OpenEvidence Targets Users
A hot medical LLM relies on a revenue model known to corrupt
OpenEvidence (OE) is a problem. It has proven susceptible to eugenics-adjacent pay-to-play misinformation, pay-to-play articles placed to help shill colostrum, and pay-to-play articles published to promote “functional medicine,” a MAHA-related pseudo-specialty.
Our Gold OA ad model has proven a corrupting influence, and an inference engine is making it clear in a new, overvalued way. The notion that you can chum together journal articles into meaningful medical meatloaf has never made sense. Journal articles describe research claims. They don’t tell you how to treat patients. It takes a different kind of expertise and editorial know-how to distill, describe, and maintain trustworthy and effective treatment guidance. Not everything physicians need to know is in journals.
Fundamental epistemic problems may be enough to warn savvy users away from such beasts but OE’s business model provides another big red flag because it is susceptible to Silicon Valley’s deepest source of corruption and bad incentives — targeted advertising.
Characterized as “the Internet’s original sin,” the targeted advertising model has arguably ruined the Internet, establishing a regime of surveillance capitalism that eroded personal privacy while leading us to the edge of a militaristic, Skynet surveillance dystopia enabled by engagement-hungry LLMs and creepy Ring doorbells.
OE appears to be following the same problem-plagued path to riches blazed by Google, Facebook, and Twitter/X. As an information source, it also adopted the signifier of producer-pays in our market, stitching “open” into its name — those of us following the money recognize this means users aren’t paying, are the product, and have no leverage beyond their utility as targets.
How OE Targets Users
For OE, user targeting depends on getting each individual’s national provider identifier (NPI).
NPIs apply to all individual HIPAA-covered healthcare providers or organizations, mostly to validate and facilitate insurance transactions. Individual HIPAA-covered healthcare providers include physicians, pharmacists, physician assistants, midwives, nurse practitioners, nurse anesthetists, dentists, denturists, licensed opticians, optometrists, chiropractors, clinical social workers, professional counselors, physical therapists, occupational therapists, prosthetists, orthotists, pharmacy technicians, and athletic trainers. Organizations such as hospitals, home health care agencies, nursing homes, residential treatment centers, group practices, laboratories, pharmacies, and medical equipment companies are also assigned NPIs.
NPIs are publicly available and can be downloaded in batch, enhancing the potential for fraud. At OE, users only need to pinky-swear they are who they claim to be.
The AAFP warns its members to protect their NPIs. One site warning health care workers about NPI risks writes:
Thousands of NPIs are stolen from healthcare professionals and used for further fraudulent schemes every year, particularly Medicaid and Medicare fraud. Indeed, one of the hallmarks of healthcare fraud is the theft or misuse of a healthcare provider’s NPI.
Crosswalking from NPIs to EINs to SSNs is often a simple matter for hackers with access to data from the dark web, making identity theft a well-known problem.
OE suggests via its privacy policy it is doing some crosswalking itself: