Michele D. Pierri

From Chart to Variable: Extracting Computable Clinical Features from the EHR

August 26, 2026August 16, 2026 by Michele Danilo Pierri

Early 20th-century doctor looks perplexed at a bedside table crowded with medicine vials and bottles in an old hospital ward.

Vasoactive-Inotropic Score as a Worked Example Introduction: The Data Is There. The Variable Is Not. Every conversation about clinical AI opens on the same premise: hospitals are sitting on enormous quantities of data. True enough, and almost useless as a starting point. An electronic health record is a transactional system, built for documentation, for billing, … Read more

Narrative Medicine: Close Reading, Clinical Empathy, and the Art of Listening to Patients

August 26, 2026August 8, 2026 by Michele Danilo Pierri

A doctor reads from a large medical book in an early 20th-century hospital ward, surrounded by attentive patients and fellow physicians.

Narrative medicine transforms clinical practice through close reading and reflective writing. A comprehensive guide for physicians and researchers, from Rita Charon’s Columbia programme to Oliver Sacks, Tolstoy, and Jerome Groopman.

The Model Runs, the User Waits: The Paradox of Large Local LLMs

August 26, 2026August 3, 2026 by Michele Danilo Pierri

distressed early 20th-century doctor struggles to inject an enormous syringe labeled “Llama 3.1 405B Parameters” into a tiny desktop PC

Hunting for the largest language model you can run on a personal computer has turned into a discipline of its own. Forums, repositories and social feeds circulate configurations that load models of 70, 120, even several hundred billion parameters, using consumer GPUs, generous amounts of system RAM and increasingly aggressive quantisation. The results are frequently … Read more

Medicine Before Theory: What the Odyssey Already Knew

August 26, 2026July 27, 2026 by Michele Danilo Pierri

Helen mixes a mysterious calming substance into wine as the grieving Telemachus and Menelaus sit beside her in an ancient Greek palace, inspired by Book IV of Homer’s Odyssey.

I went back to the Odyssey when Nolan’s film came out, for reasons that had nothing to do with medicine. I did not get far. Book I stopped me. Odysseus, we are told almost in passing, once sailed to Ephyra to find a man named Ilus, son of Mermerus, and to ask him for a … Read more

DICOM anonymization

August 26, 2026July 19, 2026 by Michele Danilo Pierri

A puzzled early 20th-century doctor examines a medical chart with the patient’s name erased while the patient lies in a modest hospital ward.

Deleting the patient name from a DICOM file feels like anonymization. It is not. A cardiac CT study I once pulled for a teaching file had a blank PatientName, a scrubbed PatientID, and a perfectly readable date of birth sitting three tags down in a private block the vendor never documented. The header looked clean. … Read more

Open-Weight Medical LLMs

August 26, 2026July 14, 2026 by Michele Danilo Pierri

A distressed early 20th-century doctor sits at a wooden desk, comparing a perfectly completed optical answer sheet with a disordered medical chart covered in handwritten notes and clinical tracings.

There is a specific moment, familiar to anyone who has gone down this road, when you finish downloading a model with “Med” in its name and realise you have no idea whether it is actually any good. The name promises domain expertise. The model card promises benchmarks. Neither tells you what happens when you ask … Read more

Local LLMs and Clinical Data: Why Privacy Is the Killer Feature in the EU

August 26, 2026July 3, 2026 by Michele Danilo Pierri

A stern judge points accusingly at an obsolete computer displaying patient data in a vintage hospital courtroom.

The most compliant place for a patient’s record to meet a large language model might be a machine sitting under your own desk. That sounds like a provocation. It is closer to a legal observation. In May and June 2026 the European Union rewrote part of its own AI rulebook, and most of the coverage … Read more

AI & Digital Health: Quarterly Review 2026Q2

August 26, 2026July 1, 2026 by Michele Danilo Pierri

A man in early 20th-century clothing flips through a calendar and stops at July 1, 2026, in a modest hospital ward lit by warm, soft light.

Article authored by Michele D. Pierri, MD Cardiac Surgeon & Medical Technology Researcher Last updated: July 2026 Reading time: 5 minutes Ten patients. Zero recurrences. That’s the headline buried inside a small New England Journal of Medicine report that, frankly, deserved more attention than it got. In April, a Johns Hopkins team used personalized “digital … Read more

Dante’s Inferno as a Clinical Gaze

August 26, 2026June 21, 2026 by Michele Danilo Pierri

Historical medical illustration showing a medieval physician examining patients in a hospital ward, with a large mural of Dante’s Inferno behind him, connecting disease, clinical observation, and medieval visions of suffering.

SummaryDante Alighieri’s Inferno is a theological poem, yes, but it is also, almost incidentally, a forensic catalogue of medieval disease and healthcare. This article reads the poem through the lens of medical history: how Dante represents specific pathologies (dropsy, scabies and possibly leprosy, neurological deformity, hypothermia, traumatic mutism), how he mimics diagnostic observation, and how … Read more

When “Not Worse” Is Enough: Understanding Non-Inferiority Trials in Medicine

August 26, 2026June 12, 2026 by Michele Danilo Pierri

an apple on top of a stylized wooden stand shaped like a head (training dummy), the apple surrounded by thin concentric rings like a target, a single arrow embedded near the apple but within an ‘acceptable ring

Non-inferiority Trials in Medicine: Last updated: June 2026 Author: Michele D. Pierri Reading time: 15–20 minutes In clinical research, we are used to thinking that a new drug, device, or procedure should be tested by asking a simple question: Is it better than what we already have? This is the logic of a superiority trial. … Read more