Ryan Radecki MD MS
@www.evidencetriage.com
FACEP FACEM ABPM-CI. HealthNZ AI & Christchurch EM. Annals of EM Podcast & Journal Club. Columnist ACEPNow. Speaker, writer, dad. Stanford '00. evidencetriage.com 🇺🇸 in 🇳🇿
Physicians are good drivers of LLMs, but regular humans who don't know how to tell the "textbook story" can get dangerously divergent results.
#medsky #MLsky
www.evidencetriage.com/p/humans-llm...
#medsky #MLsky
www.evidencetriage.com/p/humans-llm...
Humans + LLMs Can Crash & Burn
Average humans are not quite the power users physicians might be.
www.evidencetriage.com
February 11, 2026 at 7:29 PM
Physicians are good drivers of LLMs, but regular humans who don't know how to tell the "textbook story" can get dangerously divergent results.
#medsky #MLsky
www.evidencetriage.com/p/humans-llm...
#medsky #MLsky
www.evidencetriage.com/p/humans-llm...
Reposted by Ryan Radecki MD MS
8 more children died from influenza complications last week, according to CDC's FluView report, bringing the total to 60 pediatric deaths so far this season. The agency keeps tabs on childhood deaths caused by the flu, but doesn't recommend flu shots as a way to prevent infection👇
Weekly US Influenza Surveillance Report: Key Updates for Week 4, ending January 31, 2026
Seasonal influenza activity remains elevated nationally.
www.cdc.gov
February 10, 2026 at 7:00 PM
8 more children died from influenza complications last week, according to CDC's FluView report, bringing the total to 60 pediatric deaths so far this season. The agency keeps tabs on childhood deaths caused by the flu, but doesn't recommend flu shots as a way to prevent infection👇
Vinay continuing to demonstrate his utter intellectual dishonesty and cowardice.
#medsky
www.nytimes.com/2026/02/10/h...
#medsky
www.nytimes.com/2026/02/10/h...
F.D.A. Refuses to Review Moderna Flu Vaccine
www.nytimes.com
February 10, 2026 at 11:19 PM
Vinay continuing to demonstrate his utter intellectual dishonesty and cowardice.
#medsky
www.nytimes.com/2026/02/10/h...
#medsky
www.nytimes.com/2026/02/10/h...
A lot of scope creep for thrombolysis in CRAO – but, no, the higher quality data emerging shows harms outweigh the benefit.
#medsky
www.evidencetriage.com/p/do-not-use...
#medsky
www.evidencetriage.com/p/do-not-use...
Do Not Use Thrombolysis For CRAO
Absolutely not appropriate outside of a rigorous experimental setting.
www.evidencetriage.com
February 10, 2026 at 10:41 PM
A lot of scope creep for thrombolysis in CRAO – but, no, the higher quality data emerging shows harms outweigh the benefit.
#medsky
www.evidencetriage.com/p/do-not-use...
#medsky
www.evidencetriage.com/p/do-not-use...
Reposted by Ryan Radecki MD MS
Jay's passion for replication famously only applies to research he doesn't already agree with.
His Santa Clara antibody study is the best example I can think of in recent memory.
Was that ever replicated?
Was that ever replicated?
February 8, 2026 at 9:55 AM
Jay's passion for replication famously only applies to research he doesn't already agree with.
More "tissue not time" evidence – but these data are almost certainly weaker than they appear.
Unfortunately, I expect they'll simply be piled upon the ever-expanding indications for stroke thrombolysis, along with corresponding indication creep.
#medsky
www.evidencetriage.com/p/the-option...
Unfortunately, I expect they'll simply be piled upon the ever-expanding indications for stroke thrombolysis, along with corresponding indication creep.
#medsky
www.evidencetriage.com/p/the-option...
The OPTION For Tenecteplase Out to 24 Hours
In theory.
www.evidencetriage.com
February 7, 2026 at 12:32 AM
More "tissue not time" evidence – but these data are almost certainly weaker than they appear.
Unfortunately, I expect they'll simply be piled upon the ever-expanding indications for stroke thrombolysis, along with corresponding indication creep.
#medsky
www.evidencetriage.com/p/the-option...
Unfortunately, I expect they'll simply be piled upon the ever-expanding indications for stroke thrombolysis, along with corresponding indication creep.
#medsky
www.evidencetriage.com/p/the-option...
Amazing, thanks LLM helper.
