teleo-codex/inbox/queue/2026-03-20-openevidence-1m-daily-consultations-milestone.md

type	title	author	url	date	domain	secondary_domains	format	status	priority	tags	flagged_for_theseus	processed_by	processed_date	enrichments_applied	extraction_model
source	OpenEvidence Hits 1 Million Daily Clinical Consultations March 10, 2026 — Scale Without Outcomes Evidence	OpenEvidence (press release) + PMC retrospective study	https://www.prnewswire.com/news-releases/openevidence-achieves-historic-milestone-1-million-clinical-consultations-between-verified-doctors-and-an-artificial-intelligence-system-in-a-single-day-302712459.html	2026-03-10	health	ai-alignment	press release + PMC study	enrichment	high	openevidence clinical-ai physician-ai outcomes-evidence scale verification-bandwidth deskilling	verification bandwidth at scale — 1M daily consultations with zero prospective outcomes evidence is the Catalini Measurability Gap playing out in real clinical settings; cross-domain with Theseus's alignment work on oversight degradation	vida	2026-03-20	human-in-the-loop clinical AI degrades to worse-than-AI-alone because physicians both de-skill from reliance and introduce errors when overriding correct outputs.md OpenEvidence became the fastest-adopted clinical technology in history reaching 40 percent of US physicians daily within two years.md	anthropic/claude-sonnet-4.5

Content

The milestone (March 10, 2026 press release):

• OpenEvidence conducted 1 million clinical consultations with NPI-verified physicians in a single 24-hour period
• Previous benchmark: 20 million/month (50% below current run rate of 30M+/month)
• CEO Daniel Nadler: "One million clinical consultations in a single day represents one million moments where a patient received better, faster, more informed care"
• Claim: "OpenEvidence is used by more American doctors than all other AIs in the world—combined"
• No outcome data, no safety metrics, no adverse event reporting in the announcement

The PMC outcomes study (PMC12033599):

• Title: "The Use of an Artificial Intelligence Platform OpenEvidence to Augment Clinical Decision-Making for Primary Care Physicians"
• Methodology: Retrospective evaluation of 5 patient cases
• Finding: OE responses "consistently provided accurate, evidence-based responses that aligned with CDM made by physicians" and "reinforced the physician's plans"
• Limitation: This is NOT an outcomes study. It compares OE answers to what doctors said, not what happened to patients.
• No prospective outcomes data, no control group, n=5 cases

The scale-safety asymmetry:

• 30M+ consultations/month influencing clinical decisions
• Evidence base for clinical benefit: 5 retrospective cases
• Previous KB data (March 19 session): 44% of physicians concerned about accuracy/misinformation despite heavy use
• Hosanagar/Lancet deskilling data: physicians worse at polyp detection when AI removed (28% → 22% adenoma detection)
• At 1M consultations/day: if OE has even a 0.1% systematic error rate on consequential decisions, that's 1,000 potentially harmful recommendations per day

Institutional deployment:

• Sutter Health announced collaboration to bring OE into physician workflows
• Platform partnerships: NEJM, JAMA, NCCN, Cochrane Library (evidence grounding)
• No peer-reviewed clinical outcomes study from any health system using OE at scale

Agent Notes

Why this matters: This is the most consequential unmonitored clinical AI deployment in history. The March 19 session identified the OpenEvidence outcomes gap as a critical thread — this milestone dramatically escalates the urgency. 30M consultations/month without prospective outcomes evidence is exactly the Catalini verification bandwidth problem that the March 19 session identified as a new health risk category. The scale is now at a level where systematic errors, if present, would be population-scale harms.

What surprised me: The PMC study actually EXISTS — but it's 5 retrospective cases. A study comparing AI answers to doctor answers is not an outcomes study. Sutter Health's institutional adoption (a major California health system) without requiring prospective outcomes data first is striking — this suggests the "evidence-based medicine" framing of OE has convinced institutions that using it IS the evidence-based approach, when the institutional adoption decision itself has no RCT evidence.

What I expected but didn't find: Any adverse event reporting mechanism for AI-influenced clinical decisions. Drug adverse events go through FDA FAERS. Device adverse events go through MAUDE. There is no equivalent reporting system for clinical AI decision-support adverse events. If OE influences a clinical decision that harms a patient, that harm may never be attributed back to the AI's role.

KB connections:

• Deepens Belief 5 claim human-in-the-loop clinical AI degrades to worse-than-AI-alone because physicians both de-skill from reliance and introduce errors when overriding correct outputs
• Extends March 19 session's Claim Candidate 3 (verification bandwidth clinical manifestation): now with 50% more data (1M/day vs 20M/month) and an institutional health system deployment to anchor it
• Cross-domain: Theseus should evaluate whether the absence of clinical AI adverse event reporting represents a regulatory gap analogous to other AI safety reporting failures

Extraction hints: Two distinct claims: (1) OpenEvidence reached 1M daily consultations March 10, 2026, making it the highest-volume physician-AI consultation system with zero prospective outcomes evidence (proven scale + outcome gap); (2) Clinical AI health systems have no equivalent to FDA FAERS or MAUDE for AI-influenced decision adverse event reporting — the monitoring infrastructure doesn't exist (structural/regulatory claim).

Curator Notes

PRIMARY CONNECTION: human-in-the-loop clinical AI degrades to worse-than-AI-alone because physicians both de-skill from reliance and introduce errors when overriding correct outputs WHY ARCHIVED: Escalation of the clinical AI safety thread — scale has jumped from 20M/month to 30M+/month in a single milestone announcement, with no new outcomes evidence added. The asymmetry between scale and evidence is now acute enough to be a standalone claim. EXTRACTION HINT: Extractor should focus on the ASYMMETRY between scale and evidence, not just the scale itself. The claim should be specific about why this asymmetry creates risk: (1) verification bandwidth saturation, (2) deskilling degrading the oversight capacity, (3) absence of adverse event reporting infrastructure.

Key Facts

• OpenEvidence conducted 1 million clinical consultations with NPI-verified physicians in a single 24-hour period on March 10, 2026
• OpenEvidence's previous benchmark was 20 million consultations per month
• Current run rate is 30M+ consultations per month (50% above previous benchmark)
• PMC12033599 study evaluated 5 patient cases retrospectively, comparing OE responses to physician decisions
• The PMC study found OE responses 'consistently provided accurate, evidence-based responses that aligned with CDM made by physicians' and 'reinforced the physician's plans'
• Sutter Health announced collaboration to bring OpenEvidence into physician workflows
• OpenEvidence has platform partnerships with NEJM, JAMA, NCCN, and Cochrane Library
• 44% of physicians expressed concerns about accuracy/misinformation despite heavy OpenEvidence use (from March 19 session data)
• FDA FAERS handles drug adverse events, MAUDE handles device adverse events, but no equivalent exists for clinical AI