{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:56:22Z","timestamp":1790751382506,"version":"4.1.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005357","name":"Agent\u00fara na Podporu V\u00fdskumu a V\u00fdvoja","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005357","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006109","name":"Vedeck\u00e1 Grantov\u00e1 Agent\u00fara M\u0160VVa\u0160 SR a SAV","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006109","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Digit. Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Medical anamnesis is fundamental to clinical decision-making, yet outpatient consultations often provide limited time for systematic information collection. This study investigates whether structured anamnesis acquisition can be redistributed to a pre-consultation phase using a framework-driven large language model (LLM) platform.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We developed Symptio, a proof-of-concept multi-agent LLM platform that operationalises the SOCRATES, Review of Systems, and SAMPLE frameworks as machine-interpretable constraints within a human-in-the-loop workflow. The system was evaluated in 100 simulated outpatient scenarios. Generated anamneses were compared with reference-standard representations using structural agreement and field-level performance metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Full structural agreement across all three frameworks was achieved in 87% of scenarios. Framework-specific agreement reached 96% for SOCRATES, 88% for Review of Systems, and 93% for SAMPLE. Micro-averaged precision, recall, and F1-score were 99.04%, 98.54%, and 98.79%, respectively. Although no high-severity errors were identified, 58 field-level discrepancies, including 28 medium-severity errors, were observed, supporting the need for physician review of all outputs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The findings demonstrate the technical feasibility of acquiring structured anamnesis in a framework-driven manner within a process-oriented multi-agent LLM architecture under controlled conditions. The proposed approach enables the relocation of routine information collection to a pre-consultation phase while preserving physician authority through human-in-the-loop validation. Further studies are required to evaluate clinical safety, workflow impact, and effectiveness in real-world settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fdgth.2026.1882397","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:06:42Z","timestamp":1790748402000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A multi-agent large language model (LLM) platform for structured medical anamnesis in outpatient care"],"prefix":"10.3389","volume":"8","author":[{"given":"Elena","family":"Zaitseva","sequence":"first","affiliation":[{"name":"Faculty of Management Science and Informatics, University of Zilina","place":["Zilina, Slovakia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Ochotnicky","sequence":"additional","affiliation":[{"name":"Faculty of Management Science and Informatics, University of Zilina","place":["Zilina, Slovakia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Fandakova","sequence":"additional","affiliation":[{"name":"Faculty of Management Science and Informatics, University of Zilina","place":["Zilina, Slovakia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitaly","family":"Levashenko","sequence":"additional","affiliation":[{"name":"Faculty of Management Science and Informatics, University of Zilina","place":["Zilina, Slovakia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Rabcan","sequence":"additional","affiliation":[{"name":"Faculty of Management Science and Informatics, University of Zilina","place":["Zilina, Slovakia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1016","DOI":"10.1038\/s41598-025-30748-1","article-title":"A cross sectional study of the relationship between clinical scores and timing of guidance for resident physicians in outpatient settings","volume":"16","author":"Miyagami","year":"2026","journal-title":"Sci Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1097\/MLR.0000000000001752","article-title":"Assessing physician resident contributions to outpatient clinical workload","volume":"60","author":"Kashner","year":"2022","journal-title":"Med Care"},{"key":"B3","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1002\/lary.30821","article-title":"Trainees associated with improved wait times and patient satisfaction in a multidisciplinary clinic","volume":"134","author":"Yousef","year":"2024","journal-title":"Laryngoscope"},{"key":"B4","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1097\/00001786-199812000-00003","article-title":"Managing the clinic wait: an important quality of care challenge","volume":"13","author":"Rondeau","year":"1998","journal-title":"J Nurs Care Qual"},{"key":"B5","doi-asserted-by":"publisher","first-page":"166","DOI":"10.3109\/17453059709063100","article-title":"The SOCRATES curriculum: an innovative integration of technology and theory in medical education","volume":"20","author":"Kraft","year":"1997","journal-title":"J Audiov Media Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1002\/jhm.13144","article-title":"Reclaiming the review of systems: an