February 5, 2026 at 11:46 PM
Amazing, thanks LLM helper.
Trial stopped early for futility.
The opposite of the headline I would choose.
www.thelancet.com/journals/lan...
The opposite of the headline I would choose.
www.thelancet.com/journals/lan...
February 5, 2026 at 9:21 PM
Trial stopped early for futility.
The opposite of the headline I would choose.
www.thelancet.com/journals/lan...
The opposite of the headline I would choose.
www.thelancet.com/journals/lan...
The magic wand stethoscope doesn't reliably measure up – yet.
Phonographic and single-lead ECG analysis by AI did not reliably improve diagnosis of atrial fibrillation, heart failure, or valvular heart disease.
#medsky #MLsky
www.evidencetriage.com/p/not-a-magi...
Phonographic and single-lead ECG analysis by AI did not reliably improve diagnosis of atrial fibrillation, heart failure, or valvular heart disease.
#medsky #MLsky
www.evidencetriage.com/p/not-a-magi...
Not A Magic Stethoscope – Yet
TRICORDER not yet a tricorder.
www.evidencetriage.com
February 2, 2026 at 8:28 PM
The magic wand stethoscope doesn't reliably measure up – yet.
Phonographic and single-lead ECG analysis by AI did not reliably improve diagnosis of atrial fibrillation, heart failure, or valvular heart disease.
#medsky #MLsky
www.evidencetriage.com/p/not-a-magi...
Phonographic and single-lead ECG analysis by AI did not reliably improve diagnosis of atrial fibrillation, heart failure, or valvular heart disease.
#medsky #MLsky
www.evidencetriage.com/p/not-a-magi...
Fascinating thoughts and data here from Anthropic – analyses of conversations to determine the rate and extent to which AI may be providing harmful reinforcement or distortion.
Spoiler – it's a lot, both in relative frequency and in absolute terms ...
#medsky
www.anthropic.com/research/dis...
Spoiler – it's a lot, both in relative frequency and in absolute terms ...
#medsky
www.anthropic.com/research/dis...
Disempowerment patterns in real-world AI usage
Anthropic is an AI safety and research company that's working to build reliable, interpretable, and steerable AI systems.
www.anthropic.com
February 2, 2026 at 8:26 AM
Fascinating thoughts and data here from Anthropic – analyses of conversations to determine the rate and extent to which AI may be providing harmful reinforcement or distortion.
Spoiler – it's a lot, both in relative frequency and in absolute terms ...
#medsky
www.anthropic.com/research/dis...
Spoiler – it's a lot, both in relative frequency and in absolute terms ...
#medsky
www.anthropic.com/research/dis...
Reposted by Ryan Radecki MD MS
Sci-Fi Author: In my book I invented the Torment Nexus as a cautionary tale
Tech Company: At long last, we have created the Torment Nexus from classic sci-fi novel Don't Create The Torment Nexus
Tech Company: At long last, we have created the Torment Nexus from classic sci-fi novel Don't Create The Torment Nexus
May 16, 2023 at 10:51 PM
Sci-Fi Author: In my book I invented the Torment Nexus as a cautionary tale
Tech Company: At long last, we have created the Torment Nexus from classic sci-fi novel Don't Create The Torment Nexus
Tech Company: At long last, we have created the Torment Nexus from classic sci-fi novel Don't Create The Torment Nexus
All I really want is … gulls. 🎶
January 31, 2026 at 3:08 AM
All I really want is … gulls. 🎶
More evidence of there not being much of an additive or synergistic effect between different types of analgesia for moderate acute pain – this example in pediatrics:
#medsky
www.evidencetriage.com/p/ibuprofen-...
#medsky
www.evidencetriage.com/p/ibuprofen-...
Ibuprofen, Champion of the (Pediatric) World
Accept no additions!
www.evidencetriage.com
January 30, 2026 at 1:10 AM
More evidence of there not being much of an additive or synergistic effect between different types of analgesia for moderate acute pain – this example in pediatrics:
#medsky
www.evidencetriage.com/p/ibuprofen-...
#medsky
www.evidencetriage.com/p/ibuprofen-...
Reason #2148 medical care in the U.S. is so expensive – zero tolerance for poor outcomes, avoidable or not, leading to over-testing, over-referral, and generally harmful practices focused narrowly on avoiding rare badness.
#medsky
www.expertinstitute.com/resources/in...
#medsky
www.expertinstitute.com/resources/in...
