AI

In this tutorial, we build an advanced hands-on workflow with the Deepgram Python SDK and explore how modern voice AI capabilities come together in a single Python environment. We set up authentication, connect both synchronous and asynchronous Deepgram clients, and work directly with real audio data to understand how the SDK handles transcription, speech generation, and text analysis in practice. We transcribe audio from both a URL and a local file, inspect confidence scores, word-level timestamps, speaker diarization, paragraph formatting, and AI-generated summaries, and then extend the pipeline to async processing for faster, more scalable execution. We also generate speech with multiple TTS voices, analyze text for sentiment, topics, and intents, and examine advanced transcription controls such as keyword search, replacement, boosting, raw response access, and structured error handling. Through this process, we create a practical, end-to-end Deepgram voice AI workflow that is both technically detailed and easy to adapt for real-world applications. Copy CodeCopiedUse a different Browser !pip install deepgram-sdk httpx –quiet import os, asyncio, textwrap, urllib.request from getpass import getpass from deepgram import DeepgramClient, AsyncDeepgramClient from deepgram.core.api_error import ApiError from IPython.display import Audio, display DEEPGRAM_API_KEY = getpass(” Enter your Deepgram API key: “) os.environ[“DEEPGRAM_API_KEY”] = DEEPGRAM_API_KEY client = DeepgramClient(api_key=DEEPGRAM_API_KEY) async_client = AsyncDeepgramClient(api_key=DEEPGRAM_API_KEY) AUDIO_URL = “https://dpgr.am/spacewalk.wav” AUDIO_PATH = “/tmp/sample.wav” urllib.request.urlretrieve(AUDIO_URL, AUDIO_PATH) def read_audio(path=AUDIO_PATH): with open(path, “rb”) as f: return f.read() def _get(obj, key, default=None): “””Get a field from either a dict or an object — v6 returns both.””” if isinstance(obj, dict): return obj.get(key, default) return getattr(obj, key, default) def get_model_name(meta): mi = _get(meta, “model_info”) if mi is None: return “n/a” return _get(mi, “name”, “n/a”) def tts_to_bytes(response) -> bytes: “””v6 generate() returns a generator of chunks or an object with .stream.””” if hasattr(response, “stream”): return response.stream.getvalue() return b””.join(chunk for chunk in response if isinstance(chunk, bytes)) def save_tts(response, path: str) -> str: with open(path, “wb”) as f: f.write(tts_to_bytes(response)) return path print(” Deepgram client ready | sample audio downloaded”) print(“n” + “=”*60) print(” SECTION 2: Pre-Recorded Transcription from URL”) print(“=”*60) response = client.listen.v1.media.transcribe_url( url=AUDIO_URL, model=”nova-3″, smart_format=True, diarize=True, language=”en”, utterances=True, filler_words=True, ) transcript = response.results.channels[0].alternatives[0].transcript print(f”n Full Transcript:n{textwrap.fill(transcript, 80)}”) confidence = response.results.channels[0].alternatives[0].confidence print(f”n Confidence: {confidence:.2%}”) words = response.results.channels[0].alternatives[0].words print(f”n First 5 words with timing:”) for w in words[:5]: print(f” ‘{w.word}’ start={w.start:.2f}s end={w.end:.2f}s conf={w.confidence:.2f}”) print(f”n Speaker Diarization (first 5 words):”) for w in words[:5]: speaker = getattr(w, “speaker”, None) if speaker is not None: print(f” Speaker {int(speaker)}: ‘{w.word}'”) meta = response.metadata print(f”n Metadata: duration={meta.duration:.2f}s channels={int(meta.channels)} model={get_model_name(meta)}”) We install the Deepgram SDK and its dependencies, then securely set up authentication using our API key. We initialize both synchronous and asynchronous Deepgram clients, download a sample audio file, and define helper functions to make it easier to work with mixed response objects, audio bytes, model metadata, and streamed TTS outputs. We then run our first pre-recorded transcription from a URL and inspect the transcript, confidence score, word-level timestamps, speaker diarization, and metadata to understand the structure and richness of the response. Copy CodeCopiedUse a different Browser print(“n” + “=”*60) print(” SECTION 3: Pre-Recorded