Evidence map›Paper›PMID 42378622›Full record

ArticleJournal of evaluation in clinical practice2026

An Evaluation of AI-Generated Clinical Notes in the OpenNotes Era: A Thematic Analysis of Clinician Discourse.

Samuel Atiku, Olufisayo Olakotan

Abstract read
In one paragraph

Article in Journal of evaluation in clinical practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

2 authors.

Samuel AtikuResearch Services, Aston University Birmingham, UK.ORCID https://orcid.org/0009-0001-0671-6056
Olufisayo OlakotanDepartment of Neonatology, Women and Children's Directorate, University Hospitals Leicester, Leicester, UK.ORCID https://orcid.org/0000-0003-1999-5135

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe integration of ambient artificial intelligence (AI) scribes into the OpenNotes environment presents a profound governance crisis in healthcare. While patient access to medical records was designed as a transparency reform, the introduction of machine-generated text introduces novel vulnerabilities regarding record integrity, liability, and patients' trust.

objectiveThis study investigates how clinicians discursively negotiate the systemic risks and accountability challenges of patient-facing, AI-assisted documentation.

methodsEmploying a netnographically informed qualitative design, the research conducted a reflexive thematic analysis of 484 relevant comments across 120 threads from eight clinician-oriented subreddits spanning October 2020 to February 2026.

resultsThe analysis revealed five distinct governance challenges. First, an accountability vacuum exists where the mandatory clinician signature functions merely as a legal shock absorber for institutional AI liability. Second, clinicians frame AI hallucinations as a mathematically inevitable epistemic risk rather than a correctable technical bug. Third, a "dual-audience" problem emerges, as algorithmic optimization compromises both the individual clinical voice needed for peer communication and the empathetic clarity required for patient readers. Fourth, existing privacy frameworks are structurally inadequate to manage commercial data extraction during patient encounters. Finally, institutional productivity demands and AI-driven over-documentation severely threaten the fiscal credibility of the medical record through inadvertent upcoding.

conclusionsThe prevailing regulatory assumption-that a physician's digital signature combined with passive patient visibility guarantees documentation accountability-is a fragile fiction. To protect clinical truth, health systems must transition from models of passive disclosure toward contingent transparency. This requires establishing authoritative, enforceable mechanisms for provenance tracking, error contestation, and vendor accountability.

Indexed as

Artificial IntelligenceDocumentationElectronic Health RecordsConfidentialityHumansLiability, LegalQualitative Researchartificial intelligence scribesclinical documentationnetnographyOpenNotes

Identifiers

PMID42378622
PMCPMC13318360

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.