More than 65 years ago, complex clinical diagnostic reasoning cases were introduced as the gold standard for the evaluation of expert medical computing systems, a standard that has held ever since. In this study, we report the results of a physician ...
Preparing Physicians for the Clinical Algorithm Era
The U.S. government recently took steps to ensure that clinical decision support algorithms are safe for clinical use. The next and larger step will be teaching physicians how to use the algorithms ...
Preparing Physicians for the Clinical Algorithm Era
The U.S. government recently took steps to ensure that clinical decision support algorithms are safe for clinical use. The next and larger step will be teaching physicians how to use the algorithms ...
General-purpose large language models outperform specialized clinical AI tools on medical benchmarks
Specialized clinical artificial intelligence (AI) tools are entering medical practice despite scarce independent evaluation. We quantitatively evaluate two clinical AI tools, OpenEvidence and UpToDate Expert AI, built on large language models (LLMs) against three frontier LLMs: GPT-5.2, Gemini 3.1 Pro and Claude Opus 4.6. Our evaluation has three stages: (1) 500 MedQA questions testing medical knowledge, (2) 500 HealthBench items measuring alignment with clinicians and (3) the real clinical queries (RCQ) benchmark, built from 100 de-identified queries from physicians to a general-purpose language model in a live clinical environment. For the RCQ benchmark, 12 US clinicians performed randomized, blinded review of model outputs, producing 1,800 model–question annotations. Frontier LLMs outperformed clinical AI tools in all three evaluations. Clinical AI tools performed comparably to auto-enabled Google Search AI Overview on the RCQ. These findings highlight the need for independent, real-world evaluation of AI tools before they enter clinical settings.
GraphDx: A Cost-Aware Knowledge-Enhanced Multi-Agent Framework for Sequential Diagnosis
Unlike static question answering, sequential diagnosis mirrors actual clinical workflows: physicians iteratively gather information through symptom inquiries and diagnostic tests, making decisions under uncertainty while balancing diagnostic accuracy against resource costs including monetary expense, patient discomfort, and time. This multi-turn process requires not merely knowledge recall, but systematic reasoning that coordinates information acquisition with hypothesis refinement.
Using AI to help physicians diagnose rare genetic diseases affecting children
Researchers used an OpenAI reasoning model to help diagnose rare diseases, identifying 18 new diagnoses in previously unsolved cases.
Reliability of LLMs as medical assistants for the general public: a randomized preregistered study
Global healthcare providers are exploring the use of large language models (LLMs) to provide medical advice to the public. LLMs now achieve nearly perfect scores on medical licensing exams, but this does not necessarily translate to accurate performance in real-world settings. We tested whether LLMs can assist members of the public in identifying underlying conditions and choosing a course of action (disposition) in ten medical scenarios in a controlled study with 1,298 participants. Participants were randomly assigned to receive assistance from an LLM (GPT-4o, Llama 3, Command R+) or a source of their choice (control). Tested alone, LLMs complete the scenarios accurately, correctly identifying conditions in 94.9% of cases and disposition in 56.3% on average. However, participants using the same LLMs identified relevant conditions in fewer than 34.5% of cases and disposition in fewer than 44.2%, both no better than the control group. We identify user interactions as a challenge to the deployment of LLMs for medical advice. Standard benchmarks for medical knowledge and simulated patient interactions do not predict the failures we find with human participants. Moving forward, we recommend systematic human user testing to evaluate interactive capabilities before public deployments in healthcare.
Reliability of LLMs as medical assistants for the general public: a randomized preregistered study
Global healthcare providers are exploring the use of large language models (LLMs) to provide medical advice to the public. LLMs now achieve nearly perfect scores on medical licensing exams, but this does not necessarily translate to accurate performance in real-world settings. We tested whether LLMs can assist members of the public in identifying underlying conditions and choosing a course of action (disposition) in ten medical scenarios in a controlled study with 1,298 participants. Participants were randomly assigned to receive assistance from an LLM (GPT-4o, Llama 3, Command R+) or a source of their choice (control). Tested alone, LLMs complete the scenarios accurately, correctly identifying conditions in 94.9% of cases and disposition in 56.3% on average. However, participants using the same LLMs identified relevant conditions in fewer than 34.5% of cases and disposition in fewer than 44.2%, both no better than the control group. We identify user interactions as a challenge to the deployment of LLMs for medical advice. Standard benchmarks for medical knowledge and simulated patient interactions do not predict the failures we find with human participants. Moving forward, we recommend systematic human user testing to evaluate interactive capabilities before public deployments in healthcare.
Towards Expert-level Medical AI for Real-time Video Consultations
Audio-visual interaction is the standard for patient-physician consultations, enabling natural communication and effective assessment of illness through non-verbal cues. While text-based AI has shown promise, it discards essential perceptual dimensions and limits patients who cannot articulate symptoms in writing. Early efforts to extend medical AI to audio-visual interaction have demonstrated feasibility but not reached clinician-level performance. Here, we provide the first demonstration of expert-level AI in real-time clinical video consultations using AMIE (Articulate Medical Intelligence Explorer) in a video configuration. AMIE (Video) is a Gemini-based multi-agent system integrating low-latency dialogue, clinical reasoning, and real-time audio-visual perception. To guide development, we established a taxonomy and automated evaluations for clinical audio-visual cues in telehealth settings. In a randomized Objective Structured Clinical Examination (OSCE) study with 30 primary care physicians (PCPs), 15 patient actors and 100 clinical scenarios, we compared AMIE (Video), its text-only counterpart AMIE (Text), and PCPs consulting via video. Clinical evaluators rated AMIE (Video) on par or better than PCPs in history-taking, diagnosis, management, and physical observation and examination. Patient actors preferred AMIE's approach to assessing and explaining conditions, while PCPs were preferred for rapport and partnership building. In modality ablation, patient actors preferred AMIE (Video)'s interface over text chat for communicative effectiveness, convenience, and feeling understood. Limitations remain in fine anatomical precision, subtle affective nuances, and high-frequency movements. While further research is needed before real-world translation, these results mark an important milestone toward AI systems capable of augmenting care across the sensory complexity of clinical practice.
