The Lancet publishes Google's AMIE study, the first prospective test of a patient facing diagnostic chatbot in a real clinic
Today @TheLancet published our AMIE study with @BIDMC_Medicine, the first prospective study of patient-facing conversational diagnostics in a real clinic. AMIE is a research system people can chat with before doctors appointments. Testing AMIE outside the lab with real urgent care patients showed how technology can help gather medical histories safely. Clinicians reported that the summaries helped them prepare for visits in 75% of cases and influenced their approach to care in more than half. AMIE’s differential diagnoses also matched the doctors’ final diagnoses 90% of the time giving clinicians more time to focus on patient care. It’s Google’s first-ever paper in The Lancet’s main journal!
Context
It is one of the first peer reviewed tests of a medical AI talking directly to real patients before their visits, with no conversation needing to be stopped for safety under the study's criteria.
AMIE, the Articulate Medical Intelligence Explorer, is a research diagnostic chatbot from Google that had earlier been tested mainly with simulated patients. The new study was run with Beth Israel Deaconess Medical Center in Boston and is registered with ClinicalTrials.gov. Google says it is the company's first paper in The Lancet's main journal.
Deep dive
According to the Lancet abstract, the study was a prospective, single centre, single arm feasibility study. Adult patients chatted with AMIE up to five days before an urgent primary care appointment for a single complaint, and their doctors received the transcript and summary before the visit. Physician safety supervisors watched every conversation and were trained to intervene based on predefined criteria.
From April to November 2025, 114 patients enrolled and 98 completed both the AMIE chat and the appointment. The authors report that no conversation had to be stopped under the prespecified safety criteria. Supervisors noted one hallucination and added clinical information in five conversations. Clinical evaluators rated AMIE's conversations favourably in 87 to 100% of cases across 17 criteria, and patients in 48 to 96% across 16 criteria. Patients' attitudes toward AI improved after using AMIE.
Primary care doctors completed surveys in 60 of 98 cases. Of the 44 in which they had reviewed the transcript, they found AMIE helpful for preparation in 33 and said it might have changed their behaviour in 25. Google says AMIE's differential diagnoses included the final diagnosis 90% of the time. The preprint reports similar overall quality for AMIE and doctors on diagnosis and management plans, with doctors scoring better on the practicality and cost effectiveness of management.
Google's blog post says larger clinical trials are still needed to assess patient facing AI at scale.
What to expect next
The authors and Google both describe this as a first feasibility step, so watch for larger trials with more sites, more patients and a control group, which the single arm design did not have.
Also watch for how regulators and health systems treat patient facing diagnostic chatbots, since this study relied on doctors supervising every chat in real time. Whether AMIE can work safely without that supervision is still untested.