B. J. Bunning, Y. Weng, D. J. Wu, G. Hui, J. E. Hope, V. Pandurangan, I. Lopez, S. Everett, J. H. Chen, M. Desai
Doctors increasingly rely on AI in the clinic, yet which report features make AI-generated responses useful and trustworthy remains unclear. In this randomized mixed-methods study, 34 oncology physicians provided 294 ratings of four blinded AI systems across five vignettes, alongside 20 semi-structured interviews analyzed with a prespecified LLM-assisted qualitative pipeline. Despite similar references, an evidence-graded report adapted from OpenEvidence was rated significantly lower in overall utility than standard OpenEvidence (mean difference, -0.96; 95% CI, -1.26 to -0.66; P<.001). Qualitative analysis identified six themes and seven design requirements. Oncologists valued rapid orientation, evidence retrieval, and verification, preferring concise, scannable reports with quantitative outcomes, recognizable bolded guidelines, explicit uncertainty, and verifiable citations. Trust deteriorated with citation mismatch, buried provenance, evidence misclassification, overconfident recommendations, and poor organization. Evidence presented differently can alter perceptions of clinical utility and trust; accuracy alone is insufficient, and report design must also be empirically evaluated.