Using secure artificial intelligence agents integrated within the electronic medical record for the evaluation of blood culture appropriateness-Northern California, 2025

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Abstract

We evaluated large language model (LLM)-based agents integrated with the electronic medical record to assess blood culture appropriateness. While sensitivity was high, specificity remained low. Performance was shaped by prompt phrasing, sycophantic behavior, and semantic triggers, reflecting both the potential and limitations of LLMs in real-world clinical decision support.

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Rodriguez-Nava, G., Keyes, T., Ambers, N., Miranti, E., Viana-Cardenas, E. P., Tariq, W., … Salinas, J. L. (2026). Using secure artificial intelligence agents integrated within the electronic medical record for the evaluation of blood culture appropriateness-Northern California, 2025. Infection Control and Hospital Epidemiology, 47(2), 206–209. https://doi.org/10.1017/ice.2025.10349

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