Methodology

How We Evaluate Clinical Decision Support AI

Our evaluation combines hundreds of clinician interviews, 30+ days of hands-on clinical testing per platform, 200+ standardized scenarios, and seven weighted criteria to produce the most rigorous independent rankings of clinical AI tools available.

Updated February 2025·7 platforms evaluated·12 specialties

847+

Clinician reviews collected

200+

Standardized clinical scenarios

30+

Days of hands-on testing per tool

12

Medical specialties evaluated

7

Weighted evaluation criteria

6

Months from first review to publication

Editorial Independence

Our reviews are conducted by a team of practicing physicians, clinical informaticists, and health IT analysts. Each reviewer uses the platform in clinical practice for a minimum of 30 days before contributing to the evaluation. We do not accept payment for placement in our rankings. Our editorial team operates independently, and no company can influence its position in our rankings through any business relationship.


Evaluation Criteria

Each tool is scored across seven weighted criteria. The weighting reflects the relative importance of each factor to clinical practice, calibrated through interviews with hundreds of practicing clinicians across 12 specialties.

Clinical & Medical Accuracy (25%)Evidence Transparency & Citations (20%)Product Design & User Experience (15%)EHR Integration (15%)Workflow Integration & Speed (15%)Value & Accessibility (10%)

Clinical & Medical Accuracy

25%

The most critical criterion. We test each platform against 200+ standardized clinical scenarios spanning emergency medicine, internal medicine, cardiology, primary care, and eight additional specialties. Scenarios range from common presentations (chest pain, dyspnea, headache) to rare diagnoses and complex multi-system cases. We compare AI-generated recommendations against current clinical practice guidelines from AHA/ACC, ATS, and IDSA, landmark trial data, and expert consensus. Accuracy is scored on correctness of diagnosis, appropriateness of workup, treatment alignment with guidelines, and identification of critical "can't-miss" diagnoses.

Evidence Transparency & Citations

20%

We assess whether the tool provides verifiable, source-linked citations for its clinical recommendations. Physicians cannot safely act on AI output they cannot verify. We evaluate: Are citations linked to the actual peer-reviewed paper? Are sources current (within guideline update windows)? Does the tool distinguish between high-quality evidence (RCTs, meta-analyses) and lower-quality sources? Can the clinician trace from recommendation to original study in under two clicks?

Product Design & User Experience

15%

Clinical AI tools fail if physicians won't use them. We evaluate interface design, information architecture, speed-to-answer, mobile experience (iOS/Android), learning curve, and overall design quality. Our reviewers assess: Can a physician get a useful answer in under 30 seconds? Is the mobile app usable one-handed at the bedside? Does the UI surface the right information density without cognitive overload? How many interactions does it take to complete common clinical workflows?

EHR Integration

15%

We evaluate integration capabilities with Epic, Cerner, MEDITECH, and other major EHR systems. We assess: Does the tool embed within existing clinical workflows or require context-switching? How seamless is the data handoff? What is the implementation burden on health system IT teams? We also evaluate HIPAA compliance posture, BAA availability, SOC 2 certification, and data handling practices.

Workflow Integration & Speed

15%

We measure the tool's practical impact on clinical efficiency. Our reviewers time common workflows: generating a differential from a patient presentation, comparing treatment options, confirming drug dosing, calculating risk scores. We evaluate cognitive load — does the tool reduce or increase the mental burden on the physician? We also assess how the tool handles interruptions, multi-patient juggling, and the realities of a busy clinical environment.

Value & Accessibility

10%

We compare pricing models, free tier availability, and overall value proposition across practice settings — from individual physicians to academic medical centers to large health systems. We evaluate: Is there a meaningful free tier? What does enterprise pricing look like? How does cost compare to existing solutions like UpToDate? Is the tool accessible to residents, fellows, and early-career physicians?


Our Five-Phase Testing Process

Every platform goes through the same rigorous five-phase evaluation. The entire process — from initial clinician interviews to final publication — takes approximately six months per evaluation cycle.

