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01 ·CNNs & Image Recognition·★ MEMBER·9 min read Medical Imaging AI — Validation Design Comes Before the Accuracy Number An AI that scored beautifully on your own hospital's data turns out to be useless at the hospital next door — a failure that has been reported over and over in medical imaging. Sensitivity and specificity, the way prevalence flips the meaning of a positive result, internal versus external validation, what site-to-site variation actually is, and what regulators are really reviewing: building up, from first principles, the habit of questioning the validation design before the accuracy figure.