Michele Danilo Pierri

Michele D. Pierri is a cardiac surgeon and cardiovascular physiopathology researcher with a strong interest in artificial intelligence, medical data science, clinical decision support, and digital health. His work focuses on the intersection between medicine, technology, and computational methods, with the aim of translating complex biomedical concepts into clear, practical, and clinically meaningful insights.

Turbo Regression

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How to Put a Turbo on Regression Models Bootstrap Validation and Cubic Splines for Medical Data A practical guide for data scientists and clinical researchers working with limited medical datasets Last updated: December 2025 Author: Michele D. Pierri Reading time: 15–20 minutes Introduction — Why regression often disappoints in medicine Regression models are still the … Read more

Multiple Imputation for Missing Data

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A young boy kneels beside the shattered remains of a clay pot in a sunlit, rustic room, surrounded by warm golden light, long shadows, and aged earthenware in a melancholic early-20th-century painterly style.

A Complete Guide to Multiple Imputation for Missing Data: When, How, and Why Last updated: November 2025 Author: Michele D. Pierri Reading time: 15–20 minutes Glossary MCAR: Missing Completely At Random. Missingness is unrelated to observed or unobserved data; complete case can be unbiased. MAR: Missing At Random. Missingness depends only on observed variables; standard … Read more

Edvard Munch and Illness: The Ailing Body, the Soul Aflame

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Edvard Munch Melancholy

“Sickness, madness and death were the dark angels that had accompanied me since childhood.” Edvard Munch, Diaries, 1890 In the cold north of Europe, between the late nineteenth and early twentieth centuries, a Norwegian painter transformed his pain into vision. Not abstract pain, but one rooted in flesh, lungs, and nerves: a pain named tuberculosis, … Read more

Softmax

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Introduction The softmax function is essential in mathematics and machine learning. It transforms a vector of real numbers into a probability distribution. Put simply, it converts a set of numbers into probabilities. To understand how it works, let’s look at a list of risk values for some patients: Patients Surgical Risk Patient A 2 Patient … Read more

Decision Curve Analysis

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A physician in a pale coat stands at a forked mountain path at sunset, holding a glowing compass between two wooden signs marked “TREAT NONE” and “TREAT ALL,” symbolizing a clinical decision between opposing treatment strategies.

Introduction Decision Curve Analysis (DCA) is a powerful tool for evaluating the clinical utility of predictive models and diagnostic tests. Unlike traditional metrics like AUC or calibration, DCA focuses on what truly matters in practice: whether using a model leads to better decisions and outcomes. DCA was introduced by Vickers and Elkin in 2006 to … Read more

Orientation in Dicom

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Understanding DICOM Coordinate Systems and Image Orientation: Why Your 3D Volume Looks Upside Down 1. Introduction — Why Orientation Matters Have you ever opened a medical image and found the anatomy upside down or mirrored? It’s not your viewer’s fault — it’s about geometry. DICOM files contain not only pixels, but also the mathematical information … Read more

Effect Size

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A glowing magnifying glass highlights “p < 0.05” beside a winding path toward a mountain marked “Large Effect Size,” while a roadside sign warns that statistical significance is not the same as practical importance.

Effect Size: What It Is and Why It Matters More Than Statistical Significance A result can be statistically significant — yet practically meaningless. Learn how effect size reveals the real-world impact of research findings. Introduction: The Hidden Problem with p-values You’ve probably seen headlines like: “New Study Shows Coffee Improves Memory!” But what if the … Read more

Percutaneous Interventions Expand: Key Insights from 2025 ESC/EACTS Guidelines

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In an early-20th-century hospital room, two masked surgeons confer with a formally dressed man beside a reclining patient, surrounded by anatomical sketches, scientific diagrams, glass infusion bottles, and antique medical instruments.

Introduction The 2025 ESC/EACTS Guidelines on Valvular Heart Disease represent a pivotal shift in the balance between surgical and percutaneous interventions. While surgical aortic valve replacement (SAVR) remains the gold standard for younger, low-risk patients, the new guidelines expand the role of transcatheter aortic valve implantation (TAVI) and transcatheter edge-to-edge repair (TEER, MitraClip). This evolution … Read more

Calibration of Predictive Risk Models: A Guide for Clinicians

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An elderly physician in a white coat carefully shapes a red calibration curve on a large graph comparing predicted and observed risk, in a warmly lit early 20th-century medical study rendered in muted sepia and ochre tones.

Introduction: Understanding Calibration Challenges Consider a thermometer that perfectly identifies when one temperature is higher or lower than another, but consistently reads 5 degrees too high. This thermometer has good discrimination (it correctly ranks temperatures), but poor calibration (its absolute values are inaccurate). The same problem occurs with clinical risk models such as EuroSCORE: they … Read more

TCP and UDP protocol Benchmarking with Python: From Theory to Practice with FHIR APIs in Healthcare

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Two barefoot children in period clothing communicate through a tin-can telephone in a sunlit, crumbling courtyard, while a third child sits quietly against the weathered wall.

A technical comparison between TCP and UDP protocols implemented in Python: examining performance metrics, security considerations, and practical applications within healthcare systems using FHIR standards for effective data exchange between medical platforms. Introduction: The Significance of TCP vs UDP When browsing websites, streaming videos, or making video calls, our data travels across networks using protocols … Read more