Transcription from File”) print(“=”*60) file_response = client.listen.v1.media.transcribe_file( request=read_audio(), model=”nova-3″, smart_format=True, diarize=True, paragraphs=True, summarize=”v2”, ) alt = file_response.results.channels[0].alternatives[0] paragraphs = getattr(alt, “paragraphs”, None) if paragraphs and _get(paragraphs, “paragraphs”): print(“n Paragraph-Formatted Transcript:”) for para in _get(paragraphs, “paragraphs”)[:2]: sentences = ” “.join(_get(s, “text”, “”) for s in (_get(para, “sentences”) or [])) print(f” [Speaker {int(_get(para,’speaker’,0))}, ” f”{_get(para,’start’,0):.1f}s–{_get(para,’end’,0):.1f}s] {sentences[:120]}…”) else: print(f”n Transcript: {alt.transcript[:200]}…”) if getattr(file_response.results, “summary”, None): short = _get(file_response.results.summary, “short”, “”) if short: print(f”n AI Summary: {short}”) print(f”n Confidence: {alt.confidence:.2%}”) print(f” Word count : {len(alt.words)}”) print(“n” + “=”*60) print(” SECTION 4: Async Parallel Transcription”) print(“=”*60) async def transcribe_async(): audio_bytes = read_audio() async def from_url(label): r = await async_client.listen.v1.media.transcribe_url( url=AUDIO_URL, model=”nova-3″, smart_format=True, ) print(f” [{label}] {r.results.channels[0].alternatives[0].transcript[:100]}…”) async def from_file(label): r = await async_client.listen.v1.media.transcribe_file( request=audio_bytes, model=”nova-3″, smart_format=True, ) print(f” [{label}] {r.results.channels[0].alternatives[0].transcript[:100]}…”) await asyncio.gather(from_url(“From URL”), from_file(“From File”)) await transcribe_async() We move from URL-based to file-based transcription by sending raw audio bytes directly to the Deepgram API, enabling richer options such as paragraphs and summarization. We inspect the returned paragraph structure, speaker segmentation, summary output, confidence score, and word count to see how the SDK supports more readable and analysis-friendly transcription results. We also introduce asynchronous processing and run URL-based and file-based transcription in parallel, helping us understand how to build faster, more scalable voice AI pipelines. Copy CodeCopiedUse a different Browser print(“n” + “=”*60) print(” SECTION 5: Text-to-Speech”) print(“=”*60) sample_text = ( “Welcome to the Deepgram advanced tutorial. ” “This SDK lets you transcribe audio, generate speech, ” “and analyse text — all with a simple Python interface.” ) tts_path = save_tts( client.speak.v1.audio.generate(text=sample_text, model=”aura-2-asteria-en”), “/tmp/tts_output.mp3″, ) size_kb = os.path.getsize(tts_path) / 1024 print(f” TTS audio saved → {tts_path} ({size_kb:.1f} KB)”) display(Audio(tts_path)) print(“n” + “=”*60) print(” SECTION 6: Multiple TTS Voices Comparison”) print(“=”*60) voices = { “aura-2-asteria-en”: “Asteria (female, warm)”, “aura-2-orion-en”: “Orion (male, deep)”, “aura-2-luna-en”: “Luna (female, bright)”, } for model_id, label in voices.items(): try: path = save_tts( client.speak.v1.audio.generate(text=”Hello! I am a Deepgram voice model.”, model=model_id), f”/tmp/tts_{model_id}.mp3″, ) print(f” {label}”) display(Audio(path)) except Exception as e: print(f” {label} — {e}”) print(“n” + “=”*60) print(” SECTION 7: Text Intelligence — Sentiment, Topics, Intents”) print(“=”*60) review_text = ( “I absolutely love this product! It arrived quickly, the quality is ” “outstanding, and customer support was incredibly helpful when I had ” “a question. I would definitely recommend it to anyone looking for ” “a reliable solution. Five stars!” ) read_response = client.read.v1.text.analyze( request={“text”: review_text}, language=”en”, sentiment=True, topics=True, intents=True, summarize=True, ) results = read_response.results We focus on speech generation by converting text to audio using Deepgram’s text-to-speech API and saving the resulting audio as an MP3 file. We then compare multiple TTS voices to hear how different voice models behave and how easily we can switch between them while keeping the same code pattern. After that, we begin working with the Read API by passing the review text into Deepgram’s text intelligence system to analyze language beyond simple transcription. Copy CodeCopiedUse a different Browser if getattr(results, “sentiments”, None): overall = results.sentiments.average print(f” Sentiment: {_get(overall,’sentiment’,’?’).upper()} ” f”(score={_get(overall,’sentiment_score’,0):.3f})”) for seg in (_get(results.sentiments, “segments”) or [])[:2]: print(f” •

