No Handover last week, so this one covers a fortnight and runs longer: a meta-analysis finds human oversight catches fewer AI errors than we assume, six builders ship, from an angiogram simulator to an ST4 rotation map, and the MHRA takes its AI agenda to Washington.
Top signal
Human oversight is not a safety net you can assume Zeng, Lei and Li, writing in npj Digital Medicine on 23 October, reviewed 46 reports covering 41 cohort clusters of how clinicians respond to incorrect automated advice. Across three adjusted cohorts, clinician correctness was far higher when the automated advice was correct than when it was wrong (pooled OR 10.19, 95 per cent CI 7.43 to 13.98, I² = 0 per cent), and in four real-world computerised ECG studies 26.6 per cent of erroneous interpretations went unrecognised or uncorrected (95 per cent CI 6.4 to 65.6, I² = 95.8 per cent, so read that second interval as very wide). Their conclusion is the one to build on: "Human oversight should be evaluated as an error-interception capability rather than assumed to ensure safety." Language model studies showed harmful reliance too but were too heterogeneous to pool, and patient-level adverse events were reported in only one cohort. npj Digital Medicine
Shipped this week
- ST4 Anaesthetics Placement Ranking Tool: a UK anaesthetics trainee who posts as u/Propofol_Monkey on r/doctorsUK built an open-source map and ranking aid for ST4 anaesthetics rotations in England and Wales, live on GitHub Pages. "I got fed up of the dreadful archaic list of anaesthetics preferences/rotations on Oriel," they wrote, "no sensible ordering, no way to visualise where hospitals actually are." With minimal development experience, they turned to AI to make ranking the available rotations less painful. The tool shows 60+ NHS hospital trusts colour-coded by region with route lines, profiles each base with its EPR system, parking and rail links, and estimates commute times for 07:30 and 18:00 handovers, with no login or adverts. Their caveat is in the thread: the data is only as good as the deaneries' listings, and several regions posted too little to be complete. A CT1 version followed after another trainee asked. ST4 Rotation Map
- AngioView: Annas Rahman, MD, a cardiologist at Northwestern Medicine's Bluhm Cardiovascular Institute in Chicago, built a free simulator that teaches trainees to read coronary angiograms by linking C-arm angles to a 3D coronary tree, on the web at angioview.com and as an iPhone and iPad app published under his own name. "I'm so honored to be featured by the Claude team! What a great surprise to get during clinic," he posted on 17 October, linking the site. It is a teaching tool rather than a validated assessment, and we have seen no independent evaluation of it. X
- SNOMED-Scribe: Joseph Ologunja, MBBS, a GP specialty trainee and NHS Fellow in Clinical AI in the Midlands, built an open-source coding assistant that reads a clinician's free-text consultation note and suggests candidate SNOMED CT codes for each clinically relevant concept, including negation and common abbreviations, then saves none without the clinician's sign-off. It is live on GitHub as a FastAPI, React and Postgres build with tests and CI, and the README is explicit about what it is not: "SNOMED-Scribe does not diagnose, does not recommend treatment, and never saves a code without clinician approval. It is a coding aid, not a clinical decision tool." It is a young, single-developer project with no clinical evaluation yet. GitHub
- CendovaPlan: Priv.-Doz. Dr. med. Philipp A. Michel, an orthopaedic and trauma surgeon in arthroplasty at ETHIANUM Heidelberg in Germany, built a free Apache-2.0 browser tool for hip, knee and shoulder arthroplasty planning that runs fully locally: leg-axis measurement, CPAK classification, implant templating and osteotomy planning, live at cendova.de. The repository is explicit about what it is not, describing itself as "Kein Medizinprodukt" and a learning and research project, and the tool keeps processing in the browser with no data leaving the machine. No clinical validation is claimed for it. GitHub
- AchillesPlan: Bruno Gobbato, MD, an orthopaedic surgeon specialising in shoulder and elbow in Jaragua do Sul, Brazil, built a browser-based 3D planner that sizes the graft and the hook plate for clavicle reconstruction after resection, and shared it live on 19 October. "A good friend in Greece asked for help with a 3D plan. So I built him an app," he posted. "Post-resection clavicle reconstruction: it plans the graft size and the plate. You can play too." It is a single-case planning aid on a public URL, not a validated product, and carries no regulatory marking. X