opportunity for medical educators","volume":"18","author":"Rodman","year":"2023","journal-title":"J Hosp Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s12873-016-0099-9","article-title":"The incorporation of focused history in checklist for early recognition and treatment of acute illness and injury","volume":"16","author":"Jayaprakash","year":"2016","journal-title":"BMC Emerg Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"109492","DOI":"10.1016\/j.pec.2026.109492","article-title":"Patient and clinician engagement with generative artificial intelligence (GenAI): a scoping review of implications for patient-centered communication","volume":"145","author":"Hahne","year":"2026","journal-title":"Patient Educ Couns"},{"key":"B9","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s40635-026-00900-w","article-title":"Enhancing large language model clinical support information with machine learning risk and explainability: a feasibility study","volume":"14","author":"Yeh","year":"2026","journal-title":"Intensive Care Med Exp"},{"key":"B10","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1007\/s44163-025-00662-6","article-title":"Accuracy without compromise: a programming-inspired solution for EHR workflow redesign in the generative AI era","volume":"5","author":"Melnick","year":"2025","journal-title":"Discov Artif Intell"},{"key":"B11","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1038\/s41746-025-02272-z","article-title":"Policy brief: ambient AI scribes and the coding arms race","volume":"8","author":"Dai","year":"2025","journal-title":"NPJ Digit Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"7274","DOI":"10.1038\/s41598-026-38716-z","article-title":"Evaluation of large language model performance on Persian rheumatology board exams: accuracy and clinical reasoning of GPT-4o vs. GPT-5.1","volume":"16","author":"Rafiei","year":"2026","journal-title":"Sci Rep"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1930","DOI":"10.1038\/s41591-023-02448-8","article-title":"Large language models in medicine","volume":"29","author":"Thirunavukarasu","year":"2023","journal-title":"Nat Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"100970","DOI":"10.1016\/j.cosrev.2026.100970","article-title":"Large language models hallucination: a comprehensive survey","volume":"61","author":"Alansari","year":"2026","journal-title":"Comput Sci Rev"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1145\/3571730","article-title":"Survey of hallucination in natural language generation","volume":"55","author":"Ji","year":"2023","journal-title":"ACM Comput Surv"},{"key":"B16","doi-asserted-by":"publisher","first-page":"315","DOI":"10.3390\/a19040315","article-title":"Agentic hallucination risk scoring for medical LLMs via uncertainty quantification and clinical knowledge injection","volume":"19","author":"Kapadia","year":"2026","journal-title":"Algorithms"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e101959","DOI":"10.1136\/bmjhci-2025-101959","article-title":"Omission and hallucination prevalence of clinical guidelines in diagnostic large language model outputs","volume":"33","author":"van Kessel","year":"2026","journal-title":"BMJ Health Care Inform"},{"key":"B18","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1007\/s10916-025-02157-4","article-title":"Artificial intelligence (AI) \u2013 powered documentation systems in healthcare: a systematic review","volume":"49","author":"Bracken","year":"2025","journal-title":"J Med Syst"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1682","DOI":"10.1093\/jamia\/ocae138","article-title":"Patient-centered clinical decision support challenges and opportunities identified from workflow execution models","volume":"31","author":"Sittig","year":"2024","journal-title":"J Am Med Inform Assoc"},{"key":"B20","doi-asserted-by":"publisher","first-page":"4840","DOI":"10.1109\/ACCESS.2026.3651218","article-title":"Agentic AI in healthcare and medicine: a seven-dimensional taxonomy for empirical evaluation of LLM-based agents","volume":"14","author":"Vatsal","year":"2026","journal-title":"IEEE Access"},{"key":"B21","doi-asserted-by":"publisher","first-page":"894","DOI":"10.3390\/info16100894","article-title":"Large language model agents for biomedicine: a comprehensive review of methods, evaluations, challenges, and future directions","volume":"16","author":"Xu","year":"2025","journal-title":"Information"},{"key":"B22","doi-asserted-by":"crossref","first-page":"16843","DOI":"10.18653\/v1\/2024.emnlp-main.936","article-title":"MediTOD: an English dialogue dataset for medical history taking with comprehensive annotations","volume-title":"Proceedings of the 2024 Conference on Empirical Methods in Natural Language Processing","author":"Saley","year":"2024"}],"container-title":["Frontiers in Digital Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdgth.2026.1882397\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:06:43Z","timestamp":1790748403000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdgth.2026.1882397\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":22,"alternative-id":["10.3389\/fdgth.2026.1882397"],"URL":"https:\/\/doi.org\/10.3389\/fdgth.2026.1882397","relation":{},"ISSN":["2673-253X"],"issn-type":[{"value":"2673-253X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"article-number":"1882397"}}