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Apr 29

SkillForge: Forging Domain-Specific, Self-Evolving Agent Skills in Cloud Technical Support

Deploying LLM-powered agents in enterprise scenarios such as cloud technical support demands high-quality, domain-specific skills. However, existing skill creators lack domain grounding, producing skills poorly aligned with real-world task requirements. Moreover, once deployed, there is no systematic mechanism to trace execution failures back to skill deficiencies and drive targeted refinements, leaving skill quality stagnant despite accumulating operational evidence. We introduce SkillForge, a self-evolving framework that closes an end-to-end creation-evaluation-refinement loop. To produce well-aligned initial skills, a Domain-Contextualized Skill Creator grounds skill synthesis in knowledge bases and historical support tickets. To enable continuous self-optimization, a three-stage pipeline -- Failure Analyzer, Skill Diagnostician, and Skill Optimizer -- automatically diagnoses execution failures in batch, pinpoints the underlying skill deficiencies, and rewrites the skill to eliminate them. This cycle runs iteratively, allowing skills to self-improve with every round of deployment feedback. Evaluated on five real-world cloud support scenarios spanning 1,883 tickets and 3,737 tasks, experiments show that: (1) the Domain-Contextualized Skill Creator produces substantially better initial skills than the generic skill creator, as measured by consistency with expert-authored reference responses from historical tickets; and (2) the self-evolution loop progressively improves skill quality from diverse starting points (including expert-authored, domain-created, and generic skills) across successive rounds, demonstrating that automated evolution can surpass manually curated expert knowledge.

  • 6 authors
·
Apr 8

Evolving Diagnostic Agents in a Virtual Clinical Environment

In this paper, we present a framework for training large language models (LLMs) as diagnostic agents with reinforcement learning, enabling them to manage multi-turn diagnostic processes, adaptively select examinations, and commit to final diagnoses. Unlike instruction-tuned models trained on static case summaries, our method acquires diagnostic strategies through interactive exploration and outcome-based feedback. Our contributions are fourfold: (i) We present DiagGym, a diagnostics world model trained with electronic health records that emits examination outcomes conditioned on patient history and recommended examination, serving as a virtual clinical environment for realistic diagnosis training and evaluation; (ii) We train DiagAgent via end-to-end, multi-turn reinforcement learning to learn diagnostic policies that optimize both information yield and diagnostic accuracy; (iii) We introduce DiagBench, a diagnostic benchmark comprising 750 cases with physician-validated examination recommendations and 99 cases annotated with 973 physician-written rubrics on diagnosis process; (iv) we demonstrate superior performance across diverse diagnostic settings. DiagAgent significantly outperforms 10 state-of-the-art LLMs, including DeepSeek-v3 and GPT-4o, as well as two prompt-engineered agents. In single-turn settings, DiagAgent achieves 9.34% higher diagnostic accuracy and 44.03% improvement in examination recommendation hit ratio. In end-to-end settings, it delivers 15.12% increase in diagnostic accuracy and 23.09% boost in examination recommendation F1 score. In rubric-based evaluation, it surpasses the next-best model, Claude-sonnet-4, by 7.1% in weighted rubric score. These findings indicate that learning policies in interactive clinical environments confers dynamic and clinically meaningful diagnostic management abilities unattainable through passive training alone.

SKILLFOUNDRY: Building Self-Evolving Agent Skill Libraries from Heterogeneous Scientific Resources

Modern scientific ecosystems are rich in procedural knowledge across repositories, APIs, scripts, notebooks, documentation, databases, and papers, yet much of this knowledge remains fragmented across heterogeneous artifacts that agents cannot readily operationalize. This gap between abundant scientific know-how and usable agent capabilities is a key bottleneck for building effective scientific agents. We present SkillFoundry, a self-evolving framework that converts such resources into validated agent skills, reusable packages that encode task scope, inputs and outputs, execution steps, environment assumptions, provenance, and tests. SkillFoundry organizes a target domain as a domain knowledge tree, mines resources from high-value branches, extracts operational contracts, compiles them into executable skill packages, and then iteratively expands, repairs, merges, or prunes the resulting library through a closed-loop validation process. SkillFoundry produces a substantially novel and internally valid skill library, with 71.1\% of mined skills differing from existing skill libraries such as SkillHub and SkillSMP. We demonstrate that these mined skills improve coding agent performance on five of the six MoSciBench datasets. We further show that SkillFoundry can design new task-specific skills on demand for concrete scientific objectives, and that the resulting skills substantially improve performance on two challenging genomics tasks: cell type annotation and the scDRS workflow. Together, these results show that automatically mined skills improve agent performance on benchmarks and domain-specific tasks, expand coverage beyond hand-crafted skill libraries, and provide a practical foundation for more capable scientific agents.

