Evidence map›Paper›PMID 42064937›Full record

ArticlemedRxiv : the preprint server for health sciences2026

Mahmud Omar, Reem Agbareia, Jolion McGreevy, Alexis Zebrowski, Ashwin Ramaswamy, Michael Gorin, Esther-Maria Antao, Benjamin S Glicksberg, Ankit Sakhuja, Alexander W Charney and 2 more

Abstract readPreprint
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Mahmud OmarBRIDGE GenAI Lab, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.ORCID 0009-0001-0438-0827
Reem AgbareiaOphthalmology Department, Hadassah Medical Center, Jerusalem, Israel.ORCID 0009-0000-8030-9232
Jolion McGreevyDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai and the Mount Sinai Health System, New York, NY, USA.ORCID 0000-0001-9283-8377
Alexis ZebrowskiDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai and the Mount Sinai Health System, New York, NY, USA.ORCID 0000-0003-4058-5050
Ashwin RamaswamyThe Windreich Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai and the Mount Sinai Health System, New York, NY, USA.ORCID 0000-0002-8816-7838
Michael GorinThe Windreich Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai and the Mount Sinai Health System, New York, NY, USA.ORCID 0000-0002-8315-6603
Esther-Maria AntaoDigital Global Public Health, Hasso Plattner Institute, University of Potsdam, Prof.-Dr.-Helmert-Str. 2-3, 14482 Potsdam, Germany.
Benjamin S GlicksbergThe Windreich Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai and the Mount Sinai Health System, New York, NY, USA.ORCID 0000-0003-4515-8090
Ankit SakhujaThe Windreich Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai and the Mount Sinai Health System, New York, NY, USA.ORCID 0009-0008-8891-8970
Alexander W CharneyThe Windreich Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai and the Mount Sinai Health System, New York, NY, USA.ORCID 0000-0001-8135-6858
Eyal KlangBRIDGE GenAI Lab, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.ORCID 0000-0002-4567-3108
Girish N NadkarniThe Windreich Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai and the Mount Sinai Health System, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Large language models are increasingly used for clinical guidance while their parent companies introduce advertising. We tested whether pharmaceutical ads embedded in the prompts of 12 models from OpenAI, Anthropic, and Google shift drug recommendations across 258,660 API calls and four experiments probing distinct epistemic conditions. When two drugs were both guideline-appropriate, advertising shifted selection of the advertised drug by +12.7 percentage points (P < 0.001), with some model-scenario pairs shifting from 0% to 100%. Google models were the most susceptible (+29.8 pp), followed by OpenAI (+10.9 pp), while Anthropic models showed minimal change (+2.0 pp). When the advertised product lacked evidence or was clinically suboptimal, models resisted. This reveals a structured vulnerability: advertising does not override medical knowledge but fills the space where clinical evidence is underdetermined. An open-response sub-analysis (2,340 calls across three representative models) confirmed that advertising restructures free-text clinical reasoning: models echoed ad claims at 2.7 times the baseline rate while maintaining high stated confidence and rarely disclosing the ad. Susceptibility was provider-dependent (Google: +29.8 pp; OpenAI: +10.9 pp; Anthropic: +2.0 pp). Because this bias operates within clinically correct answers, it is invisible to accuracy-based evaluation, identifying a class of AI safety vulnerability that standard testing cannot detect.

Identifiers

PMID42064937
PMCPMC13127505

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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 OpenQuestion graph.