Plastic Surgery

Systematic review: combining biologics with surgery may improve outcomes in moderate‑to‑severe hidradenitis suppurativa

In 8 mostly retrospective studies including 508 patients, combination therapy generally achieved higher HiSCR and IHS4‑55 responses than biologic monotherapy. Combination approaches reported greater pain reduction and improved Dermatology Life Quality Index scores versus biologic alone. Safety appeared similar between groups with no consistent increase in postoperative complications reported. Evidence quality was low and heterogeneous, wound healing outcomes were poorly reported, and prospective trials are needed before changing standards of care. 1

Kaiser cohort: combined mammography AI, polygenic, and clinical models improve 10‑year breast cancer risk discrimination

Among 82,957 women with negative screening mammograms, the combined Mirai+PRS313adj+BCSCv3 model achieved a C‑index 0.70 for 10‑year breast cancer risk. Single‑domain models had lower discrimination (BCSCv3 0.62, PRS313adj 0.61, Mirai 0.66). Integration of imaging AI, polygenic risk, and clinical factors significantly improved risk stratification versus any single model. These results support consideration of combined risk scores for personalized screening pathways, acknowledging the need for implementation assessment. 2

Pragmatic cluster RCT: LLM‑assisted EMR in Kenyan primary care was safe but did not reduce 14‑day treatment failures

In 16 clinics and 9,691 patients, treatment failure occurred in 2.2% of the LLM arm versus 2.0% of controls (adjusted OR 0.77, P=0.13). No serious adverse events were attributed to the LLM intervention and independent review found no safety signal. The trial found no significant reduction in short‑term treatment failures, implying any clinical benefit is likely modest. Applicability is strongest for low‑resource primary care; effects in surgical or high‑income settings remain unknown. 3