Sabrine Angelo

[Vincent Rajkumar @VincentRK]

For physicians who deal with lots of referrals on “abnormal free light chain ratio” incidental finding.

Our recommendation is unless the FLC ratio is <0.125 or >8 or unless you are worried about myeloma clinically, or dealing with biopsy proven AL amyloid or MIDD or PGNMID, ask referring physicians to repeat in 6 months and if stable consider it as possible LC-MGUS with subsequent testing only if symptoms concerning for myeloma, amyloid etc develop. Defer bone marrow biopsy or bone survey.

See algorithm below. @nejm
Note labs report K/L ratio. Not involved /uninvolved. For ease of use you can calculate involved (high value) / uninvolved (low value). And use 8 as cut off as shown in figure. Otherwise you have to follow one cutoff for lambda and one for kappa.

https://t.co/vxDm5hpoPx

[Vitor Borin P. de Souza @vitorborin_]

Probably the most uninformative figure ever created

[Sabrine Angelo @AngeloSabrine]

@jasonryanmd OK

[Sabrine Angelo @AngeloSabrine]

@VincentRK @HiraSMian @End_myeloma @NEJM OK

[Sabrine Angelo @AngeloSabrine]

@Simi_2210_ Skin

[Vincent Rajkumar @VincentRK]

AI is not a medical expert. AI is a pseudo expert. It possesses incredible a capacity to scour all of the available information and put together a coherent answer or summary. This answer or summary will greatly help the general public and physicians who are not experts in a given disease by making search, retrieval, synthesis of available information. But it’s not an expert.

AI cannot be expected to know data that’s known to experts but is not yet published. It cannot know when data in published form differs from that experienced in real world practice by clinicians who see a large volume of patients with the same disease. Where the published data are wrong or exaggerate benefits or minimize risks. It cannot judge the right treatment option among similar competing treatment options (except superficially), especially based on what the patient evaluation reveals on history and examination.

AI appears to be an expert in everything in the world by knowing what experts have written and made public but lacks wisdom by the very nature of how it works to produce the answer. It’s not thinking. It knows as the famous saying where the puck is but not where it’s going to be.

That’s why the even the most ardent proponents of AI including the uber rich who own the models will always seek out the best human expert available for serious diseases. They may use AI to provide a summary of their disease for the expert but they are not going to mistake or substitute AI for the expert. I don’t see this changing. Because medicine is more than knowing everything that’s published or being able to retrieve it quickly.

We live in a world of medicine where it’s easy to confuse pseudo experts who have gained or granted prominence with real depth of expertise and wisdom. So it’s easy to see how a lot of us are mesmerized by the speed and eloquence of AI to answer queries. Yes it does that well (and is probably sufficient 90% of the time). But as you learn how LLMs and other AI tools work you know it’s no expert, but a useful side kick. I do think it can help both experts and non experts but we must know what it’s capable of and what it’s not.

[Sabrine Angelo @AngeloSabrine]

@abdulhamid_199 I'd são Castleman disease

[Sabrine Angelo @AngeloSabrine]

@AJamesMcCarthy 🤔🤔🤔🤔

[Sabrine Angelo @AngeloSabrine]

@docakx @ziad_zaatari The garden

[Sabrine Angelo @AngeloSabrine]

@OGdukeneurosurg Samurai

[Sabrine Angelo @AngeloSabrine]

Drop off your luggage and enjoy Japan more freely!

https://t.co/WPbQMU154X

#手ぶらくん #TEBURAKUN #EXPO2025 #Osaka Kansai Expo #手ぶらくん返金キャンペーン #f4083c54

[Sabrine Angelo @AngeloSabrine]

@drkeithsiau Aps

[Sabrine Angelo @AngeloSabrine]

@camiladurando Ja aconteceu comigo tmb... sou hematologista, entao a maioria das pessoas nem sabe o que eu trato, só vai pra mim encaminhado de outro colega ou quando marca errado pq queria um dermatologista. Mas esses dias apareceu um paciente que só queria um check-up mesmo. 🤷‍♀️

[Sabrine Angelo @AngeloSabrine]

@MaryCushmanMD 😢

[Sabrine Angelo @AngeloSabrine]

@tobyeyre82 Thank you for sharing this!

[Sabrine Angelo @AngeloSabrine]

@AJamesMcCarthy 🤣🤣🤣🤣🤣🤣🤣🤣🤣

[Sabrine Angelo @AngeloSabrine]

@MelDMann 🥹🥳🤩

[Sabrine Angelo @AngeloSabrine]

@GuiperiniMD 🤔🤔🤔🤔

[Sabrine Angelo @AngeloSabrine]

@PedroHTunes Que massa, nunca tinha pensado na reprodu��ão de tantos animais! Obrigada por isso!

[Sabrine Angelo @AngeloSabrine]

@NovosClassicos Amigo, pelo menos ela não está se pagando de intelectual postando capa de livro clássico que não leu, nem ta na internet criando conteúdo de lixo coach... vai ler o que vc quiser e deixa as pessoa