN, DSM5AgentFlow, and BRAD).
“Study designs varied, with several studies representing proof-of-concept implementations (e.g., CBM-RAG, ENTAgents, ArgMed-AgentN, DSM5AgentFlow, and BRAD) [20,21,24,25,27].”
From Explainable Agentic Artificial Intelligence in Healthcare: A Scoping Review (2026) · cites this paper as [27]
Systems focused on CDSSs, screening, and biomedical reasoning primarily relied on a reasoning-plus-evidence paradigm, combining textual rationales with explicit grounding in retrieved sources.
“Systems focused on CDSSs, screening, and biomedical reasoning (e.g., ENTAgents, DrugAgent, DSM5AgentFlow, BRAD, and CASSIA) primarily relied on a “reasoning + evidence” paradigm, combining textual rationales with explicit grounding in retrieved sources [19,24,25,26,27].”
From Explainable Agentic Artificial Intelligence in Healthcare: A Scoping Review (2026) · cites this paper as [27]
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References 120 · Cited by 9
- Authors
- Chan, T. K., & Dinh, N.-D.
- Affiliations
- Chinese University of Hong Kong (HK)
- Corresponding author
- Dinh, Ngoc-Duy
- ORCID
- Dinh, Ngoc-Duy
- Venue
- medRxiv
- Publisher
- openRxiv
- Published
- 2025-01-07
- OpenAlex
- W4406140557
- Cited by
- 9
- References
- 120
- Citations by year
- 2026: 4 · 2025: 5
- Type
- posted content
- Language
- en
- Open access
- green
- doi.org
- Locations
- medRxiv (acceptedVersion)
- Topics
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Physical Sciences › Computer Science › Artificial Intelligence › Topic Modeling
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Multimodal Machine Learning Applications
- Keywords
- multi-agent systems, retrieval-augmented generation, large language models, reflexion, task planning, self-reflection, hallucination mitigation, otolaryngology, medical education, clinical decision support, question answering
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