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Triage and Referral Behavior of Patient Facing Medical Artificial Intelligence Products

Margolis, S. J.; Maddipatla, N. V. S. K.; Ioannides, K. L. H.; Wisk, L. E.; Schriger, D. L.; Elmore, J. G.

2026-08-17 health informatics
10.64898/2026.08.15.26360518 medRxiv
Show abstract

We evaluated nine patient-facing artificial intelligence products using 60 physician-developed standardized clinical cases and 540 multi-turn simulated patient encounters. Although overall triage accuracy showed no statistically significant difference across product categories, referral behavior differed substantially. Branded health AI products more frequently over-triaged low-acuity cases (28% vs 3% vs 2%) and recommended affiliated, fee-requiring clinical services. These findings suggest evaluation of patient-facing medical AI should assess referral behavior alongside overall triage accuracy.

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