Phase 01Ongoing

Clinician Interviews & Survey Collection

We interview hundreds of practicing clinicians across 12+ specialties and multiple countries to understand how they use clinical decision support in practice, what they value, and where current tools fall short. These interviews inform our evaluation criteria weighting and help us identify the clinical scenarios that matter most. We also collect structured satisfaction surveys from verified physicians who use each platform.

Phase 0230+ days per tool

Hands-On Clinical Testing

Each platform undergoes a minimum 30-day evaluation period during which our physician reviewers use the tool in real clinical practice across multiple care settings — emergency departments, inpatient wards, outpatient clinics, and telehealth encounters. Reviewers document response quality, speed, citation accuracy, and workflow fit in structured evaluation logs.

Phase 03200+ scenarios

Standardized Scenario Testing

Every platform is tested against the same battery of 200+ standardized clinical scenarios. These include: 50 emergency medicine cases (chest pain, trauma, toxicology, pediatric emergencies), 40 internal medicine cases (multi-system disease, diagnostic dilemmas, medication management), 30 primary care scenarios (preventive care, chronic disease management, screening decisions), and 80+ specialty-specific cases across cardiology, neurology, psychiatry, oncology, and other fields. We score each response on diagnostic accuracy, treatment appropriateness, evidence quality, and identification of red flags.

Phase 0412 specialties

Specialty-Weighted Analysis

We re-weight our evaluation criteria for each medical specialty based on what matters most in that clinical context. Emergency medicine weights speed and accuracy highest. Psychiatry emphasizes nuance in treatment recommendations. Primary care prioritizes breadth of coverage and preventive guidelines. This produces specialty-specific rankings that reflect the actual needs of physicians in each field.

Phase 052 weeks

Comparative Scoring & Peer Review

All scores are calibrated across the full set of tools to ensure consistency. Our editorial team cross-references individual reviewer scores, resolves discrepancies, and produces final weighted ratings. Every review is read by at least two additional physician reviewers before publication. Ratings are updated when platforms release significant feature updates or when new clinical evidence changes our assessment.


Clinical Scenario Categories

Our 200+ standardized test scenarios are designed to evaluate clinical AI across the full spectrum of medical decision-making. Scenarios are developed by practicing physicians in each specialty and reviewed for clinical accuracy before inclusion.

Diagnostic Reasoning

60 scenarios

Differential generation, rare disease identification, multi-system presentations

Treatment Decisions

45 scenarios

Guideline-concordant therapy, drug interactions, contraindication detection

Emergency & Critical Care

35 scenarios

Time-sensitive diagnoses, resuscitation protocols, trauma management

Drug Dosing & Safety

25 scenarios

Renal/hepatic adjustment, pediatric dosing, high-alert medications

Preventive & Chronic Care

20 scenarios

Screening recommendations, chronic disease management, risk stratification

Edge Cases & Red Flags

15 scenarios

"Can't-miss" diagnoses, atypical presentations, safety-critical alerts


Specialty-Specific Weighting

Different medical specialties have fundamentally different needs from clinical AI. An emergency physician needs speed and diagnostic accuracy above all else. A psychiatrist needs nuanced treatment recommendations. A primary care physician needs breadth across thousands of conditions. We re-weight our seven evaluation criteria for each of the 12 specialties we cover, producing rankings that reflect what actually matters in each clinical context.


How Ratings Are Updated

Our ratings are living evaluations. We monitor each platform for significant feature updates, pricing changes, new integrations, and changes to evidence sourcing. When a platform releases a material update, we re-evaluate the affected criteria. Full re-evaluations are conducted annually. Between evaluation cycles, we continuously collect clinician feedback through surveys and interviews to inform the next cycle.


References & Frameworks

Our evaluation methodology draws on established clinical quality frameworks, health IT standards, and usability research. The following external resources inform our criteria and scoring.

Methodology last updated February 2025. Questions about our evaluation process? We welcome feedback from clinicians and platform teams.