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MedRLM: Recursive Multimodal Health Intelligence for Long-Context Clinical Reasoning, Sensor-Guided Screening, Evidence-Grounded Decision Support, and Community-to-Tertiary Referral Optimization

Real-world clinical decision support requires reasoning over heterogeneous and longitudinal patient information rather than answering isolated medical questions. However, current medical large language models and retrieval-augmented generation systems often rely on single-step prompting or retrieval, which can be fragile when clinical evidence is distributed across long electronic health records, medical images, sensor streams, guidelines, and referral constraints. This paper proposes MedRLM, a Recursive Multimodal Health Intelligence framework for long-context clinical reasoning, sensor-guided screening, and community-to-tertiary referral support. Instead of compressing all patient information into one prompt, MedRLM treats the patient case as an external clinical environment that can be recursively inspected, decomposed, retrieved, verified, and synthesized. The framework coordinates specialized agents for clinical text, longitudinal EHR, medical imaging, physiological sensor signals, guideline retrieval, uncertainty auditing, and referral planning. It further introduces a Clinical Evidence Graph Memory to connect patient-specific observations with retrieved evidence, standardized definitions, sensor-derived biomarkers, and referral criteria. A sensor-guided recursive triggering mechanism activates deeper reasoning when abnormal physiological or behavioral patterns are detected, while uncertainty-gated refinement supports clinician review for high-risk or low-confidence cases. We also outline a real-data evaluation design using public and credentialed clinical datasets spanning EHR, radiology, ECG, ICU time series, and referral-proxy outcomes. MedRLM aims to move medical AI from static question answering toward auditable, multimodal, and workflow-aware clinical decision support.

Trustworthy Self-Composable Big-Data-as-a-Service: An LLM-Orchestrated Multi-Agent Framework for Automated Data Engineering, AutoML, MLOps Deployment, and Drift-Aware Lifecycle Optimization

arXiv:2606.17915v1 Announce Type: cross Abstract: Big-Data-as-a-Service (BDaaS) platforms require re liable automation across data ingestion, cleaning, feature engi neering, model development, deployment, and post-deployment monitoring. However, existing LLM-based data science agents and AutoML systems mainly focus on isolated workflow stages, leaving limited support for lifecycle-level orchestration, artifact governance, human oversight, and drift-aware adaptation. This paper proposes a trustworthy self-composable BDaaS frame work based on LLM-orchestrated multi-agent collaboration. The proposed architecture decomposes the BDaaS lifecycle into specialized agents for data ingestion, data cleaning, feature engineering, AutoML training, model evaluation, MLOps de ployment, monitoring, and drift detection. A central LLM or chestration layer coordinates agent execution, validates interme diate outputs, manages workflow context, and enables dynamic workflow composition. The framework also incorporates shared artifact governance, reproducibility support, human-in-the-loop checkpoints, and drift-aware feedback loops. A prototype-based evaluation is conducted using controlled tabular benchmark datasets with missing values, categorical variables, outliers, class imbalance, and simulated covariate drift. Compared with manual ML, AutoML-only, and single-agent LLM baselines, the pro posed multi-agent BDaaS pipeline achieves competitive predictive performance while improving lifecycle-level reliability, including workflow completion, artifact traceability, deployment readiness, reproducibility, and drift recovery. The results suggest that LLM-orchestrated multi-agent systems can extend conventional AutoML toward trustworthy, adaptive, and production-oriented BDaaS lifecycle automation.