In this tutorial, we work with Microsoft’s OpenMementos dataset and explore how reasoning traces are structured through blocks and mementos in a practical, Colab-ready workflow. We stream the dataset efficiently, parse its special-token format, inspect how reasoning and summaries are organized, and measure the compression provided by the memento representation across different domains. As we move through the analysis, we also visualize dataset patterns, align the streamed format with the richer full subset, simulate inference-time compression, and prepare the data for supervised fine-tuning. In this way, we build both an intuitive and technical understanding of how OpenMementos captures long-form reasoning while preserving compact summaries that can support efficient training and inference. Copy CodeCopiedUse a different Browser !pip install -q -U datasets transformers matplotlib pandas import re, itertools, textwrap from collections import Counter from typing import Dict import pandas as pd import matplotlib.pyplot as plt from datasets import load_dataset DATASET = “microsoft/OpenMementos” ds_stream = load_dataset(DATASET, split=”train”, streaming=True) first_row = next(iter(ds_stream)) print(“Columns :”, list(first_row.keys())) print(“Domain :”, first_row[“domain”], “| Source:”, first_row[“source”]) print(“Problem head:”, first_row[“problem”][:160].replace(“n”, ” “), “…”) We install the required libraries and import the core tools needed for dataset streaming, parsing, analysis, and visualization. We then connect to the Microsoft OpenMementos dataset in streaming mode to inspect it without downloading the entire dataset locally. By reading the first example, we begin understanding the dataset schema, the problem format, and the domain and source metadata attached to each reasoning trace. Copy CodeCopiedUse a different Browser BLOCK_RE = re.compile(r”<|block_start|>(.*?)<|block_end|>”, re.DOTALL) SUMMARY_RE = re.compile(r”<|summary_start|>(.*?)<|summary_end|>”, re.DOTALL) THINK_RE = re.compile(r”<think>(.*?)</think>”, re.DOTALL) def parse_memento(response: str) -> Dict: blocks = [m.strip() for m in BLOCK_RE.findall(response)] summaries = [m.strip() for m in SUMMARY_RE.findall(response)] think_m = THINK_RE.search(response) final_ans = response.split(“</think>”)[-1].strip() if “</think>” in response else “” return {“blocks”: blocks, “summaries”: summaries, “reasoning”: (think_m.group(1) if think_m else “”), “final_answer”: final_ans} parsed = parse_memento(first_row[“response”]) print(f”n→ {len(parsed[‘blocks’])} blocks, {len(parsed[‘summaries’])} mementos parsed”) print(“First block :”, parsed[“blocks”][0][:140].replace(“n”, ” “), “…”) print(“First memento :”, parsed[“summaries”][0][:140].replace(“n”, ” “), “…”) N_SAMPLES = 500 rows = [] for i, ex in enumerate(itertools.islice( load_dataset(DATASET, split=”train”, streaming=True), N_SAMPLES)): p = parse_memento(ex[“response”]) if not p[“blocks”] or len(p[“blocks”]) != len(p[“summaries”]): continue blk_c = sum(len(b) for b in p[“blocks”]) sum_c = sum(len(s) for s in p[“summaries”]) blk_w = sum(len(b.split()) for b in p[“blocks”]) sum_w = sum(len(s.split()) for s in p[“summaries”]) rows.append(dict(domain=ex[“domain”], source=ex[“source”], n_blocks=len(p[“blocks”]), block_chars=blk_c, summ_chars=sum_c, block_words=blk_w, summ_words=sum_w, compress_char=sum_c / max(blk_c, 1), compress_word=sum_w / max(blk_w, 1))) if (i + 1) % 100 == 0: print(f” processed {i+1}/{N_SAMPLES}”) df = pd.DataFrame(rows) print(f”nAnalyzed {len(df)} rows. Domain counts:”) print(df[“domain”].value_counts().to_string()) per_dom = df.groupby(“domain”).agg( n=(“domain”, “count”), median_blocks=(“n_blocks”, “median”), median_block_words=(“block_words”, “median”), median_summ_words=(“summ_words”, “median”), median_char_ratio=(“compress_char”, “median”), median_word_ratio=(“compress_word”, “median”), ).round(3) print(“nPer-domain