The short version
Most records report AI performing well on scans, slides, signals and patient data, usually in retrospective or internal tests. TRV-2026-0486TRV-2026-1490 Few records show that patients did better, and reviews repeatedly note missing outside validation and missing outcome data. TRV-2026-1924TRV-2026-1490TRV-2026-0486
What is well measured
A randomized trial of 300 people with suspected inherited retinal disease shows specialists using an AI tool named the right gene category in their top four answers 81.8% of the time versus 53.1% alone. TRV-2026-0575 In a randomized crossover test, 21 physician assistants reading 50 ECGs reached 92.9% accuracy on heart attack diagnosis with AI versus 79.0% without it, though they took longer. TRV-2026-0651 A systematic review shows AI detected STEMI heart attacks on ECGs with higher sensitivity than clinicians (0.91 versus 0.78), and another review shows AI help raised doctors' fracture detection to 87% from 73%. TRV-2026-2312TRV-2026-1145 A meta-analysis of urological cancer imaging found AI reached a pooled AUC of 0.91 against 0.83 for clinicians, mostly in retrospective studies. TRV-2026-0640
Where it falls short
In a randomized trial of 171 veterans after a heart failure hospitalization, AI-guided monitoring did not significantly cut rehospitalization (16.3% versus 18.7% for controls). TRV-2026-1587 A review of 48 studies found generative AI was 13.0 percentage points less accurate than physicians at radiology diagnosis. TRV-2026-1284 Four commercial chest X-ray tools did not improve five readers' accuracy across 1200 patients, and eight dental AI systems caught only 32.7% to 48.7% of decay next to fillings. TRV-2026-0854TRV-2026-1673 A study of 826 chest X-rays in Nepal found only 17.89% of the AI's abnormal flags were correct at a threshold set for high sensitivity. TRV-2026-1265
Where the evidence is thin
Many models lose accuracy outside the hospital that built them: a review of knee arthritis AI found median AUC fell to 0.75 from 0.81 on outside data, and Alzheimer's brain-scan AI performed worse outside single centers. TRV-2026-0638TRV-2026-1244 Reviews of heart, lung and eye AI say most studies are retrospective and single-center, with little data on workflow, patient outcomes or cost. TRV-2026-1434TRV-2026-1017TRV-2026-1490 Small pilots add little certainty: a 13-patient simulation suggested patient feedback cut false seizure alarms, while in about 60 children none of seven models using brain-scan signals beat chance at spotting autism. TRV-2026-1616TRV-2026-2016 Performance across patient groups is rarely tested; cuffless blood pressure estimates were less accurate for older and Black ICU patients, and a Brazilian sick-leave model was less accurate for Black workers. TRV-2026-1497TRV-2026-1528
What is disputed
At one hospital, an AI model diagnosed chronic atrophic gastritis better than 15 novice and 16 expert endoscopists, and in 33 hard-to-read ECGs an AI app flagged all 13 occlusion heart attacks. TRV-2026-1937TRV-2026-1923 Other records point the other way: on 1000 prostate MRI cases AI did not confirm non-inferiority against routine practice, and dentists predicted tooth survival more accurately than an AI model (75.6% and 74.9% versus 69.2%). TRV-2026-0402TRV-2026-0856 A pooled analysis found the edge depends on the task, with AI less sensitive than clinicians in the prostate cancer and MRI subgroups. TRV-2026-0640