Evidence map›Paper›PMID 41199808›Full record

ArticleFrontiers in artificial intelligence2025

Assessing the quality of AI-generated clinical notes: validated evaluation of a large language model ambient scribe.

Erin Palm, Astrit Manikantan, Herprit Mahal, Srikanth Subramanya Belwadi, Mark E Pepin

Abstract read
In one paragraph

Article in Frontiers in artificial intelligence, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Erin PalmSuki AI, Redwood City, CA, United States.
Astrit ManikantanSuki AI, Redwood City, CA, United States.
Herprit MahalSuki AI, Redwood City, CA, United States.
Srikanth Subramanya BelwadiSuki AI, Redwood City, CA, United States.
Mark E PepinSuki AI, Redwood City, CA, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Generative artificial intelligence (AI) tools are increasingly being used as "ambient scribes" to generate drafts for clinical notes from patient encounters. Despite rapid adoption, few studies have systematically evaluated the quality of AI-generated documentation against physician standards using validated frameworks. Objective: This study aimed to compare the quality of large language model (LLM)-generated clinical notes ("Ambient") with physician-authored reference ("Gold") notes across five clinical specialties using the Physician Documentation Quality Instrument (PDQI-9) as a validated framework to assess document quality. Methods: We pooled 97 de-identified audio recordings of outpatient clinical encounters across general medicine, pediatrics, obstetrics/gynecology, orthopedics, and adult cardiology. For each encounter, clinical notes were generated using both LLM-optimized "Ambient" and blinded physician-drafted "Gold" notes, based solely on audio recording and corresponding transcripts. Two blinded specialty reviewers independently evaluated each note using the modified PDQI-9, which includes 11 criteria rated on a Likert-scale, along with binary hallucination detection. Interrater reliability was assessed using within-group interrater agreement coefficient (RWG) statistics. Paired comparisons were performed using Results: Paired analysis of 97 clinical encounters yielded 194 notes (2 per encounter) and 388 paired reviews. Overall, high interrater agreement was observed (RWG > 0.7), with moderate concordance noted in pediatrics and cardiology. Gold notes achieved higher overall quality scores (4.25/5 vs. 4.20/5, Conclusion: LLM-generated Ambient notes demonstrated quality comparable to physician-authored notes across multiple specialties. While Ambient notes were more thorough and better organized, they were also less succinct and more prone to hallucination. The PDQI-9 provides a validated, practical framework for evaluating AI-generated clinical documentation. This quality assessment methodology can inform iterative quality optimization and support the standardization of ambient AI scribes in clinical practice.

Indexed as

artificial intelligenceclinical quality improvementdictation accuracylarge language modelsmedical scribe

Identifiers

PMID41199808
PMCPMC12586549

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.