medians (ratio = mementos / blocks):”) print(per_dom.to_string()) We define the regex-based parser that extracts reasoning blocks, memento summaries, the main thinking section, and the final answer from each response. We test the parser on the first streamed example and confirm that the block-summary structure is being captured correctly. We then run a streaming analysis over multiple samples to compute block counts, word counts, character counts, and compression ratios, which helps us study how the dataset behaves across examples and domains. Copy CodeCopiedUse a different Browser def compress_trace(response: str, keep_last_k: int = 1) -> str: blocks, summaries = BLOCK_RE.findall(response), SUMMARY_RE.findall(response) if not blocks or len(blocks) != len(summaries): return response out, n = [“<think>”], len(blocks) for i, (b, s) in enumerate(zip(blocks, summaries)): if i >= n – keep_last_k: out.append(f”<|block_start|>{b}<|block_end|>”) out.append(f”<|summary_start|>{s}<|summary_end|>”) else: out.append(f”<|summary_start|>{s}<|summary_end|>”) out.append(“</think>”) out.append(response.split(“</think>”)[-1]) return “n”.join(out) orig, comp = first_row[“response”], compress_trace(first_row[“response”], 1) print(f”nOriginal : {len(orig):>8,} chars”) print(f”Compressed : {len(comp):>8,} chars ({len(comp)/len(orig)*100:.1f}% of original)”) from transformers import AutoTokenizer tok = AutoTokenizer.from_pretrained(“gpt2”) MEM_TOKENS = [“<|block_start|>”, “<|block_end|>”, “<|summary_start|>”, “<|summary_end|>”, “<think>”, “</think>”] tok.add_special_tokens({“additional_special_tokens”: MEM_TOKENS}) def tlen(s): return len(tok(s, add_special_tokens=False).input_ids) blk_tok = sum(tlen(b) for b in parsed[“blocks”]) sum_tok = sum(tlen(s) for s in parsed[“summaries”]) print(f”nTrace-level token compression for this example:”) print(f” block tokens = {blk_tok}”) print(f” memento tokens = {sum_tok}”) print(f” compression = {blk_tok / max(sum_tok,1):.2f}× (paper reports ~6×)”) def to_chat(ex): return {“messages”: [ {“role”: “user”, “content”: ex[“problem”]}, {“role”: “assistant”, “content”: ex[“response”]}, ]} chat_stream = load_dataset(DATASET, split=”train”, streaming=True).map(to_chat) chat_ex = next(iter(chat_stream)) print(“nSFT chat example (truncated):”) for m in chat_ex[“messages”]: print(f” [{m[‘role’]:9s}] {m[‘content’][:130].replace(chr(10),’ ‘)}…”) We visualize the dataset’s structural patterns by plotting block counts, compression ratios, and the relationship between block size and memento size. We compare these distributions across domains to see how reasoning organization differs between math, code, and science examples. We also stream one example from the full subset and inspect its additional sentence-level and block-alignment fields, which helps us understand the richer internal annotation pipeline behind the dataset. Copy CodeCopiedUse a different Browser def compress_trace(response: str, keep_last_k: int = 1) -> str: blocks, summaries = BLOCK_RE.findall(response), SUMMARY_RE.findall(response) if not blocks or len(blocks) != len(summaries): return response out, n = [“<think>”], len(blocks) for i, (b, s) in enumerate(zip(blocks, summaries)): if i >= n – keep_last_k: out.append(f”<|block_start|>{b}<|block_end|>”) out.append(f”<|summary_start|>{s}<|summary_end|>”) else: out.append(f”<|summary_start|>{s}<|summary_end|>”) out.append(“</think>”) out.append(response.split(“</think>”)[-1]) return “n”.join(out) orig, comp = first_row[“response”], compress_trace(first_row[“response”], 1) print(f”nOriginal : {len(orig):>8,} chars”) print(f”Compressed : {len(comp):>8,} chars ({len(comp)/len(orig)*100:.1f}% of original)”) from transformers import AutoTokenizer tok = AutoTokenizer.from_pretrained(“gpt2”) MEM_TOKENS = [“<|block_start|>”, “<|block_end|>”, “<|summary_start|>”, “<|summary_end|>”, “<think>”, “</think>”] tok.add_special_tokens({“additional_special_tokens”: MEM_TOKENS}) def tlen(s): return len(tok(s, add_special_tokens=False).input_ids) blk_tok = sum(tlen(b) for b in parsed[“blocks”]) sum_tok = sum(tlen(s) for s in