Table 3.

AI Agent Architecture Selection Framework for Clinical Medicine

Architecture Type	When to Use (Decision Criteria)	Clinical Applications	Implementation Requirements	Key Considerations & Limitations
Simple Tool Augmentation Direct tool invocation without iteration	Single, deterministic operation Well-defined input/output No reasoning required Immediate response needed Clear success metrics	Medication Dosing Lab Value Conversion DICOM HU Extraction ICD-10 Lookup Drug Interaction Check Risk Score Calculation	Technical: API integration Minimal compute No model fine-tuning Clinical: EHR integration Validated algorithms Regulatory clearance for calculations	Limited to discrete tasks No complex reasoning Cannot handle ambiguity Best for: High-volume, repetitive tasks requiring consistent accuracy Avoid for: Tasks requiring clinical judgment or context
Single-Agent Systems Autonomous reasoning with tool orchestration	Multi-step workflows Tool selection decisions Iterative refinement needed End-to-end task completion Context preservation required	Radiology Reports EMG Interpretation Literature Triage Clinical Summaries Treatment Planning Discharge Notes	Technical: ReAct/CoT prompting Memory management Tool API suite GPT-4+ class models Clinical: Workflow integration Audit trails Human oversight protocols	Context window limits Single perspective Tool timing critical Best for: Structured workflows with clear objectives Optimal tools: 3–5 specialized tools Key success factor: Well-defined task boundaries
Multi-Agent Ecosystems Collaborative specialized agents	Cross-specialty expertise Conflicting evidence synthesis Bias mitigation critical Complex consensus needed Interdisciplinary collaboration	Rare Disease Dx Tumor Board Gene Editing Virtual Lab Multi-Omics ICU Management	Technical: Agent orchestration Consensus mechanisms Distributed compute Optimal: 4–5 agents Clinical: Multi-disciplinary protocols Role definitions Conflict resolution Clinical BIases	Coordination overhead Conflicting outputs Error propagation Best for: Genuinely interdisciplinary challenges Caution: Diminishing returns >5 agents