Peter Hames

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.