parsed[“summaries”]) print(f”nTrace-level token compression for this example:”) print(f” block tokens = {blk_tok}”) print(f” memento tokens = {sum_tok}”) print(f” compression = {blk_tok / max(sum_tok,1):.2f}× (paper reports ~6×)”) def to_chat(ex): return {“messages”: [ {“role”: “user”, “content”: ex[“problem”]}, {“role”: “assistant”, “content”: ex[“response”]}, ]} chat_stream = load_dataset(DATASET, split=”train”, streaming=True).map(to_chat) chat_ex = next(iter(chat_stream)) print(“nSFT chat example (truncated):”) for m in chat_ex[“messages”]: print(f” [{m[‘role’]:9s}] {m[‘content’][:130].replace(chr(10),’ ‘)}…”) We simulate inference-time compression by rewriting a reasoning trace so that older blocks are replaced by their mementos while the latest blocks remain intact. We then compare the original and compressed trace lengths to see how much context can be reduced in practice. After that, we integrate a tokenizer, add special memento tokens, measure token-level compression, and convert the dataset to an SFT-style chat format suitable for training workflows. Copy CodeCopiedUse a different Browser def render_trace(response: str, width: int = 220) -> None: p = parse_memento(response) print(“=” * 72) print(f”{len(p[‘blocks’])} blocks ·

On Friday, Chinese AI firm DeepSeek released a preview of V4, its long-awaited new flagship model. Notably, the model can process much longer prompts than its last generation, thanks to a new design that helps it handle large amounts of text more efficiently. Like DeepSeek’s previous models, V4 is open source, meaning it is available for anyone to download, use, and modify. V4 marks DeepSeek’s most significant release since R1, the reasoning model it launched in January 2025. R1, which was trained on limited computing resources, stunned the global AI industry with its strong performance and efficiency, turning DeepSeek from a little-known research team into China’s best-known AI company almost overnight. It also helped set off a wave of open-weight model releases from other Chinese AI firms.  DeepSeek has kept a relatively low profile since then—but earlier this month, it effectively teased V4’s release when it added “expert” and “flash” modes to the online version of its model, prompting speculation that the updates were tied to a bigger upcoming release. While the company has become a powerful symbol of China’s AI ambitions, its big return to cutting-edge frontier models comes after months of scrutiny—including major personnel departures, delays to previous model launches, and growing scrutiny from both the US and Chinese governments.  So, will V4 shake the AI field the way R1 did? Almost certainly not, but here are three big reasons why this release matters. 1. It breaks new ground for an open-source model. As with R1 before it, DeepSeek claims that V4’s performance rivals the best models available at a fraction of the price. This is great news for developers and for companies using the tech, because it means they can access frontier AI capabilities on their own terms, and without worrying about skyrocketing costs. The new model comes in two versions, both of which are available on DeepSeek’s website and in its app, with API access also open to developers. V4-Pro is a larger model built for coding and complex agent tasks, and V4-Flash is a smaller version designed to be faster and cheaper to run. Both versions offer reasoning modes, in which the model can carefully parse a user’s prompt and show each step as it works through the problem. For V4-Pro, DeepSeek charges $1.74 per million input tokens and $3.48 per million output tokens, a fraction of the cost of comparable models from OpenAI and Anthropic. V4-Flash is even cheaper, at about $0.14 per million input tokens and about $0.28 per million output tokens, making it one of the cheapest top-tier models available. This would make it a very appealing model to build applications on. In terms of performance, V4 is, perhaps unsurprisingly, a huge jump from R1—and it seems to be a strong alternative to just about all the latest big AI models. On the major benchmarks, according to results shared by the company, DeepSeek V4-Pro competes with leading closed-source models, matching the performance of Anthropic’s Claude-Opus-4.6, OpenAI’s GPT-5.4, and Google’s Gemini-3.1. And compared to other open-source models, such as Alibaba’s Qwen-3.5 or Z.ai’s GLM-5.1, DeepSeek V4 exceeds them all on coding, math, and STEM problems, making it one of the strongest open-source models ever released.  