openevidence-rate-limits

Rate Limits for OpenEvidence. Trigger: "openevidence rate limits".

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openevidence-pack Plugin
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openevidence-pack

Claude Code skill pack for OpenEvidence medical AI (24 skills)

saas packs v1.0.0
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Installation

This skill is included in the openevidence-pack plugin:

/plugin install openevidence-pack@claude-code-plugins-plus

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Instructions

OpenEvidence Rate Limits

Overview

OpenEvidence's clinical decision support API enforces strict rate limits to ensure reliable evidence retrieval for healthcare applications. Clinical query endpoints are throttled per API key, with lower limits on evidence synthesis calls that involve AI-powered literature analysis. In clinical settings, rate limiting directly impacts patient care workflows, so implementations must prioritize graceful degradation over retry storms. Batch research queries during off-peak hours and cache evidence summaries aggressively since medical literature changes infrequently.

Rate Limit Reference

Endpoint Limit Window Scope
Clinical query 30 req 1 minute Per API key
Evidence synthesis 10 req 1 minute Per API key
Literature search 60 req 1 minute Per API key
Citation retrieval 120 req 1 minute Per API key
Bulk evidence export 5 req 1 hour Per API key

Rate Limiter Implementation


class OpenEvidenceRateLimiter {
  private tokens: number;
  private lastRefill: number;
  private readonly max: number;
  private readonly refillRate: number;
  private queue: Array<{ resolve: () => void }> = [];

  constructor(maxPerMinute: number) {
    this.max = maxPerMinute;
    this.tokens = maxPerMinute;
    this.lastRefill = Date.now();
    this.refillRate = maxPerMinute / 60_000;
  }

  async acquire(): Promise<void> {
    this.refill();
    if (this.tokens >= 1) { this.tokens -= 1; return; }
    return new Promise(resolve => this.queue.push({ resolve }));
  }

  private refill() {
    const now = Date.now();
    this.tokens = Math.min(this.max, this.tokens + (now - this.lastRefill) * this.refillRate);
    this.lastRefill = now;
    while (this.tokens >= 1 && this.queue.length) {
      this.tokens -= 1;
      this.queue.shift()!.resolve();
    }
  }
}

const queryLimiter = new OpenEvidenceRateLimiter(25);
const synthesisLimiter = new OpenEvidenceRateLimiter(8);

Retry Strategy


async function openEvidenceRetry<T>(
  limiter: OpenEvidenceRateLimiter, fn: () => Promise<Response>, maxRetries = 3
): Promise<T> {
  for (let attempt = 0; attempt <= maxRetries; attempt++) {
    await limiter.acquire();
    const res = await fn();
    if (res.ok) return res.json();
    if (res.status === 429) {
      const retryAfter = parseInt(res.headers.get("Retry-After") || "30", 10);
      const jitter = Math.random() * 2000;
      await new Promise(r => setTimeout(r, retryAfter * 1000 + jitter));
      continue;
    }
    if (res.status >= 500 && attempt < maxRetries) {
      await new Promise(r => setTimeout(r, Math.pow(2, attempt) * 3000));
      continue;
    }
    throw new Error(`OpenEvidence API ${res.status}: ${await res.text()}`);
  }
  throw new Error("Max retries exceeded");
}

Batch Processing


async function batchClinicalQueries(queries: string[], batchSize = 5) {
  const results: any[] = [];
  for (let i = 0; i < queries.length; i += batchSize) {
    const batch = queries.slice(i, i + batchSize);
    const batchResults = await Promise.all(
      batch.map(q => openEvidenceRetry(queryLimiter, () =>
        fetch(`${OE_BASE}/api/v1/clinical/query`, {
          method: "POST", headers,
          body: JSON.stringify({ question: q, includeEvidence: true }),
        })
      ))
    );
    results.push(...batchResults);
    if (i + batchSize < queries.length) await new Promise(r => setTimeout(r, 12_000));
  }
  return results;
}

Error Handling

Issue Cause Fix
429 on clinical query Exceeded 30 req/min query cap Queue queries, return cached if available
429 on synthesis Synthesis limit (10/min) is strict Pre-cache common drug interaction queries
Synthesis timeout Complex multi-study analysis Set 120s timeout, poll async endpoint
401 key expired API key rotation missed Automate key rotation with 7-day buffer
Stale evidence Cached result older than 30 days Set TTL on cache, re-query on expiry

Resources

Next Steps

See openevidence-performance-tuning.

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