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Ambient AI Scribes in Clinical Practice: A Randomized Trial
Paul J Lukac1,2, William Turner3, Sitaram Vangala3
1Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
NEJM AI
|January 7, 2026
Summary
Ambient AI scribes show promise in reducing physician documentation time and burnout. One AI scribe, Nabla, significantly decreased time-in-note, while both AI scribes potentially improved physician burnout and task load.
Area of Science:
- Medical Informatics
- Artificial Intelligence in Healthcare
- Clinical Documentation
Background:
- Ambient artificial intelligence (AI) scribes offer a potential solution to the significant documentation burden and physician burnout.
- Despite their promise, the real-world impact of AI scribes has not been rigorously evaluated in randomized clinical trials.
Purpose of the Study:
- To evaluate the impact of two ambient AI scribe applications, Microsoft Dragon Ambient eXperience (DAX) Copilot and Nabla, on physician documentation time and burnout.
- To compare the effectiveness of DAX Copilot and Nabla against a usual-care control group in a pragmatic randomized clinical trial.
Main Methods:
- A parallel three-group pragmatic randomized clinical trial involving 238 physicians across 14 specialties.
- Physicians were randomized 1:1:1 to either DAX Copilot, Nabla, or a usual-care control group.
- Primary outcome was change in log writing time-in-note; secondary outcomes included physician task load and burnout scores.
Main Results:
- Nabla use was associated with a statistically significant 9.5% decrease in time-in-note compared to the control group (P=0.02).
- DAX Copilot did not show a significant change in time-in-note compared to the control group (P=0.66).
- Both DAX Copilot and Nabla users reported potential improvements in physician task load, burnout, and work exhaustion scores, though findings require further validation.
Conclusions:
- Nabla demonstrated a significant reduction in physician time-in-note, suggesting its effectiveness in streamlining documentation.
- Both AI scribes showed potential benefits for physician well-being, but further multicenter trials are needed to confirm these secondary outcomes.
- Clinicians perceived similar performance between the two AI scribe platforms, highlighting the need for ongoing vigilance regarding occasional inaccuracies.
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