MedAgent-Pro: Towards Evidence-based Multi-modal Medical Diagnosis via Reasoning Agentic Workflow

Modern clinical diagnosis relies on the comprehensive analysis of multi-modal patient data, drawing on medical expertise to ensure systematic and rigorous reasoning. Recent advances in Vision–Language Models (VLMs) and agent-based methods are reshaping medical diagnosis by effectively integrating multi-modal information. However, they often output direct answers and empirical-driven conclusions without clinical evidence supported by quantitative analysis, which compromises their reliability and hinders clinical usability. Here we propose MedAgent-Pro, an agentic reasoning paradigm that mirrors modern diagnosis principles via a hierarchical diagnostic workflow, consisting of disease-level standardized plan generation and patient-level personalized step-by-step reasoning. To support disease-level planning, a retrieval-augmented generation agent is designed to access medical guidelines for alignment with clinical standards. For patient-level reasoning, MedAgent-Pro leverages professional tools such as visual models to take various actions to analyze multi-modal input, and performs evidence-based reflection to iteratively adjust memory, enforcing rigorous reasoning throughout the process. Extensive experiments across a wide range of anatomical regions, imaging modalities, and diseases demonstrate the superiority of MedAgent-Pro over mainstream VLMs, agentic systems and leading expert models. Ablation studies and expert evaluation further confirm its robustness and clinical relevance. Anonymized code link is available in the reproducibility statement.