OpenEvidence Clinical Question-Answering Platform: Systematic Review of Early Evaluations

OpenEvidence Clinical Question-Answering Platform: Systematic Review of Early Evaluations | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article OpenEvidence Clinical Question-Answering Platform: Systematic Review of Early Evaluations Yaara Artsi, Vera Sorin, Benjamin S. Glicksberg, Robert Freeman, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8896277/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 16 You are reading this latest preprint version Abstract Background OpenEvidence answers clinical questions using retrieval augmented generation on curated sources with explicit citations. The company reports that over 40% of U.S. physicians (~ 400,000) consult it daily. Although several studies have evaluated the platform, the evidence base remains heterogeneous. Objective To systematically review studies evaluating OpenEvidence for clinical question answering and decision support. Methods A systematic search of MEDLINE/PubMed, Scopus, Web of Science, and Google Scholar was conducted from database inception to January 2026. Peer-reviewed studies evaluating OpenEvidence in clinical or clinically simulated contexts were included. Study selection, data extraction, and risk-of-bias assessment were performed independently by two reviewers in accordance with PRISMA guidelines. Results Eleven studies published between 2024 and 2026 were included in the analysis. OpenEvidence was evaluated as the primary platform in eight studies and as a comparator in three. OpenEvidence demonstrated the ability to generate evidence-supported responses and avoided fabricated citations. Performance was strongest in structured, guideline-based contexts. However, accuracy varied in complex clinical scenarios, and the platform often reinforced rather than altered clinical decisions. Limitations included dependence on the available retrieval context, interpretive errors despite accurate citations, variability across clinical domains, and the fact that OpenEvidence is a continuously updated system, limiting the generalizability and cross‑study comparability of point‑in‑time evaluations. Conclusions The rapid adoption of OpenEvidence among clinicians outpaces the sparse research available. With just 11 studies, limited in scope or confined to niche clinical domains, the evidence is still thin relative to its purported usage in daily medical practice. Adoption of such platforms demands prospective real-world studies with clinical endpoints and ongoing benchmarking. Biological sciences/Computational biology and bioinformatics Health sciences/Health care Health sciences/Medical research Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementaryMaterial.docx Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 18 May, 2026 Reviews received at journal 13 May, 2026 Reviews received at journal 11 May, 2026 Reviewers agreed at journal 07 May, 2026 Reviewers agreed at journal 06 May, 2026 Reviews received at journal 04 May, 2026 Reviewers agreed at journal 03 May, 2026 Reviewers agreed at journal 03 May, 2026 Reviewers agreed at journal 02 May, 2026 Reviewers agreed at journal 01 May, 2026 Reviews received at journal 23 Mar, 2026 Reviewers agreed at journal 03 Mar, 2026 Reviewers invited by journal 26 Feb, 2026 Editor assigned by journal 22 Feb, 2026 Submission checks completed at journal 21 Feb, 2026 First submitted to journal 16 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8896277","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":598619427,"identity":"958e859e-7fe5-4775-8520-4c5d42b90abd","order_by":0,"name":"Yaara Artsi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABAUlEQVRIiWNgGAWjYHADxvbffyqANDNzA3EaeBgYGyR4zoC0MBKthYFBgrcNbB1+LQbHDz/78IPBLt+e/3CDgeS82mj+dqCWHxXbcGs5k2Y8s4ch2bJHIrEhwXDb8dwZhxkbGHvO3Mat5UCCMdBRzAY8EowNBxK3HcttAGphZmzDo+X888+MfxjqDXj4DzY2HJxzLHc+QS03coyZeRgOG/AwJDYzNjbU5G4gpEXyxptiZhmD4wY8NxLbmBmOHcjdCNRyEJ9f+M6nb2Z8U1FtwN5//BkzQ01d7rzzhw8++FGBW4vCAbDz4PzDYPIATvVAIN+Ayq/Dp3gUjIJRMApGKAAAuIxZUJBJE/QAAAAASUVORK5CYII=","orcid":"","institution":"Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel","correspondingAuthor":true,"prefix":"","firstName":"Yaara","middleName":"","lastName":"Artsi","suffix":""},{"id":598619428,"identity":"db3ba1a6-8a50-4fc2-959b-7e967c77d955","order_by":1,"name":"Vera Sorin","email":"","orcid":"","institution":"Department of Radiology, Mayo Clinic, Rochester, MN, USA","correspondingAuthor":false,"prefix":"","firstName":"Vera","middleName":"","lastName":"Sorin","suffix":""},{"id":598619429,"identity":"e4f02548-1f50-479f-9353-07d83f19d273","order_by":2,"name":"Benjamin S. 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The company reports that over 40% of U.S. physicians (~\u0026thinsp;400,000) consult it daily. Although several studies have evaluated the platform, the evidence base remains heterogeneous.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eTo systematically review studies evaluating OpenEvidence for clinical question answering and decision support.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA systematic search of MEDLINE/PubMed, Scopus, Web of Science, and Google Scholar was conducted from database inception to January 2026. Peer-reviewed studies evaluating OpenEvidence in clinical or clinically simulated contexts were included. Study selection, data extraction, and risk-of-bias assessment were performed independently by two reviewers in accordance with PRISMA guidelines.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eEleven studies published between 2024 and 2026 were included in the analysis. OpenEvidence was evaluated as the primary platform in eight studies and as a comparator in three. OpenEvidence demonstrated the ability to generate evidence-supported responses and avoided fabricated citations. Performance was strongest in structured, guideline-based contexts. However, accuracy varied in complex clinical scenarios, and the platform often reinforced rather than altered clinical decisions. Limitations included dependence on the available retrieval context, interpretive errors despite accurate citations, variability across clinical domains, and the fact that OpenEvidence is a continuously updated system, limiting the generalizability and cross‑study comparability of point‑in‑time evaluations.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe rapid adoption of OpenEvidence among clinicians outpaces the sparse research available. With just 11 studies, limited in scope or confined to niche clinical domains, the evidence is still thin relative to its purported usage in daily medical practice. Adoption of such platforms demands prospective real-world studies with clinical endpoints and ongoing benchmarking.\u003c/p\u003e","manuscriptTitle":"OpenEvidence Clinical Question-Answering Platform: Systematic Review of Early Evaluations","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-03 19:13:48","doi":"10.21203/rs.3.rs-8896277/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision 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