Daily Papers

Deep-space crews cannot rely on real-time ground support for urgent off-nominal events. Initial alerts may underdetermine cause, while discriminating evidence may reside in crew observations or at locations that are unsafe, costly, or unavailable for crew inspection. We present an evidence-driven architecture for human-agent-robot teaming in Earth-independent anomaly triage. Agentic AI is treated as a stateful coordinator over bounded, inspectable services rather than as a fully autonomous vehicle controller. A triage state manager maintains hypotheses, evidence provenance, uncertainty, operational context, and tool status; a crew-facing embodied agent elicits observations and explains assessment changes; and a mobile robot acquires targeted, localized evidence. Typed interfaces separate dialogue and orchestration from monitoring, robot command, context retrieval, and safety-critical control. Two scenarios illustrate the architecture: a crewed deep-space mission based on an actual ISS ammonia false alarm, where suspected contamination restricts crew access, and a power-interface anomaly at a crewed lunar base, where robotic inspection distinguishes a local connector fault from other causes ambiguous in remote telemetry. Our main contribution is an authority-bounded closed evidence-loop architecture, exercised in a hardware-in-the-loop integration prototype using Reachy Mini and an Innate MARS mobile robot.

As modern software systems continue to grow in complexity, triage has become a fundamental process in system operations and maintenance. Triage aims to efficiently prioritize, assign, and assess issues to ensure the reliability of complex environments. The vast amount of heterogeneous data generated by software systems has made effective triage indispensable for maintaining reliability, facilitating maintainability, and enabling rapid issue response. Motivated by these challenges, researchers have devoted extensive effort to advancing triage automation and have achieved significant progress over the past two decades. This survey provides a comprehensive review of 234 papers from 2004 to the present, offering an in-depth examination of the fundamental concepts, system architecture, and problem statement. By comparing the distinct goals of academic and industrial research and by analyzing empirical studies of industrial practices, we identify the major obstacles that limit the practical deployment of triage systems. To assist practitioners in method selection and performance evaluation, we summarize widely adopted open-source datasets and evaluation metrics, providing a unified perspective on the measurement of triage effectiveness. Finally, we outline potential future directions and emerging opportunities to foster a closer integration between academic innovation and industrial application. All reviewed papers and projects are available at https://github.com/AIOps-Lab-NKU/TriageSurvey.

The post-pandemic surge in healthcare demand, coupled with critical nursing shortages, has placed unprecedented pressure on medical triage systems, necessitating innovative AI-driven solutions. We present a multi-agent interactive intelligent system for medical triage that addresses three fundamental challenges in current AI-based triage systems: inadequate medical specialization leading to misclassification, heterogeneous department structures across healthcare institutions, and inefficient detail-oriented questioning that impedes rapid triage decisions. Our system employs three specialized agents--RecipientAgent, InquirerAgent, and DepartmentAgent--that collaborate through Inquiry Guidance mechanism and Classification Guidance Mechanism to transform unstructured patient symptoms into accurate department recommendations. To ensure robust evaluation, we constructed a comprehensive Chinese medical triage dataset from "Ai Ai Yi Medical Network", comprising 3,360 real-world cases spanning 9 primary departments and 62 secondary departments. Experimental results demonstrate that our multi-agent system achieves 89.6% accuracy in primary department classification and 74.3% accuracy in secondary department classification after four rounds of patient interaction. The system's dynamic matching based guidance mechanisms enable efficient adaptation to diverse hospital configurations while maintaining high triage accuracy. We successfully developed this multi-agent triage system that not only adapts to organizational heterogeneity across healthcare institutions but also ensures clinically sound decision-making.

