Nature Medicine, Published online: 14 September 2026; doi:10.1038/s41591-026-04639-5

Trust in clinical artificial intelligence (AI) cannot be benchmarked into existence. It must be earned through rigorous prospective studies in real-world clinical settings, where the hardest lessons often concern the humans and systems around the AI, not the technology itself.

arXiv:2603.08448v1 Announce Type: cross Abstract: Large language model (LLM)-based AI systems have shown promise for patient-facing diagnostic and management conversations in simulated settings. Translating these systems into clinical practice requires assessment in real-world workflows with rigorous safety oversight. We report a prospective, single-arm feasibility study of an LLM-based conversational AI, the Articulate Medical Intelligence Explorer (AMIE), conducting clinical history taking and presentation of potential diagnoses for patients to discuss with their provider at urgent care appointments at a leading academic medical center. 100 adult patients completed an AMIE text-chat interaction up to 5 days before their appointment. We sought to assess the conversational safety and quality, patient and clinician experience, and clinical reasoning capabilities compared to primary care providers (PCPs). Human safety supervisors monitored all patient-AMIE interactions in real time and did not need to intervene to stop any consultations based on pre-defined criteria. Patients reported high satisfaction and their attitudes towards AI improved after interacting with AMIE (p