Adoption, usability and perceived clinical value of a UK AI clinical reference platform (iatroX): a mixed-methods formative evaluation of real-world usage and a 1,223-respondent user survey

Abstract

Clinicians face growing information overload from biomedical literature and guidelines, hindering evidence-based care. Retrieval-augmented generation (RAG) with large language models may provide fast, provenance-linked answers, but requires real-world evaluation. We describe iatroX, a UK-centred RAG-based clinical reference platform, and report early adoption, usability, and perceived clinical value from a formative implementation evaluation. Methods comprised a retrospective analysis of usage across web, iOS, and Android over 16 weeks (8 April-31 July 2025) and an in-product intercept survey. Usage metrics were drawn from web and app analytics with bot filtering. A client-side script randomized single-item prompts to approx. 10% of web sessions from a predefined battery assessing usefulness, reliability, and adoption intent. Proportions were summarized with Wilson 95% confidence intervals; free-text comments underwent thematic content analysis. iatroX reached 19,269 unique web users, 202,660 engagement events, and approx. 40,000 clinical queries. Mobile uptake included 1,960 iOS downloads and Android growth (peak >750 daily active users). The survey yielded 1,223 item-level responses: perceived usefulness 86.2% (95% CI 74.8-93.9%; 50/58); would use again 93.3% (95% CI 68.1-99.8%; 14/15); recommend to a colleague 88.4% (95% CI 75.1-95.9%; 38/43); perceived accuracy 75.0% (95% CI 58.8-87.3%; 30/40); reliability 79.4% (95% CI 62.1-91.3%; 27/34). Themes highlighted speed, guideline-linked answers, and UK specificity. Early real-world use suggests iatroX can mitigate information overload and support timely answers for UK clinicians. Limitations include small per-item samples and early-adopter bias; future work will include accuracy audits and prospective studies on workflow and care quality.