Emergency department (ED) triage is a high-stakes prioritization task in which demographic, socioeconomic, and system-context information may improperly influence acuity assignment. Although open-source large language models (LLMs) are increasingly considered for local and privacy-preserving clinical decision support, it remains unclear how counterfactual bias varies across model families, sizes, medical-domain models, and domain-adapted models. We present a comparative counterfactual audit of ten open-source LLMs for pediatric Emergency Severity Index (ESI) prediction. Starting from real and handbook-style clinical vignettes, we construct paired counterfactual variants that change only one injected demographic, socioeconomic, healthcare-access, behavioral, social, or system-context variable while holding the clinical presentation fixed. Models include Qwen2.5-7B, Qwen2.5-14B-Instruct, a QLoRA fine-tuned Qwen2.5-7B, MedGemma variants, MedLLaMA2-7B, GPT-OSS-20B, and GPT-OSS-120B. We measure any counterfactual shift, undertriage, overtriage, shifts greater than one ESI level, mean shift, and mean absolute shift. Counterfactual sensitivity varied substantially and did not consistently decrease with larger model size or medical-domain pretraining. The fine-tuned Qwen2.5-7B showed the lowest overall sensitivity, with a 5.27% any-shift rate and mean absolute shift of 0.0534, versus 16.02% and 0.1706 for the base model. Several larger or medical-domain models showed more significant shifts. Stratified and correlation analyses further revealed clinically important directionality and shared failure patterns hidden by aggregate rates. These findings support counterfactual auditing as a lightweight, clinically interpretable framework for comparing fairness risks in open-source LLMs before clinical deployment.

Research in emergency triage is restricted to structured electronic health records (EHR) due to regulatory constraints on nurse-patient interactions. We introduce TriageSim, a simulation framework for generating persona-conditioned triage conversations from structured records. TriageSim enables multi-turn nurse-patient interactions with explicit control over disfluency and decision behaviour, producing a corpus of ~800 synthetic transcripts and corresponding audio. We use a combination of automated analysis for linguistic, behavioural and acoustic fidelity alongside manual evaluation for medical fidelity using a random subset of 50 conversations. The utility of the generated corpus is examined via conversational triage classification. We observe modest agreement for acuity levels across three modalities: generated synthetic text, ASR transcripts, and direct audio inputs. The code, persona schemata and triage policy prompts for TriageSim will be available upon acceptance.

Medical triage is the task of allocating medical resources and prioritizing patients based on medical need. This paper introduces the first large-scale public dataset for studying medical triage in the context of asynchronous outpatient portal messages. Our novel task formulation views patient message triage as a pairwise inference problem, where we train LLMs to choose `"which message is more medically urgent" in a head-to-head tournament-style re-sort of a physician's inbox. Our novel benchmark PMR-Bench contains 1569 unique messages and 2,000+ high-quality test pairs for pairwise medical urgency assessment alongside a scalable training data generation pipeline. PMR-Bench includes samples that contain both unstructured patient-written messages alongside real electronic health record (EHR) data, emulating a real-world medical triage scenario. We develop a novel automated data annotation strategy to provide LLMs with in-domain guidance on this task. The resulting data is used to train two model classes, UrgentReward and UrgentSFT, leveraging Bradley-Terry and next token prediction objective, respectively to perform pairwise urgency classification. We find that UrgentSFT achieves top performance on PMR-Bench, with UrgentReward showing distinct advantages in low-resource settings. For example, UrgentSFT-8B and UrgentReward-8B provide a 15- and 16-point boost, respectively, on inbox sorting metrics over off-the-shelf 8B models. Paper resources can be found at https://tinyurl.com/Patient-Message-Triage

Clinical early warning systems built on irregularly sampled medical time series (ISMTS) from electronic health records must deliver continuous risk scores for patient triage as well as interpretable rationales that clinicians can verify. Large language models (LLMs) are uniquely positioned for both, deriving risk from their output probabilities and rationales from their medical knowledge. However, we find that conventional LLM reasoning collapses graded risk into overconfident predictions and thereby undermines the cross-patient comparability on which triage depends. We refer to this failure mode as risk polarization and identify two underlying behaviors: early commitment to a single outcome, and one-sided reasoning that focuses only on the evidence for that outcome. To address this, we propose TRIAGE, a framework that trains an LLM to reason dialectically over competing clinical outcomes by eliciting outcome-specific rationales. This dialectical formulation mitigates risk polarization, enabling a single LLM to jointly provide explicit clinical rationales and risk scores comparable across patients. Across five ISMTS benchmarks, TRIAGE improves mean AUPRC by 17.0% and reduces mean calibration error by 82.8% relative to the competitive LLM-based baseline, while surpassing the strongest ISMTS baseline by 3.5% in mean AUPRC.