AI chatbots recommend care costing 3 times what physicians order
Oct 31, 2026
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read by AI voices · all episodesTHE SHORT READ
Twenty general-purpose AI chatbots given 200 outpatient and emergency department notes recommended care costing an average of $314 per visit, more than three times the $97 the treating physicians ordered, a NEJM AI study found.
Most of the gap came from tests the chatbots suggested at visits where physicians had ordered none, the authors reported. A separate Annals of Internal Medicine benchmark found six commercial models usually held back on low-value care but recommended thyroid ultrasound for incidental subcentimeter nodules in 42.8% of responses.
In other news, Medline is removing or correcting all of its beds after reports of two deaths and 16 serious injuries, U.S. measles cases reached 4,852 for the year, STAT reported that Epic has used its market power against rival app makers, and the Food and Drug Administration approved the first plasmid DNA immunotherapy, for recurrent respiratory papillomatosis.
THE DETAILS
- FYIEvidence Oct 15, 2026Researchers from the Technion, Stanford and Tel Aviv University gave 24 AI systems 200 deidentified outpatient and emergency department notes, cut off before the physician's assessment, and priced each plan at 2026 Medicare rates. Across 20 general-purpose systems, recommended tests and referrals averaged $314 per visit vs. $97 for the treating physicians' documented plans, a difference of $216 (95% CI, $177 to $257), and four specialized medical systems ran 2.7 to 3.5 times the physicians' cost, according to the study in NEJM AI. Physicians recorded no testing at 66% of visits, and every AI system suggested testing at those visits, usually a stereotyped panel; prompts asking for cost awareness or parsimony cut the excess to 2.5 and 1.4 times but did not remove it, the authors reported. In a separate Annals of Internal Medicine benchmark of six commercial models on 225 Choosing Wisely scenarios, the models endorsed overuse in 5.4% of responses and withheld appropriate care in 0.6%, with overuse concentrated in thyroid ultrasound for incidental subcentimeter nodules (42.8%) and routine electrocardiography in low-risk adults (28.3%).
- ActIncident Oct 29, 2026
Medline's updated instructions say to unplug beds except while repositioning patients and to call 1-800-950-0128, option 7, for repair or replacement.
Medline is removing or correcting all Medline-brand beds and accessories, including homecare, bariatric and long-term care beds, pendants and replacement parts, the Food and Drug Administration said in an Oct. 29 early alert. Electrical parts can overheat to the point of fire with excessive loading, jammed motors, damaged or fluid-exposed pendants, extension cords or unapproved accessories, and patients can be trapped or asphyxiated when beds are used with accessories, when a user lies on a pendant or when rails are loose, according to the alert. As of Oct. 20, Medline had reported two deaths and 16 serious injuries. Beds may stay in use until repaired or replaced if they are unplugged except while repositioning, never run on extension cords and never self-repaired, with a second person assisting when possible; some beds bought in the last five years qualify for replacement or a refund, the agency said.Source: FDA early alert - FYIEvidence Oct 30, 2026The Centers for Disease Control and Prevention counted 4,852 confirmed measles cases as of Oct. 29, 4,834 reported by 47 jurisdictions and 18 among international visitors, with 96% tied to outbreaks and three deaths, according to its Oct. 30 update. The agency has recorded 43 new outbreaks this year. A Pennsylvania Department of Health advisory issued Oct. 19, amid rising measles in pregnancy in the state's outbreak, says all neonates of mothers with measles in pregnancy should be considered exposed and monitored, that asymptomatic neonates born from maternal symptom onset through 14 days after rash onset should receive immune globulin and be managed in airborne isolation, and that nonimmune pregnant patients should be offered IVIG within six days of exposure. Measles is not an independent indication for delivery, the advisory says.
- FYIMoney Oct 28, 2026Executives at 12 companies featured in Epic's hospital app marketplace told STAT that the electronic health record vendor undercut their businesses by denying access to data interfaces and technical specifications, spreading negative rumors about their products or charging high fees, according to an Oct. 28 report that opens a series based on interviews with more than 50 people. Epic holds data on some 8 in 10 Americans and collects more than $6.5 billion a year in revenue, STAT reported. Epic says it provides more data connections than federal law requires, while some hospital executives and app developers told STAT its market power blocks adoption of the most useful software.Source: STAT
- FYIIncident Oct 30, 2026The Bundibugyo virus outbreak in the Democratic Republic of the Congo reached 10,274 confirmed cases and 4,992 related deaths as of Oct. 29, with community transmission continuing across eight provinces, the European Centre for Disease Prevention and Control reported Oct. 30. In its Oct. 27 update, the agency said a case reported in Nigeria on Oct. 20 had been medically evacuated to Switzerland and that contacts were being followed.Source: ECDC
- FYIRegulation Oct 30, 2026The Food and Drug Administration on Oct. 30 granted accelerated approval to Inovio Pharmaceuticals' Voceryq, two plasmids encoding specific HPV proteins and interleukin-12, injected intramuscularly with an electroporation device. In an open-label trial of 32 adults who had needed at least two papilloma surgeries in the prior 12 months, 7 of 26 patients with at least three baseline surgeries (27%) needed no surgery in the first year after treatment, according to the agency. The approval rests on reduced surgical frequency as an intermediate endpoint, and the company must run trials to confirm clinical benefit. The most common adverse reactions were injection site reactions, headache, fatigue, high blood pressure, nausea and dizziness, the agency said.Source: FDA