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Main Authors: Ghafoor, Zainab, Islam, Md Shafiqul, Howlader, Koushik, Khondokar, Md Rasel, Bhattacharjee, Tanusree, Chakraborty, Sayantan, Roy, Adrito, Bhattacharjee, Ushashi, Roy, Tirtho
Format: Preprint
Published: 2026
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Online Access:https://arxiv.org/abs/2601.13268
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author Ghafoor, Zainab
Islam, Md Shafiqul
Howlader, Koushik
Khondokar, Md Rasel
Bhattacharjee, Tanusree
Chakraborty, Sayantan
Roy, Adrito
Bhattacharjee, Ushashi
Roy, Tirtho
author_facet Ghafoor, Zainab
Islam, Md Shafiqul
Howlader, Koushik
Khondokar, Md Rasel
Bhattacharjee, Tanusree
Chakraborty, Sayantan
Roy, Adrito
Bhattacharjee, Ushashi
Roy, Tirtho
contents Large Language Models (LLMs) are increasingly applied in healthcare, yet ensuring their ethical integrity and safety compliance remains a major barrier to clinical deployment. This work introduces a multi-agent refinement framework designed to enhance the safety and reliability of medical LLMs through structured, iterative alignment. Our system combines two generative models - DeepSeek R1 and Med-PaLM - with two evaluation agents, LLaMA 3.1 and Phi-4, which assess responses using the American Medical Association's (AMA) Principles of Medical Ethics and a five-tier Safety Risk Assessment (SRA-5) protocol. We evaluate performance across 900 clinically diverse queries spanning nine ethical domains, measuring convergence efficiency, ethical violation reduction, and domain-specific risk behavior. Results demonstrate that DeepSeek R1 achieves faster convergence (mean 2.34 vs. 2.67 iterations), while Med-PaLM shows superior handling of privacy-sensitive scenarios. The iterative multi-agent loop achieved an 89% reduction in ethical violations and a 92% risk downgrade rate, underscoring the effectiveness of our approach. This study presents a scalable, regulator-aligned, and cost-efficient paradigm for governing medical AI safety.
format Preprint
id arxiv_https___arxiv_org_abs_2601_13268
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Improving the Safety and Trustworthiness of Medical AI via Multi-Agent Evaluation Loops
Ghafoor, Zainab
Islam, Md Shafiqul
Howlader, Koushik
Khondokar, Md Rasel
Bhattacharjee, Tanusree
Chakraborty, Sayantan
Roy, Adrito
Bhattacharjee, Ushashi
Roy, Tirtho
Artificial Intelligence
Large Language Models (LLMs) are increasingly applied in healthcare, yet ensuring their ethical integrity and safety compliance remains a major barrier to clinical deployment. This work introduces a multi-agent refinement framework designed to enhance the safety and reliability of medical LLMs through structured, iterative alignment. Our system combines two generative models - DeepSeek R1 and Med-PaLM - with two evaluation agents, LLaMA 3.1 and Phi-4, which assess responses using the American Medical Association's (AMA) Principles of Medical Ethics and a five-tier Safety Risk Assessment (SRA-5) protocol. We evaluate performance across 900 clinically diverse queries spanning nine ethical domains, measuring convergence efficiency, ethical violation reduction, and domain-specific risk behavior. Results demonstrate that DeepSeek R1 achieves faster convergence (mean 2.34 vs. 2.67 iterations), while Med-PaLM shows superior handling of privacy-sensitive scenarios. The iterative multi-agent loop achieved an 89% reduction in ethical violations and a 92% risk downgrade rate, underscoring the effectiveness of our approach. This study presents a scalable, regulator-aligned, and cost-efficient paradigm for governing medical AI safety.
title Improving the Safety and Trustworthiness of Medical AI via Multi-Agent Evaluation Loops
topic Artificial Intelligence
url https://arxiv.org/abs/2601.13268