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Perspective independence, more than personas, drives LLM teams - and where they reverse

Feng, J.; Jiao, Y.; Li, Y.; Xie, L.; Peng, W.; Sun, X.

2026-09-26 health informatics
10.64898/2026.09.24.26363897 medRxiv
Show abstract

Multi-agent prompting of large language models has produced contradictory diagnostic results, and it remains unclear whether any benefit comes from specialist personas or from perspective independence. We compared a single direct call, five personas in one context, and the same five roles as isolated agents integrated by a moderator, with five repeat runs per case, on 87 CPC cases, 406 MedCaseReasoning cases, and 364 emergency department encounters, under an LLM judge validated against clinicians. On the external benchmark the team beat the single call on both pre-specified recall endpoints (top-3 +3.0 points, p = 0.0079; top-5 +3.9, p = 3.8 x 10^-5;); a factorial attributes the gain to independent generation plus moderated synthesis, not the specialist roles. On real emergency presentations the benefit reversed (top-1 40.1% versus 34.3%, p < 0.0001), carried by the specialist role lists and surviving added objective results. Deployment should key on the question and the input at hand.

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