geoffrey modest medical blogs

  a recent study found that using artificial intelligence (AI) was more accurate in detecting early pancreatic cancer from a CT scan than trained radiologists   ( pancreatic cancer AI radiology LancetOnc2026  in dropbox, or https://doi.org/10.1016/S1470-2045(25)00567-4) Details : --this international, paired, non-inferiority, confirmatory, observational study (PANORAMA) compared AI diagnoses of pancreatic ductal adenocarcinoma (PDAC) between trained radiologists and an AI system developed to read/interpret contrast-enhanced CT scans     -- the AI system was trained and externally validated within an international benchmark, with a cohort of these 2310 patients from four tertiary care centers in the Netherlands and the USA for training (n=2224) and tuning (n=86), and a sequestered cohort of 1130 patients from five tertiary care centers (the Netherlands, Sweden, and Norway) for testing. -- AI system used: the top three performing algorithms were deep learning...

  A recent pragmatic, randomized controlled European trial compared CT angiography with invasive coronary angiography in patients with intermediate pretest probability of obstructive coronary artery disease (CAD) and stable chest pain, finding no significant difference in subsequent cardiac events but fewer major procedural complications with the CT (see cad stable CT vs invasive angio NEJM2022   in dropbox, or DOI: 10.1056/NEJMoa2200963), the DISCHARGE trial.   Details: -- 3561 patients who had intermediate pretest probability of obstructive CAD and were referred to one of 26 European centers for invasive angiography (ICA), between October 2015 and April 2019 -- patients were randomized equally to CT vs ICA, with >97% adherence to the randomized assignments -- 56% women, median age 61, 80% were outpatient at the time of enrollment, 99% white,  41% employed/40% retired/2% disabled -- chest pain: typical angina 14%/atypical angina 46%/non-anginal ...