DeepSeek also says that V4-Pro now ranks among the strongest open-source models on benchmarks for agentic coding tasks and performs well on other tests that measure ability to carry out multistep problems. Its writing ability and world knowledge also lead the field, according to benchmarking results shared by the company.  In a technical report released alongside the model, DeepSeek shared results from an internal survey of 85 experienced developers: More than 90% included V4-Pro among their top model choices for coding tasks. DeepSeek says it has specifically optimized V4 for popular agent frameworks such as Claude Code, OpenClaw, and CodeBuddy. 2. It delivers on a new approach to memory efficiency. One of the key innovations of V4 is its long context window—the amount of text the model can process at once. Both versions can handle 1 million tokens, which is large enough to fit all three volumes of The Lord of the Rings and The Hobbit combined. The company says this context window size is now the default across all DeepSeek services and it matches what is offered by cutting-edge versions of models like Gemini and Claude.  But it’s important to know not just that DeepSeek has made this leap, but how it did so. V4 makes significant architectural changes to the company’s former models—especially in the attention mechanism, which is the feature of AI models that helps them understand each part of a prompt in relation to the rest. As the prompt text gets longer, these comparisons become much more costly, making attention one of the main bottlenecks for long-context models. DeepSeek’s innovation was to make the model more selective about what it pays attention to. Instead of treating all earlier text as equally important, V4 compresses older information and focuses on the parts most likely to matter in the present moment, while still keeping nearby text in full so it does not miss important details.  DeepSeek says this sharply reduces the cost of using long context. In a 1-million-token context, V4-Pro uses only 27% of the computing power required by its previous model, V3.2, while cutting memory use to 10%. The reduction in V4-Flash is even larger, using just 10% of the computing power and 7% of the memory. In practice, this could make it cheaper to build tools that need to work across huge amounts of material, such as an AI coding assistant that can read an entire codebase or a research agent that can analyze a long archive of documents without constantly forgetting what came before. DeepSeek’s interest in long context windows didn’t start with V4. Over the past year and a half, the company has quietly published a series of papers on how AI models “remember” information, experimenting with compression and mathematical techniques to extend what AI models could realistically handle. 3.

arXiv:2604.21469v1 Announce Type: new Abstract: Automating the detection of regulatory compliance remains a challenging task due to the complexity and variability of legal texts. Models trained on one regulation often fail to generalise to others. This limitation underscores the need for principled methods to improve cross-domain transfer. We study data selection as a strategy to mitigate negative transfer in compliance detection framed as a natural language inference (NLI) task. Specifically, we evaluate four approaches for selecting augmentation data from a larger source domain: random sampling, Moore-Lewis’s cross-entropy difference, importance weighting, and embedding-based retrieval. We systematically vary the proportion of selected data to analyse its effect on cross-domain adaptation. Our findings demonstrate that targeted data selection substantially reduces negative transfer, offering a practical path toward scalable and reliable compliance automation across heterogeneous regulations.