  • 6 authors
·
Apr 4

Towards Accurate Differential Diagnosis with Large Language Models

An accurate differential diagnosis (DDx) is a cornerstone of medical care, often reached through an iterative process of interpretation that combines clinical history, physical examination, investigations and procedures. Interactive interfaces powered by Large Language Models (LLMs) present new opportunities to both assist and automate aspects of this process. In this study, we introduce an LLM optimized for diagnostic reasoning, and evaluate its ability to generate a DDx alone or as an aid to clinicians. 20 clinicians evaluated 302 challenging, real-world medical cases sourced from the New England Journal of Medicine (NEJM) case reports. Each case report was read by two clinicians, who were randomized to one of two assistive conditions: either assistance from search engines and standard medical resources, or LLM assistance in addition to these tools. All clinicians provided a baseline, unassisted DDx prior to using the respective assistive tools. Our LLM for DDx exhibited standalone performance that exceeded that of unassisted clinicians (top-10 accuracy 59.1% vs 33.6%, [p = 0.04]). Comparing the two assisted study arms, the DDx quality score was higher for clinicians assisted by our LLM (top-10 accuracy 51.7%) compared to clinicians without its assistance (36.1%) (McNemar's Test: 45.7, p < 0.01) and clinicians with search (44.4%) (4.75, p = 0.03). Further, clinicians assisted by our LLM arrived at more comprehensive differential lists than those without its assistance. Our study suggests that our LLM for DDx has potential to improve clinicians' diagnostic reasoning and accuracy in challenging cases, meriting further real-world evaluation for its ability to empower physicians and widen patients' access to specialist-level expertise.

  • 28 authors
·
Nov 30, 2023 1

Sequential Diagnosis with Language Models

Artificial intelligence holds great promise for expanding access to expert medical knowledge and reasoning. However, most evaluations of language models rely on static vignettes and multiple-choice questions that fail to reflect the complexity and nuance of evidence-based medicine in real-world settings. In clinical practice, physicians iteratively formulate and revise diagnostic hypotheses, adapting each subsequent question and test to what they've just learned, and weigh the evolving evidence before committing to a final diagnosis. To emulate this iterative process, we introduce the Sequential Diagnosis Benchmark, which transforms 304 diagnostically challenging New England Journal of Medicine clinicopathological conference (NEJM-CPC) cases into stepwise diagnostic encounters. A physician or AI begins with a short case abstract and must iteratively request additional details from a gatekeeper model that reveals findings only when explicitly queried. Performance is assessed not just by diagnostic accuracy but also by the cost of physician visits and tests performed. We also present the MAI Diagnostic Orchestrator (MAI-DxO), a model-agnostic orchestrator that simulates a panel of physicians, proposes likely differential diagnoses and strategically selects high-value, cost-effective tests. When paired with OpenAI's o3 model, MAI-DxO achieves 80% diagnostic accuracy--four times higher than the 20% average of generalist physicians. MAI-DxO also reduces diagnostic costs by 20% compared to physicians, and 70% compared to off-the-shelf o3. When configured for maximum accuracy, MAI-DxO achieves 85.5% accuracy. These performance gains with MAI-DxO generalize across models from the OpenAI, Gemini, Claude, Grok, DeepSeek, and Llama families. We highlight how AI systems, when guided to think iteratively and act judiciously, can advance diagnostic precision and cost-effectiveness in clinical care.

  • 15 authors
·
Jun 27, 2025

From Skill Text to Skill Structure: The Scheduling-Structural-Logical Representation for Agent Skills

LLM agents increasingly rely on reusable skills, capability packages that combine instructions, control flow, constraints, and tool calls. In most current agent systems, however, skills are still represented by text-heavy artifacts, including SKILL.md-style documents and structured records whose machine-usable evidence remains embedded largely in natural-language descriptions. This poses a challenge for skill-centered agent systems: managing skill collections and using skills to support agent both require reasoning over invocation interfaces, execution structure, and concrete side effects that are often entangled in a single textual surface. An explicit representation of skill knowledge may therefore help make these artifacts easier for machines to acquire and leverage. Drawing on Memory Organization Packets, Script Theory, and Conceptual Dependency from Schank and Abelson's classical work on linguistic knowledge representation, we introduce what is, to our knowledge, the first structured representation for agent skill artifacts that disentangles skill-level scheduling signals, scene-level execution structure, and logic-level action and resource-use evidence: the Scheduling-Structural-Logical (SSL) representation. We instantiate SSL with an LLM-based normalizer and evaluate it on a corpus of skills in two tasks, Skill Discovery and Risk Assessment, and superiorly outperform the text-only baselines: in Skill Discovery, SSL improves MRR from 0.573 to 0.707; in Risk Assessment, it improves macro F1 from 0.744 to 0.787. These findings reveal that explicit, source-grounded structure makes agent skills easier to search and review. They also suggest that SSL is best understood as a practical step toward more inspectable, reusable, and operationally actionable skill representations for agent systems, rather than as a finished standard or an end-to-end mechanism for managing and using skills.

  • 4 authors
·
Apr 26