Clinical value claims in multimodal AI outpace supporting evidence

Jiayu Feng

Multimodal prediction models add a data source, such as imaging or an assay, to clinical information, and health systems must decide whether that added test is worth acquiring. We audited 177 studies comparing multimodal with unimodal models: 81 from a systematic review and 96 from a probability sample of 2025-2026 PubMed records. Gains in the area under the receiver operating characteristic curve (AUROC) were smaller when a study fitted a separate model for every data source (adjusted difference, -0.030; 95% CI, -0.056 to -0.005). Within 78 such studies, leaving out the strongest source's model would have raised the average gain from 0.046 to 0.108. This complete benchmarking fell from 69.1% of review studies to an estimated 46.0% of recent ones. An estimated 22% assessed decision utility and none evaluated a model prospectively, yet most claimed potential clinical usefulness or improved care (84.0% and an estimated 87.7%).