Daily Briefing for October 16, 2026

Show Notes

JAMA study counts 271 million clinician queries to OpenEvidence

The voices on this episode are generated, and so is the script, from the day's post at Physician in the Loop. Every fact in the post links to its source.

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More than 950,000 U.S. clinicians, 556,200 of them physicians, sent 271 million queries to the AI reference platform OpenEvidence over 2.5 years, according to a study published Oct. 15 in JAMA.

Just over half of the queries, 51.9%, concerned clinical decisions, led by treatment and management at 33.1%, while 13.9% concerned diagnosis, the authors reported. The share of a physician's queries about topics outside the physician's own specialty ranged from 35% among oncologists and hematologists to 88% among emergency physicians. Physicians within a decade of graduation used the platform at 2.54 times their share of the workforce, and residents and fellows at 1.84 times.

Three of the study's seven authors list OpenEvidence affiliations, and the senior author, Dr. Anupam B. Jena, is at Harvard Medical School and Massachusetts General Hospital. OpenEvidence is free to clinicians, carries advertising and licenses content from journals including JAMA, NBC Miami reported in May.

In this episode

• More than 950,000 clinicians sent OpenEvidence 271 million queries in 2.5 years, many outside their own specialty, JAMA study finds
• AMA framework says AI agents taking on clinical functions must earn authority through evidence and keep it through performance
• States ask bankruptcy court to make any Character.AI buyer remove bots posing as therapists, doctors and other licensed professionals
• Continuous glucose monitors cut A1C 0.9 point more than routine care in type 2 diabetes without insulin, Dexcom-funded NEJM trial finds
• Prostate MRI AI matches radiology readings for significant cancer in 1,974 external patients across 12 countries, SCARLET-1 study reports
• Penn team links EEG to a language-model chat app that tells epilepsy patients about seizure risk and learns from their replies
• Zimmer Biomet extends exclusive deal to sell THINK Surgical's handheld TMINI knee robot
• Epic plans a 2027 prescription marketplace showing pharmacy cash prices beside insurance costs before a prescription is sent

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Voice 1: This is Physician in the Loop, the daily briefing on AI in medicine. It's Friday, October 16th, 2026.

Voice 1: More than 950,000 U.S. clinicians, 556,200 of them physicians, sent 271 million queries to OpenEvidence over 2.5 years, according to a study published in JAMA.

Voice 2: What were they actually asking it?

Voice 1: Just over half were about clinical decisions. Treatment and management led, at about a third of all queries, and about 14% were about diagnosis.

Voice 2: How much of that crossed outside a physician's own specialty?

Voice 1: It varied a lot by field. Oncologists and hematologists kept 35% of their queries outside their specialty, but for emergency physicians it was 88%.

Voice 2: Who's using it most, relative to their share of the workforce?

Voice 1: Physicians within a decade of graduation used it at about 3 times their share of the workforce, and residents and fellows at about 2 times.

Voice 2: Does OpenEvidence have a hand in the study measuring all this?

Voice 1: Three of the seven authors list OpenEvidence affiliations, including the senior author, Dr. Anupam B. Jena, who's at Harvard Medical School and Massachusetts General Hospital. The platform is free to clinicians, carries advertising, and licenses content from journals including JAMA.

Voice 2: So the company that built the tool helped write the paper measuring how much it's used.

Voice 1: That's the disclosure in the paper. The usage figures themselves came from accounts verified against each clinician's National Provider Identifier.

Voice 2: The AMA spent the same week trying to write rules for AI that acts, not just answers.

Voice 1: Its new governance framework for agentic AI runs on four questions: what clinical function the AI performs, what evidence shows it can do it and what happens if it fails, what it should be allowed to do and under what oversight, and who's responsible for the risks and outcomes.

Voice 2: How does it handle AI doing more over time?

Voice 1: It describes a progression from informing to recommending, deciding and acting, with stronger evidence required as autonomy and consequences grow. It splits accountability among developers, deployers, health systems, physicians and payers, based on their authority, control, knowledge of risk and ability to prevent harm.

Voice 2: Does getting licensed under this framework mean the AI is practicing medicine?

Voice 1: No. The AMA defines AI licensure as authorization to operate in a defined clinical capacity, not a license to practice medicine. It said these four questions will guide its future work on liability, licensure and regulation.

Voice 2: A rulebook with no enforcement yet, written the same week states went after a different kind of AI for acting like a clinician without one.

Voice 1: A coalition of state attorneys general filed a notice in Character.AI's bankruptcy case, asking that any buyer remove characters that present themselves as therapists, psychologists, doctors or other licensed professionals.

Voice 2: What else are they asking for?

Voice 1: Age verification that doesn't rely only on self-reported birthdates, self-harm and suicide safeguards that, in the notice's words, “cannot be defeated with a simple click-through,” consent before processing health information shared in chats, and a chance for users to delete their data before any sale.

Voice 2: Is there a specific case behind the filing?

Voice 1: It cites a complaint the Pennsylvania State Board of Medicine filed in May, over a character that claimed to be a licensed psychiatrist. Michigan joined 38 other states and the District of Columbia on this notice.

Voice 2: And the company's still trying to close a sale through all this?

Voice 1: It is. Character.AI plans to sell about $20 million in assets to Disney, and the states want their conditions attached before that goes through.

Voice 2: Different kind of evidence out of diabetes care this week.

Voice 1: A Dexcom-funded trial called CONNECT found continuous glucose monitors cut A1C 0.9 percentage point more than routine care, in people with type 2 diabetes who don't use insulin.

Voice 2: What did the actual numbers look like in each group?

Voice 1: Average A1C fell from about 9% to about 7% with monitoring, and from about 9% to 8% with routine care, over 26 weeks. Time spent in the target glucose range was 21 percentage points higher with monitoring, and no severe hypoglycemia was reported.

Voice 2: Who funded it, and who's deciding what happens next?

Voice 1: Dexcom funded the trial, using its G7 sensor, and five of the authors list Dexcom affiliations. CMS is now considering extending Medicare coverage of these monitors to people who don't take insulin.

Voice 2: A company-funded trial pointing straight at a coverage decision that would expand that company's own market.

Voice 1: Before we go, something to watch.

Voice 2: Noridian is holding an open meeting on October 22nd on a proposal to stop covering AI brain MRI quantification.

Voice 1: What's the proposal called, and who would it affect?

Voice 2: It's proposed LCD DL40454, and it would cover 13 Western states and three territories if it's finalized.

Voice 1: So one contractor's call could change AI coverage across a big piece of the map.

Voice 2: A teleconference deciding that, not a courtroom or a professional group this time.

Voice 1: Sources and corrections are at physicianintheloop.org, where you can sign up for the free email briefing. This briefing was read by AI voices.