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Aug 12

The Path to Self-Evolving Clinical Systems: Scaling Medical Agents from Assistance to Autonomy

The growing ability of large language models and vision language models to jointly interpret and reason over images and text is reshaping medical agents, moving them from task specific predictors toward autonomous systems that perceive, reason, plan, remember, and act in clinical environments. This work departs from the capability first perspective of existing literature and instead begins from clinical deployment, asking what tasks, contamination resistant benchmarks, and interactive training environments are required before medical agents can be trusted in practice. Medical agents are formalized as sequential decision making systems under partial observability, together with a three level autonomy taxonomy spanning assisted, cooperative, and fully autonomous operation. The field is organized along a unified scaling spine consisting of framework scaling, capability scaling, and environment scaling. Within this framework, clinical environment scaling, the integration of tools, data, and clinical gyms, is identified as the most actionable yet underexplored direction for agents operating in PACS, EHR, and FHIR ecosystems. Clinical self evolution, where agents improve through interaction with their environments rather than parameter scaling alone, is further positioned as a key research frontier, drawing insights from self improving agents, agent gyms, and test time compute scaling. Applications across radiology, pathology, ophthalmology, and hospital workflows are examined together with deployment challenges including hallucination, cascading failures, and fairness. By consolidating more than 300 references, with particular emphasis on advances from 2025 to 2026, this work provides a roadmap toward trustworthy, self improving medical imaging systems for real clinical practice.

  • 18 authors
·
Jul 12

EnterpriseOps-Gym: Environments and Evaluations for Stateful Agentic Planning and Tool Use in Enterprise Settings

Large language models are shifting from passive information providers to active agents intended for complex workflows. However, their deployment as reliable AI workers in enterprise is stalled by benchmarks that fail to capture the intricacies of professional environments, specifically, the need for long-horizon planning amidst persistent state changes and strict access protocols. In this work, we introduce EnterpriseOps-Gym, a benchmark designed to evaluate agentic planning in realistic enterprise settings. Specifically, EnterpriseOps-Gym features a containerized sandbox with 164 database tables and 512 functional tools to mimic real-world search friction. Within this environment, agents are evaluated on 1,150 expert-curated tasks across eight mission-critical verticals (including Customer Service, HR, and IT). Our evaluation of 14 frontier models reveals critical limitations in state-of-the-art models: the top-performing Claude Opus 4.5 achieves only 37.4% success. Further analysis shows that providing oracle human plans improves performance by 14-35 percentage points, pinpointing strategic reasoning as the primary bottleneck. Additionally, agents frequently fail to refuse infeasible tasks (best model achieves 53.9%), leading to unintended and potentially harmful side effects. Our findings underscore that current agents are not yet ready for autonomous enterprise deployment. More broadly, EnterpriseOps-Gym provides a concrete testbed to advance the robustness of agentic planning in professional workflows.

ServiceNow-AI ServiceNow-AI
·
Mar 13 4

R2E-Gym: Procedural Environments and Hybrid Verifiers for Scaling Open-Weights SWE Agents

Improving open-source models on real-world SWE tasks (solving GITHUB issues) faces two key challenges: 1) scalable curation of execution environments to train these models, and, 2) optimal scaling of test-time compute. We introduce AgentGym, the largest procedurally-curated executable gym environment for training real-world SWE-agents, consisting of more than 8.7K tasks. AgentGym is powered by two main contributions: 1) SYNGEN: a synthetic data curation recipe that enables scalable curation of executable environments using test-generation and back-translation directly from commits, thereby reducing reliance on human-written issues or unit tests. We show that this enables more scalable training leading to pass@1 performance of 34.4% on SWE-Bench Verified benchmark with our 32B model. 2) Hybrid Test-time Scaling: we provide an in-depth analysis of two test-time scaling axes; execution-based and execution-free verifiers, demonstrating that they exhibit complementary strengths and limitations. Test-based verifiers suffer from low distinguishability, while execution-free verifiers are biased and often rely on stylistic features. Surprisingly, we find that while each approach individually saturates around 42-43%, significantly higher gains can be obtained by leveraging their complementary strengths. Overall, our approach achieves 51% on the SWE-Bench Verified benchmark, reflecting a new state-of-the-art for open-weight SWE-agents and for the first time showing competitive performance with proprietary models such as o1, o1-preview and sonnet-3.5-v2 (with tools). We will open-source our environments, models, and agent trajectories.

