Endocrinologist and Assistant Professor @MayoClinic, Internist @gtown_medres, MD @UniversidadCES. Views are my own.
Joined May 2018
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Just like a resident memorizing practice exams, an AI that memorizes training data will fail in the real world. In my latest for @TheAACE Endocrine AI, I explore overfitting, data leakage, and the critical skepticism clinicians need
tinyurl.com/2s3z67vb
@MayoClinicEndo
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Time to challenge the "lifelong" levothyroxine dogma? In Clinical Thyroidology, I review new data: 64% of older adults on ≤50 µg/day successfully stopped at 1 yr. But relaxed TSH targets & long-term unknowns require a careful approach
tinyurl.com/3tk6nhsx
@MayoClinicEndo
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Our latest @MayoClinicEndo study uses AI to expose a major driver of thyroid cancer overdiagnosis: incidental findings on routine CT/MRI scans. We built an NLP pipeline to analyze 115,683 patients over 6 years. The data: 🧵
doi.org/10.1210/clinem/dgag1…
@doctorjuanpa
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• The diagnostic cascade is massive: an incidental finding led to 46.8x higher odds of biopsy, 55.8x higher odds of total thyroidectomy, and 61.7x higher odds of a cancer diagnosis.
• 88.1% of these detected cancers were small, low-risk papillary carcinomas. 🧵
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Current management shifts patients toward invasive procedures for subclinical disease unlikely to cause harm. We need standardized cross-sectional imaging reporting & far more selective follow-up protocols.
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May 26
Our recent commentary examines AI-enhanced molecular diagnostics for thyroid nodules. While combining AI & genetics could improve precision, small cohorts and NIFTP classification remain hurdles to clear before clinical reality
@MayoClinicEndo @TheAACE
doi.org/10.1016/j.eprac.2026…
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The "clinician in the loop" model is a flawed solution for AI oversight. It shifts accountability from developers to doctors, making clinicians the "moral crumple zone" for system failures.
Our new BMJ analysis: 🧵 doi.org/10.1136/bmj-2025-089…
@MayoClinicEndo
@doctorjuanpa
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We propose an alternative: "AI as adviser". AI should operate in the background to support the therapeutic alliance, rather than mediating it.
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Safe AI requires shifting from bedside vigilance to system-level safeguards. This relies on three pillars:
- Enterprise accountability and shared risk
- Institutionalized stakeholder governance
- Continuous automated monitoring.
Responsibility belongs upstream
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David Toro Tobon retweeted
May 5
Regulators and health systems increasingly rely on human oversight at the point of use as a primary safeguard for AI.
“Clinician in the loop” oversight shifts responsibility for AI safety from developers to doctors
bmj.com/content/393/bmj-2025…
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David Toro Tobon retweeted
Build practical diabetes management skills with the Essential Diabetes Care online course—recorded lectures and case studies in a self‑paced 9 hour online format for providers.
Learn more: tinyurl.com/r29x45na
#CME #Diabetes
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David Toro Tobon retweeted
At @MayoClinicEndo, we are evaluating next-gen therapies targeting the root causes of thyroid autoimmunity. Explore our active clinical trials for Graves' disease and TED here: tinyurl.com/4s9bbykh
#Endocrinology #ClinicalTrials
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David Toro Tobon retweeted
Apr 24
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David Toro Tobon retweeted
Practical tips for using AI in clinical practice. Great session by @DavidToroT at #AACE2026
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David Toro Tobon retweeted
How does the way our bodies process dietary fats affect our weight over time? A new @mayoclinicendo study reveals a key link between meal fatty acid metabolism and long-term weight gain in females
Learn more: tinyurl.com/yckusm
#WomensHealth #Metabolism #Endocrinology
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Overdiagnosis drives unnecessary thyroid biopsies. My commentary explores deploying AI as a "goalkeeper" to double-check flagged nodules. It cut unnecessary FNAs from 68.5% to 9.1%. AI doesn't replace the clinician; it refines our focus.
tinyurl.com/mr385xuk
@MayoClinicEndo
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Thyroid molecular classifiers are likelihood ratios 📊, not magic verdicts 🎱
Our new @JAMAOnc viewpoint explores how to reclaim clinical reasoning and shared decision-making in the era of AI and automated testing
@doctorjuanpa
@vmontori
@MayoClinicEndo jamanetwork.com/journals/jam…
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26 Oct 2025
It was a pleasure to join the great group of the Mexican Society of Endocrinology, discussing management strategies for thyroid eye disease & RAI indications per new ATA guidelines, plus insights on redifferentiation at the International Forum of Thyroid Experts @SMNE_Oficial
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