- Endoscopy simulator: Samir C. Grover, MD, a gastroenterologist, professor at the University of Toronto and EVP Academics at Scarborough Health Network, built a browser-based introductory endoscopy simulator for entry-level trainees and was the first to tell you what it is not. "We built this delightful intro to #endoscopy simulator for the entry endoscopy trainee in three.js with 45 minutes of vibe coding," he posted on 18 October. "It is quick and dirty and flawed, but most importantly can be made and deployed in almost an instant." It is a teaching novelty built in under an hour, not an evaluated training tool, and he says so himself. X
Build safely
- AI-assisted fracture screening, measured in one emergency department: Tan and colleagues, writing in npj Digital Medicine on 27 October, ran a three-month deployment in one emergency department: thirteen radiographers in a radiographer-led screening programme independently read 2,496 consecutive musculoskeletal examinations, then reviewed a commercial deep-learning system's output, then recorded a final decision. Standalone AI sensitivity was 75.6 per cent overall and 46.2 per cent for subtle fractures, below the radiographers' own baseline of 91.6 per cent; radiographers' accuracy was 97.6 per cent and rose to 98.0 per cent with AI assistance, correcting 11 errors and introducing one, a net gain of 10 cases. The behavioural number: radiographers changed their decision in only 11 of 729 discordant cases, and no or incomplete AI output was returned for 8.8 per cent of examinations. It is one site, and downstream clinical outcomes were not measured. npj Digital Medicine
- The MHRA takes its AI agenda to Washington: the MHRA took its AI and device agenda to AdvaMed 2026 in the United States, where Jessica Paulsen, its Deputy Director for AI and Software, spoke on 20 October. Most of it restates the 2030 Strategy (Issue 11) and the 44 Commission recommendations (Issue 10). What is new is the US-facing machinery: under the MHRA-FDA Pioneer Programme announced in June, the MHRA is recruiting a Regional Deputy Director of US Partnerships in Washington, D.C., as its dedicated liaison officer to the FDA. Her line: "In the UK we are moving from policy into practice, using initiatives like AI Airlock to build a more proportionate, lifecycle-based approach." It is a press release about a speech, not guidance you can follow. GOV.UK
Tools & guides
- Infrastructure as Code for medical AI: a team at Charité University Medical Center Berlin, with co-authors at Oxford, Harvard Medical School and Microsoft, posted a medRxiv preprint (not yet peer reviewed) on 13 October describing how they encode the governed backend a clinical AI service needs, a secure backend, a private model endpoint and managed identity, as Infrastructure as Code, so the same configuration can be reviewed once and executed identically at any institution. Deploying the governed service at a tertiary centre took, on average, 310.3 seconds (n = 25). Their first application, an LLM inconsistency checker for medical documents, flagged a clinically severe inconsistency in 105 of 1,347 physician-approved documents (7.8 per cent, about one in thirteen), and a physician audit confirmed 149 of 150 sampled findings. Caveats: it is a preprint, one author is a Microsoft employee, and that audit is small. medRxiv
- OMNI: a rubric for judging generative AI in health: Cornelisse, Menz and colleagues, writing in JMIR on 27 October, published OMNI, a 10-domain rubric (Accuracy, Safety, Recognizes Uncertainty, Completeness, Communicates Clearly, Empathetic, Context Aware, Referencing, Follows Instructions and Avoids Coerciveness) scored on 4-point Likert scales, built for health professionals to evaluate generative AI outputs. In a four-scenario pilot, assessors produced 9,600 domain-level ratings and 4,010 qualitative comments, with mean pairwise agreement on the 4-point scale ranging from 30.8 to 53.4 per cent, rising to 59.3 to 79.6 per cent once collapsed into broad agreement categories. Referencing, Recognizes Uncertainty, Completeness, Empathetic and Accuracy were the recurring weaknesses, and their own limit is that whether it transfers to purpose-built health AI tools and agentic systems is untested. JMIR