  • 6 authors
·
Apr 9, 2025

Gym-Anything: Turn any Software into an Agent Environment

Computer-use agents hold the promise of assisting in a wide range of digital economic activities. However, current research has largely focused on short-horizon tasks over a limited set of software with limited economic value, such as basic e-commerce and OS-configuration tasks. A key reason is that creating environments for complex software requires significant time and human effort, and therefore does not scale. To address this, we introduce Gym-Anything, a framework for converting any software into an interactive computer-use environment. We frame environment creation itself as a multi-agent task: a coding agent writes setup scripts, downloads real-world data, and configures the software, while producing evidence of correct setup. An independent audit agent then verifies evidence for the environment setup against a quality checklist. Using a taxonomy of economically valuable occupations grounded in U.S. GDP data, we apply this pipeline to 200 software applications with broad occupational coverage. The result is CUA-World, a collection of over 10K long-horizon tasks spanning domains from medical science and astronomy to engineering and enterprise systems, each configured with realistic data along with train and test splits. CUA-World also includes CUA-World-Long, a challenging long-horizon benchmark with tasks often requiring over 500 steps, far exceeding existing benchmarks. Distilling successful trajectories from the training split into a 2B vision-language model outperforms models 2times its size. We also apply the same auditing principle at test time: a separate VLM reviews completed trajectories and provides feedback on what remains, improving Gemini-3-Flash on CUA-World-Long from 11.5% to 14.0%. We release all code, infrastructure, and benchmark data to facilitate future research in realistic computer-use agents.

  • 3 authors
·
Apr 6

Spreadsheet-RL: Advancing Large Language Model Agents on Realistic Spreadsheet Tasks via Reinforcement Learning

Spreadsheet systems (e.g., Microsoft Excel, Google Sheets) play a central role in modern data-centric workflows. As AI agents grow increasingly capable of automating complex tasks, such as controlling computers and generating presentations, building an AI-driven spreadsheet agent has emerged as a promising research direction. Most existing spreadsheet agents rely on specialized prompting over general-purpose LLMs; while this design has potentials on simple spreadsheet operations, it struggles to manage the complex, multi-step workflows typical of real-world applications. We introduce Spreadsheet-RL, a reinforcement learning (RL) fine-tuning framework designed to train specialized spreadsheet agents within a realistic Microsoft Excel environment. Spreadsheet-RL features an automated pipeline for scalable collection of paired start-goal spreadsheets from online forums, as well as domain-specific evaluation tasks in areas such as finance and supply chain management, which we compile into the new Domain-Spreadsheet benchmark dataset. It also includes a Spreadsheet Gym environment designed for multi-turn RL: Spreadsheet Gym exposes extensive Excel functionality through a Python sandbox, along with a refined harness that incorporates a comprehensive tool set and carefully designed tool-routing rules for spreadsheet tasks. Through comprehensive experiments, we show that Spreadsheet-RL substantially enhances AI agent's performance on both general and domain-specific spreadsheet tasks: it improves Qwen3-4B-Thinking-2507's Pass@1 on SpreadsheetBench from 12.0% to 23.4%, and raises Pass@1 from 8.4% to 17.2% on our curated Domain-Spreadsheet dataset. These results highlight Spreadsheet-RL's strong potential for generalization and real-world adoption in spreadsheet automation, and broadly, its promise for advancing LLM-based interactions with data interfaces in everyday work.