arXiv:2604.21235v1 Announce Type: cross Abstract: Multimodal clinical records contain structured measurements and clinical notes recorded over time, offering rich temporal information about the evolution of patient health. Yet these observations are sparse, and whether they are recorded depends on the patient’s latent condition. Observation patterns also differ across modalities, as structured measurements and clinical notes arise under distinct recording processes. While prior work has developed methods that accommodate missingness in clinical time series, how to extract and use the information carried by the observation process itself remains underexplored. We therefore propose a patient representation learning framework for multimodal clinical time series that explicitly leverages informative missingness. The framework combines (1) a multimodal encoder that captures signals from structured and textual data together with their observation patterns, (2) a Bayesian filtering module that updates a latent patient state over time from observed multimodal signals, and (3) downstream modules for offline treatment policy learning and patient outcome prediction based on the learned patient state. We evaluate the framework on ICU sepsis cohorts from MIMIC-III, MIMIC-IV, and eICU. It improves both offline treatment policy learning and adverse outcome prediction, achieving FQE 0.679 versus 0.528 for clinician behavior and AUROC 0.886 for post-72-hour mortality prediction on MIMIC-III.

I don’t need to tell you that AI is everywhere. Or that it is being used, increasingly, in hospitals. Doctors are using AI to help them with notetaking. AI-based tools are trawling through patient records, flagging people who may require certain support or treatments. They are also used to interpret medical exam results and X-rays. A growing number of studies suggest that many of these tools can deliver accurate results. But there’s a bigger question here: Does using them actually translate into better health outcomes for patients? We don’t yet have a good answer. That’s what Jenna Wiens, a computer scientist at the University of Michigan, and Anna Goldenberg of the University of Toronto, argue in a paper published in the journal Nature Medicine this week. Wiens tells me she has spent years investigating how AI might benefit health care. For the first decade of her career she tried to pitch the technology to clinicians. Over the last few years, she says, it’s as though “a switch flipped.” Health-care providers not only appear much more interested in the promise of these technologies, they have also begun rapidly deploying them. The problem is that many providers aren’t rigorously assessing how well they actually work. Take “ambient AI” tools, for example. Also known as AI scribes, they “listen” to conversations between doctors and patients, then transcribe and summarize them. Multiple tools are available, and they are already being widely adopted by health-care providers. A few months ago, a staffer at a major New York medical center who develops AI tools for doctors told me that, anecdotally, medics are “overjoyed” by the technology—it allows them to focus all their attention on their patients during appointments, and it saves them from a lot of time-consuming paperwork. Early studies support these anecdotes and suggest that the tools can reduce clinician burnout. That’s all well and good. But what about patient health outcomes? “[Researchers] have evaluated provider or clinician and patient satisfaction, but not really how these tools are affecting clinical decision-making,” says Wiens. “We just don’t know.” The same holds true for other AI-based technologies used in health-care settings. Some are used to predict patients’ health trajectories, others to recommend treatments. They are designed to make health care more effective and efficient. But even a tool that is “accurate” won’t necessarily improve health outcomes. AI might speed up the interpretation of a chest X-ray, for example. But how much will a doctor rely on its analysis? How will that tool affect the way a doctor interacts with patients or recommends treatment? And ultimately: What will this mean for those patients? The answers to those questions might vary between hospitals or departments and could depend on clinical workflows, says Wiens. They might also differ between doctors at various stages of their careers. Take the AI scribes, as another example. Some research on AI use in education suggests that such tools can impact the way people cognitively process information. Could they affect the way a doctor processes a patient’s information? Will the tools affect the way medical students think about patient data in a way that impacts care? These questions need to be explored, says Wiens. “We like things that save us time, but we have to think about the unintended consequences of this,” she says. In a study published in January 2025, Paige Nong at the University of Minnesota and her colleagues found that around 65% of US hospitals used AI-assisted predictive tools. Only two-thirds of those hospitals evaluated their accuracy. Even fewer assessed them for bias. The number of hospitals using these tools has probably increased since then, says Wiens. Those hospitals, or entities other than the companies developing the tools, need to evaluate how much they help in specific settings. There’s a possibility that they could leave patients worse off, although it’s more likely that AI tools just aren’t as beneficial as health-care providers might assume they are, says Wiens. “I do believe in the potential of AI to really improve clinical care,” says Wiens, who stresses that she doesn’t want to stop the adoption of AI tools in health care. She just wants more information about how they are affecting people. “I have to believe that in the future it’s not all AI or no AI,” she says. “It’s somewhere in between.” This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.