A taxonomy for next-generation reasoning models
Where we've been and where we're going with RLVR.
The Illusion of Thinking: Understanding the Strengths and Limitations of Reasoning Models via the Lens of Problem Complexity
Recent generations of frontier language models have introduced Large Reasoning Models (LRMs) that generate detailed thinking processes…
Chatbots Make Terrible Doctors, New Study Finds
Chatbots provided incorrect, conflicting medical advice, researchers found: “Despite all the hype, AI just isn't ready to take on the role of the physician.”
Doctor forced to apologise after AI makes 'scary' error about illegal drugs
Artificial Intelligence is listening to many people's medical appointments, but it is not always hearing things correctly.
Establishing trust in automated reasoning - MetaROR
Since its beginnings in the 1940s, automated reasoning by computers has become a tool of ever growing importance in scientific research. So far, the rules underlying automated reasoning have mainly been formulated by humans, in the form of program source code. Rules derived from large amounts of data, via machine learning techniques, are a complementary approach currently under intense development. The question of why we should trust these systems, and the results obtained with their help, has been discussed by early practitioners of computational science, but was later forgotten. The present work focuses on independent reviewing, an important source of trust in science, and identifies the characteristics of automated reasoning systems that affect their reviewability. It also discusses possible steps towards increasing reviewability and trustworthiness via a combination of technical and social measures.
Towards Conversational Medical AI with Eyes, Ears and a Voice
The practice of medicine relies not only upon skillful dialogue but also on the nuanced exchange and interpretation of rich auditory and visual cues between doctors and patients. Building on the low-latency voice and video processing capabilities of Gemini, we introduce AI co-clinician, a first-of-its-kind conversational AI system utilizing continuous streams of audio-visual data from live patient conversations to inform real-time clinical decisions. Its dual-agent architecture balances deep clinical reasoning with the low latency required for natural dialogue. To assess this system, we implemented a video-based interface emulating telemedicine consultations. We crafted 20 standardized outpatient scenarios requiring proactive real-time auditory and visual reasoning and designed "TelePACES" evaluation criteria alongside case-specific rubrics. In a randomized, interface-blinded, crossover simulation study (n = 120 encounters) with 10 internal medicine residents as patient actors, we compared AI co-clinician with primary care physicians (PCPs), GPT-Realtime, and a baseline agent. AI co-clinician approached PCPs in key TelePACES dimensions, including management plans and differential diagnosis, while significantly outperforming GPT-Realtime across all general criteria. While our agent demonstrated parity with PCPs in case-specific triage measures, physicians maintained superior overall performance in case-specific assessments. Although AI co-clinician marks a significant advance in real-time telemedical AI, gaps remain in physical examination and disease-specific reasoning. Our work shows that text-only approaches fail to capture the true challenges of medical consultation and suggests that high-stakes real-time diagnostic AI is most safely advanced in collaborative, triadic models where AI can be a supportive co-clinician for doctors and patients.
Prompting Science Report 4: Playing Pretend: Expert Personas Don't Improve Factual Accuracy
<span> <p><span>This is the fourth in a series of short reports that help business, education, and policy leaders understand the technical details of working with AI through rigorous testing. Here, we ask whether assigning personas to models improves performance on difficult objective multiple-choice questions. We study both domain-specific expert personas and low-knowledge personas, evaluating six models on GPQA Diamond (Rein et al. 2024) and MMLU-Pro (Wang et al. 2024), graduate-level questions spanning science, engineering, and law. </span></p> <p><span>We tested three approaches:</span></p> <p><span>• In-Domain Experts: Assigning the model an expert persona (“you are a physics expert”) matched to the problem type (physics problems) had no significant impact on performance (with the exception of the Gemini 2.0 Flash model).</span></p> <p><span> • Off-Domain Experts (Domain-Mismatched): Assigning the model an expert persona (“you are a physics expert”) not matched to the problem type (law problems) resulted in marginal differences.</span></p> <p><span> • Low-Knowledge Personas: We assigned the model negative capability personas (layperson, young child, toddler), which were generally harmful to benchmark accuracy. </span></p> <p><span>Across both benchmarks, persona prompts generally did not improve accuracy relative to a no-persona baseline. Expert personas showed no consistent benefit across models, with few exceptions. Domain-mismatched expert personas sometimes degraded performance. Low-knowledge personas often reduced accuracy. These results are about the accuracy of answers only; personas may serve other purposes (such as altering the tone of outputs), beyond improving factual performance.</span></p></span>
Company Offering ‘100% Human-Written, Never AI’ Medical Research Is Entirely AI
Research Gold's team of human methodologists are either AI generated or using the identity of real people without their permission
