Viknesh Sounderajah

Veith Weilnhammer, Lennart Luettgau, Christopher Summerfield et al.

AI chatbots are increasingly used for health advice, but their performance in psychiatric triage remains undercharacterized. Psychiatric triage is particularly challenging because urgency must often be inferred from thoughts, behavior, and context rather than from objective findings. We evaluated the performance of 15 frontier AI chatbots on psychiatric triage from realistic single-message disclosures using 112 clinical vignettes, each paired with 1 of 4 original benchmark triage labels: A, routine; B, assessment within 1 week; C, assessment within 24 to 48 hours; and D, emergency care now. Vignettes covered 9 psychiatric presentation clusters and 9 focal risk dimensions, organized into 28 presentation-by-risk groups. Each group contributed 4 distinct vignettes, with 1 vignette at each triage level. Each vignette was rendered as a realistic human-authored conversational query, and the AI chatbots were tasked with assigning a triage label from that disclosure. Emergency under-triage occurred in 23 of 410 level D trials (5.6%), and all under-triaged emergencies were reassigned to level C urgency. Across target models, average accuracy ranged from 42.0% to 71.8%. Accuracy was highest for level D vignettes (94.3%) and lowest for level B vignettes (19.7%). Mean signed ordinal error was positive (+0.47 triage levels), indicating net over-triage. Dispersion was highest around the middle triage levels. All results were confirmed relative to clinician consensus labels from 50 medical doctors. When presented with user messages containing sufficient clinical information, frontier AI chatbots thus recognized psychiatric emergencies as requiring urgent medical assessment with near-zero error rates, yet showed marked over-triage for low and intermediate risk presentations.

Beatriz Costa-Gomes, Pavel Tolmachev, Eloise Taysom et al.

We analyze over 500,000 de-identified health-related conversations with Microsoft Copilot from January 2026 to characterize what people ask conversational AI about health. We develop a hierarchical intent taxonomy of 12 primary categories using privacy-preserving LLM-based classification validated against expert human annotation, and apply LLM-driven topic-clustering for prevalent themes within each intent. Using this taxonomy, we characterize the intents and topics behind health queries, identify who these queries are about, and analyze how usage varies by device and time of day. Five findings stand out. First, nearly one in five conversations involve personal symptom assessment or condition discussion, and even the dominant general information category (40%) is concentrated on specific treatments and conditions, suggesting that this is a lower bound on personal health intent. Second, one in seven of these personal health queries concern someone other than the user, such as a child, a parent, a partner, suggesting that conversational AI can be a caregiving tool, not just a personal one. Third, personal queries about symptoms and emotional health queries increase markedly in the evening and nighttime hours, when traditional healthcare is most limited. Fourth, usage diverges sharply by device: mobile concentrates on personal health concerns, while desktop is dominated by professional and academic work. Fifth, a substantial share of queries focuses on navigating healthcare systems such as finding providers, and understanding insurance, highlighting friction in the delivery of existing healthcare. These patterns have direct implications for platform-specific design, safety considerations, and the responsible development of health AI.

Harsha Nori, Mayank Daswani, Christopher Kelly et al.

Artificial intelligence holds great promise for expanding access to expert medical knowledge and reasoning. However, most evaluations of language models rely on static vignettes and multiple-choice questions that fail to reflect the complexity and nuance of evidence-based medicine in real-world settings. In clinical practice, physicians iteratively formulate and revise diagnostic hypotheses, adapting each subsequent question and test to what they've just learned, and weigh the evolving evidence before committing to a final diagnosis. To emulate this iterative process, we introduce the Sequential Diagnosis Benchmark, which transforms 304 diagnostically challenging New England Journal of Medicine clinicopathological conference (NEJM-CPC) cases into stepwise diagnostic encounters. A physician or AI begins with a short case abstract and must iteratively request additional details from a gatekeeper model that reveals findings only when explicitly queried. Performance is assessed not just by diagnostic accuracy but also by the cost of physician visits and tests performed. We also present the MAI Diagnostic Orchestrator (MAI-DxO), a model-agnostic orchestrator that simulates a panel of physicians, proposes likely differential diagnoses and strategically selects high-value, cost-effective tests. When paired with OpenAI's o3 model, MAI-DxO achieves 80% diagnostic accuracy--four times higher than the 20% average of generalist physicians. MAI-DxO also reduces diagnostic costs by 20% compared to physicians, and 70% compared to off-the-shelf o3. When configured for maximum accuracy, MAI-DxO achieves 85.5% accuracy. These performance gains with MAI-DxO generalize across models from the OpenAI, Gemini, Claude, Grok, DeepSeek, and Llama families. We highlight how AI systems, when guided to think iteratively and act judiciously, can advance diagnostic precision and cost-effectiveness in clinical care.

LearnLM Team, Abhinit Modi, Aditya Srikanth Veerubhotla et al. · amazon-science, cmu

Today's generative AI systems are tuned to present information by default, rather than engage users in service of learning as a human tutor would. To address the wide range of potential education use cases for these systems, we reframe the challenge of injecting pedagogical behavior as one of \textit{pedagogical instruction following}, where training and evaluation examples include system-level instructions describing the specific pedagogy attributes present or desired in subsequent model turns. This framing avoids committing our models to any particular definition of pedagogy, and instead allows teachers or developers to specify desired model behavior. It also clears a path to improving Gemini models for learning -- by enabling the addition of our pedagogical data to post-training mixtures -- alongside their rapidly expanding set of capabilities. Both represent important changes from our initial tech report. We show how training with pedagogical instruction following produces a LearnLM model (available on Google AI Studio) that experts substantially prefer across a diverse set of learning scenarios, with average preference strengths of +31\% over GPT-4o, +11\% over Claude 3.5 Sonnet, and +13\% over the Gemini 1.5 Pro model on which LearnLM was based.