Medical AI has promising signals. Patients need proof of benefit.

These are results worth taking seriously—not because they settle the case for medical AI, but because they make the next questions sharper. A fracture-detection umbrella review covered 50 reviews and 387 primary studies. Its pooled sensitivity was 89.7% and specificity 90.4%, but certainty was generally low or very low. Comparisons between clinicians, standalone AI and assisted clinicians remained inconclusive. No included review reported adverse events or other safety outcomes. That is missing evidence, not a clean bill of health. A separate BREST-AI study examined three-year breast-cancer risk from negative screening mammograms. In external UK case–control validation, its AUC was 0.751 versus 0.700 for Mirai. The smaller US comparison did not demonstrate a statistically significant improvement. AUC measures ranking performance across thresholds; 0.751 does not mean that 75.1% of women received a correct diagnosis. The promise is real enough to investigate. Better risk stratification might help target follow-up, while better fracture detection might help clinicians notice an injury. But a useful score becomes a useful service only through decisions: who gets another examination, who waits, who receives reassurance and who is exposed to unnecessary procedures. NICE's conditional approach to certain fracture tools offers a practical model: use as an adjunct while gathering evidence, rather than substituting software for definitive review. These two new papers do not establish reduced mortality or safer care. They tell us where to look next, and which outcomes deserve to decide whether a promising tool earns a lasting place.