The Biggest Medical Malpractice Verdicts of 2025
A look back at 2025's record-breaking medical malpractice verdicts, highlighting the impact of negligence and the push for accountability.
www.expertinstitute.com
January 28, 2026 at 11:44 PM
Reason #2148 medical care in the U.S. is so expensive – zero tolerance for poor outcomes, avoidable or not, leading to over-testing, over-referral, and generally harmful practices focused narrowly on avoiding rare badness.
#medsky
www.expertinstitute.com/resources/in...
#medsky
www.expertinstitute.com/resources/in...
Yourself, but as a cartoon.
January 28, 2026 at 5:55 PM
Yourself, but as a cartoon.
These sorts of retrospective analyses are always confounded by indication, but it is probably the case hyPERnatremia can be corrected as rapidly the salient clinical context requires.
#medsky
www.evidencetriage.com/p/does-it-ma...
#medsky
www.evidencetriage.com/p/does-it-ma...
Does It Matter: Slow Dilution or Fast Dilution?
For hypernatremia, it might not.
www.evidencetriage.com
January 27, 2026 at 2:17 AM
These sorts of retrospective analyses are always confounded by indication, but it is probably the case hyPERnatremia can be corrected as rapidly the salient clinical context requires.
#medsky
www.evidencetriage.com/p/does-it-ma...
#medsky
www.evidencetriage.com/p/does-it-ma...
Credit to Ed, toughing out the Christchurch "summer" in apparent good humour.
Whilst you'd think it would be basic expectations for any professional to do their well-paid "job", not every touring artist displays the same level of resilience.
thespinoff.co.nz/pop-culture/...
Whilst you'd think it would be basic expectations for any professional to do their well-paid "job", not every touring artist displays the same level of resilience.
thespinoff.co.nz/pop-culture/...
Review: New Zealand rain kills Ed Sheeran’s guitars
As the sky chucked it down Christchurch's Apollo Projects Stadium, Ed Sheeran's retractable bridge failed to retract and he told the crowd it was the first time he'd seen a puddle in his set list.
thespinoff.co.nz
January 25, 2026 at 12:02 AM
Credit to Ed, toughing out the Christchurch "summer" in apparent good humour.
Whilst you'd think it would be basic expectations for any professional to do their well-paid "job", not every touring artist displays the same level of resilience.
thespinoff.co.nz/pop-culture/...
Whilst you'd think it would be basic expectations for any professional to do their well-paid "job", not every touring artist displays the same level of resilience.
thespinoff.co.nz/pop-culture/...
Reposted by Ryan Radecki MD MS
Remember – influenza antivirals have precarious, if any, evidence they save lives. Vaccination remains your best protection if high-risk.
What little evidence (in pharma-sponsored trials) they have is minimal symptom duration reduction – usually less than a day in a weeklong illness.
What little evidence (in pharma-sponsored trials) they have is minimal symptom duration reduction – usually less than a day in a weeklong illness.
January 24, 2026 at 11:44 PM
Remember – influenza antivirals have precarious, if any, evidence they save lives. Vaccination remains your best protection if high-risk.
What little evidence (in pharma-sponsored trials) they have is minimal symptom duration reduction – usually less than a day in a weeklong illness.
What little evidence (in pharma-sponsored trials) they have is minimal symptom duration reduction – usually less than a day in a weeklong illness.
Reposted by Ryan Radecki MD MS
Whatever publicity this NEJM article got, the recent advertorial in @theatlantic.com no doubt tops it.
Right after opining that Xofluza could impact mortality (data?), the author concedes they mixed up Xofluza with a HIV medication.
Strong work.
www.theatlantic.com/health/2026/...
Right after opining that Xofluza could impact mortality (data?), the author concedes they mixed up Xofluza with a HIV medication.
Strong work.
www.theatlantic.com/health/2026/...
January 24, 2026 at 7:09 PM
Whatever publicity this NEJM article got, the recent advertorial in @theatlantic.com no doubt tops it.
Right after opining that Xofluza could impact mortality (data?), the author concedes they mixed up Xofluza with a HIV medication.
Strong work.
www.theatlantic.com/health/2026/...
Right after opining that Xofluza could impact mortality (data?), the author concedes they mixed up Xofluza with a HIV medication.
Strong work.
www.theatlantic.com/health/2026/...
The new reality: if you have a information aggregation/interpretation problem that previously required a team of engineers and data scientists, there's an awfully good chance Claude Code or a tool like it can address it given functional requirements.
