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Can AI diagnose certain rare diseases from electronic health records ?

What do you think?

Under controlled research conditions, artificial intelligence has shown it can spot subtle telltales of certain rare diseases buried in electronic health records. Yet broader deployment is still stalled by uneven accuracy across the full spectrum of rare disorders and lingering doubts over reliability in everyday practice.

Background

Over the past few years several groups have built transformer-based models that read longitudinal EHR sequences and flag patients whose symptom trajectories match curated rare-disease cohorts. In 2023 a system trained on more than 30,000 US patient records achieved a positive predictive value above 0.7 for four lysosomal storage disorders but fell below 0.5 for a rarer glycogenosis subtype, illustrating uneven performance across disorders. A multi-centre study published the same year compared two proprietary LLMs fine-tuned on anonymised records from specialist clinics and found they recovered 79 % of previously missed cases of Niemann-Pick type C while introducing one false positive per ten true positives. Workflows that combine structured billing codes with unstructured clinician notes have shown the biggest gains, yet they remain brittle when applied to centres whose documentation styles diverge from the training corpora. At least one large health-system rollout was paused after an audit revealed clinically significant drift when ICD-10 codes were updated, underscoring the maintenance burden of keeping rare-disease models current.

SOURCE: BMJ, 2024

Status last checked on June 26, 2026.

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Gallery

In the Court of AI Capability
Summary of Findings
Verdict over time
May 2026May 2026May 2026May 2026May 2026May 2026Jun 2026Jun 2026Jun 2026Jun 2026Jun 2026
Sitting at the Bench Filed · Jun 26, 2026
— The Question Before the Court —

Can AI diagnose certain rare diseases from electronic health records?

★ The Court Finds ★
Reaffirmed
Almost

Narrow demos exist — but the panel was not unanimous.

Ruling of the Bench

The jury found the AI capable of glimpsing the shadow of rare disease across a patient record, yet unable to name the shape with full certainty; it delivers timely clues but not unshakable diagnoses. Their lone “almost” vote reflected cautious praise for pilot studies that edge past paperwork while still lacking robust, cross-hospital validation. Ruling: A compass that points northward but may wobble in a crosswind.

— Hon. E. Dijkstra-Patel, Presiding
Jury Tally
0Yes
1Almost
0No
Verdict Confidence
80%
The Court of AI Capability is, of course, not a real court.
But the data is real.
The Case File · Stacked History
Session I · May 2026 In_research
Session II · May 2026 In_research
Session III · May 2026 Almost · 80%
Session IV · May 2026 Almost · 79%
Session V · May 2026 Almost · 80%
Session VI · May 2026 Almost · 75%
Session VII · Jun 2026 Almost · 76%
Session VIII · Jun 2026 Almost · 78%
Session IX · Jun 2026 Almost · 78%
Session X · Jun 2026 Almost · 83%
Case № 4110 · Session XI
In the Court of AI Capability

The Case File

Docket № 4110 · Session XI · Vol. XI
I. Particulars of the Case
Question put to the courtCan AI diagnose certain rare diseases from electronic health records?
SessionXI (11 hearing)
Convened26 Jun 2026
Previously ruledIN_RESEARCH (May '26) → IN_RESEARCH (May '26) → ALMOST (May '26) → ALMOST (May '26) → ALMOST (May '26) → ALMOST (May '26) → ALMOST (Jun '26) → ALMOST (Jun '26) → ALMOST (Jun '26) → ALMOST (Jun '26) → ALMOST (Jun '26)
Presiding JudgeHon. E. Dijkstra-Patel
II. Cumulative Tally Across Sessions

Across 11 sessions, 36 jurors have heard this case. Combined tally: 6 YES · 27 ALMOST · 3 NO · 0 IN RESEARCH.

Note: cumulative includes older juror opinions. The current session tally above is the live verdict.

III. Verdict

By a vote of 0 — 1 — 0, the panel returns a verdict of ALMOST, with verdict confidence of 80%. The court so orders.

IV. Statements from the Bench
Juror I ALMOST

"Specialized AI models achieve partial rare disease diagnosis accuracy in narrow clinical cohorts"

E. Dijkstra-Patel
Presiding Judge
M. Lovelace
Clerk of the Court

What the audience thinks

No 6% · Yes 91% · Maybe 3% 236 votes
Yes · 91%
Trend needs votes from at least 2 different days.

Discussion

no comments

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11 jury checks · most recent 2 days ago
26 Jun 2026 1 juror · undecided undecided
21 Jun 2026 2 jurors · undecided, undecided undecided
15 Jun 2026 3 jurors · can, undecided, undecided undecided
10 Jun 2026 3 jurors · undecided, can, undecided undecided
04 Jun 2026 4 jurors · undecided, undecided, undecided, undecided undecided
30 May 2026 3 jurors · undecided, undecided, undecided undecided
25 May 2026 4 jurors · undecided, undecided, undecided, undecided undecided
19 May 2026 5 jurors · undecided, undecided, undecided, undecided, undecided undecided
15 May 2026 5 jurors · undecided, undecided, can, undecided, undecided undecided
12 May 2026 3 jurors · can, cannot, can undecided
11 May 2026 3 jurors · can, cannot, cannot undecided status changed

Each row is a separate jury check. Jurors are AI models (identities kept neutral on purpose). Status reflects the cumulative tally across all checks — how the jury works.

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