KnowBench: Effort Reduction as a Unified, Deployment-Grounded Benchmark for Clinical AI

Abstract

Clinical AI systems are evaluated with instruments built for research settings (reference-based similarity metrics and expert rubric panels) that measure resemblance to an artifact rather than reduction of a burden. We introduce KnowBench, pioneered by Knowtex, whose unifying metric is Effort Reduction (ER): the proportion of system-generated clinical work product accepted by the responsible clinician under expert and safety review. ER is defined once and instantiated per task across the administrative workload clinical AI automates: visit notes, diagnosis and billing codes, orders, EHR chart summarization, patient after-visit summaries, and clinical decision support. In every instantiation the construction is identical: the clinician's review-and-attestation event is the ground truth, every accepted unit is work the system completed, and every correction is residual effort returned to the clinician. The primary contribution of this paper is the benchmark itself: the metric, its degenerate cases, and a reporting protocol under which ER claims are auditable and cross-system comparable. Alongside it we report an initial headline measurement from the documentation instantiation: over one million signed encounters across a production window exceeding six months and thirteen medical specialties, Knowtex's proprietary fine-tuned clinical foundation models operating inside a closed feedback architecture achieve an aggregate ER of 97.99%, with per-specialty aggregates spanning 96.8-98.9%. This release reports the protocol's checklist partially, and states which companion statistics are withheld; the benchmark is offered so that this figure, and every figure reported after it, can be held to the same standard.