Events
- 12 Nov (virtual): the 2026 NurseHack4Health Pitch-A-Thon runs virtually on 12 November, with nurse-led teams pitching care tools and solutions after the programme's Innovation Accelerator, which ran from 12 October to 6 November, and up to $435,000 in funding on offer. It is run by Johnson & Johnson Nursing and registration is open. Johnson & Johnson Nursing
- 15 to 18 Nov (Las Vegas): HLTH USA 2026 runs in Las Vegas with clinician-directed build programming: a Nurse Hackathon on 17 November, from 9 to 12, tackling workforce and workflow challenges with AI, alongside a Nurse Innovators Pavilion of nurse-led startups. The Physician Builder Challenge run with Abridge sits in the same event and has closed its applications, so treat this as one to follow rather than enter. HLTH
- 16 Nov (Scotland, last call): the last call for the NHS Fellowship in Clinical AI we flagged in Issue 11: applications close on 16 November for eight funded places starting in August 2027, four for doctors in training, three for registered healthcare staff and accredited healthcare scientists, and one for the allied health professions. PSD Scotland
New in the directory
- Brian Sutterer, MD (United States): a sports medicine physician, PM&R trained, in Cape Girardeau, Missouri, whose Load/Ready app for iPhone and Apple Watch turns Apple Health data into readiness, recovery and training-load views that show their workings, with no server and no account. It is published on the App Store under his own name. App Store
- David Ouyang, MD (United States): a cardiologist and echocardiographer at Kaiser Permanente Northern California who built The Heart by Ultrasound, an interactive echocardiography guide with chapters following the ASE guidelines, echo views cut from a 3D heart and live probe controls, written with Claude Code in his own open GitHub repository. intro2echo.com
- Grzegorz Miekisiak, MD, PhD (Poland): a neurosurgeon and spine surgeon at Vratislavia Medica in Wroclaw and professor at the University of Opole, whose SpineRebel platform for continuous at-home spinal motion monitoring gathers the wearable firmware, a frozen data extractor, a viewer and the analysis pipeline behind a study he lists as submitted to Sensors in 2026. GitHub
- Rudolf Bumm, MD (Switzerland): a thoracic and visceral surgeon at Kantonsspital Graubuenden in Chur who built LungCTAnalyzer, an open-source 3D Slicer extension for lung CT segmentation first released for COVID-19 assessment in 2020. He wrote about 415 of its roughly 430 commits, and it now sits under the Slicer organisation. GitHub
- Stefano Garzon, MD (Brazil): an interventional cardiologist at Hospital Israelita Albert Einstein in Sao Paulo who builds open-source research software with Claude Code, including Et al., a local PDF library manager for clinical research, and clinical-ai-skills, free Claude skills for systematic-review screening and claim checking with verbatim sources. GitHub
- Sungil Hwang, MD (South Korea): a radiologist and professor at Seoul National University Bundang Hospital and Secretary General of the Korean Society of Radiology, who built PIRADSreport, a single-file browser tool for structured prostate MRI reporting with a PI-RADS v2.1 sector map, automatic volume and PSA density and a one-click report, and wrote it up in a Korean Journal of Radiology paper on vibe coding by clinicians. GitHub
- The directory now counts 99 clinician-builders with verified, evidence-graded ships, 11 more than the last issue: seven were published on 27 October (Annas Rahman, Bruno Gobbato, Grzegorz Miekisiak, Joseph Ologunja, Philipp A. Michel, Stefano Garzon and Sungil Hwang) and four on 16 October (Brian Sutterer, David Ouyang, Edward Bender and Rudolf Bumm), with no removals. Edward Bender's Bender Apps was the Shipped item in Issue 11. Browse it, forward this to a colleague who ships, and reply if you know someone who belongs in it. cliniciansthatcode.com
From us
- Tell us about your hackathon: if you organise or take part in a hackathon, healthtech or clinical, let us know and we will put it on the schedule of Hackathon Hub, the European hackathon platform, which today lists 363 upcoming hackathons across Europe. Write to assistant@hyperadvancer.com with the date, the place and a link. The two November events above are exactly the kind of thing that belongs there. Disclosure: Bart Collet, who edits this briefing, is Hackathon Hub's Healthtech ambassador. Hackathon Hub