#medsky
medium.com/data-science...
#medsky
medium.com/data-science...
I Gave Claude Code 9.5 Years of Health Data to Help Manage my Thyroid Disease
A case study in personal machine learning, agentic coding, and why the future of health management might be personalized ML
medium.com
January 21, 2026 at 3:20 AM
The new reality: if you have a information aggregation/interpretation problem that previously required a team of engineers and data scientists, there's an awfully good chance Claude Code or a tool like it can address it given functional requirements.
#medsky
medium.com/data-science...
#medsky
medium.com/data-science...
Example #2914 of telling clinicians there's no bacteria to treat, but clinicians continuing the antibiotics.
(in this case, the test is flawed, but I digress)
#medsky
www.evidencetriage.com/p/no-bacteri...
(in this case, the test is flawed, but I digress)
#medsky
www.evidencetriage.com/p/no-bacteri...
No Bacteria? No Antibiotics? No?
Changing practice is harder than providing a test result.
www.evidencetriage.com
January 19, 2026 at 10:23 PM
Example #2914 of telling clinicians there's no bacteria to treat, but clinicians continuing the antibiotics.
(in this case, the test is flawed, but I digress)
#medsky
www.evidencetriage.com/p/no-bacteri...
(in this case, the test is flawed, but I digress)
#medsky
www.evidencetriage.com/p/no-bacteri...
Emoji usage is slowly percolating into clinical documentation – and with some rather quirky choices, if I might say.
#medsky
www.evidencetriage.com/p/emojis-in-...
#medsky
www.evidencetriage.com/p/emojis-in-...
😬 Emojis in Clinical Documentation 😭
No, thank you – but, does Gen Z/Gen Alpha care what I think?
www.evidencetriage.com
January 18, 2026 at 10:59 PM
Emoji usage is slowly percolating into clinical documentation – and with some rather quirky choices, if I might say.
#medsky
www.evidencetriage.com/p/emojis-in-...
#medsky
www.evidencetriage.com/p/emojis-in-...
Reposted by Ryan Radecki MD MS
Amusingly, the cost-effectiveness manuscript produced by Roche assumed the floor for CENTERSTONE would be a reduction in transmission of 5% ... when in actuality, the reduction in symptomatic cases was less than 2%.
pmc.ncbi.nlm.nih.gov/articles/PMC...
pmc.ncbi.nlm.nih.gov/articles/PMC...
Cost-Effectiveness of Baloxavir Marboxil Versus Oseltamivir or no Treatment for the Management of Influenza in the United States
This study sought to evaluate the cost-effectiveness of baloxavir marboxil compared with oseltamivir or no antiviral treatment from a US payer perspective using data from a real-world US administrativ...
pmc.ncbi.nlm.nih.gov
April 24, 2025 at 8:05 PM
Amusingly, the cost-effectiveness manuscript produced by Roche assumed the floor for CENTERSTONE would be a reduction in transmission of 5% ... when in actuality, the reduction in symptomatic cases was less than 2%.
pmc.ncbi.nlm.nih.gov/articles/PMC...
pmc.ncbi.nlm.nih.gov/articles/PMC...
Reposted by Ryan Radecki MD MS
Most people don't need an antiviral to treat influenza, the least of which being Xofluza – unless you're bored with just causing antibiotic resistance and want to start working on some new influenza mutations.
#medsky
www.evidencetriage.com/p/another-ba...
#medsky
www.evidencetriage.com/p/another-ba...
Another Baloxavir Advertorial In NEJM
Does anyone seriously make treatment decisions off this pharma junk?
www.evidencetriage.com
April 24, 2025 at 8:02 PM
Most people don't need an antiviral to treat influenza, the least of which being Xofluza – unless you're bored with just causing antibiotic resistance and want to start working on some new influenza mutations.
#medsky
www.evidencetriage.com/p/another-ba...
#medsky
www.evidencetriage.com/p/another-ba...
Important Science — future IgNobel award?
www.pbs.org/wgbh/nova/ar...
www.pbs.org/wgbh/nova/ar...
How Does Microwaving Grapes Create Plasma? | NOVA | PBS
No kitchen appliances were harmed in the writing of this article.
www.pbs.org
January 9, 2026 at 8:50 PM
Important Science — future IgNobel award?
www.pbs.org/wgbh/nova/ar...
www.pbs.org/wgbh/nova/ar...