Live data from Hacker News

I’m a doctor: Here’s what I found when I asked ChatGPT to diagnose my patients

inflecthealth.medium.com

161–170 of 368 posts

Re: I’m a doctor: Here’s what I found when I asked ChatGPT to diagnose my patients

#161

When GPT starts to auto-incorporate the best yet known prompts, then we'll have a better idea of its potential. You must, must use the best prompts, of which many are not widely known, and some have not (of course) been discovered ... yet. Even with human experts, you must provide sufficient detail, and the expert must ask clarifying questions for differential diagnosis.

This is nonsense - a LLMs output is a pseudo random mishmash of its training data. How can there be a "best prompt" when the same prompt gives you different output each time, but there is only one correct output?

Prompts constrain the possible output space.

This is true in trivial ways: ask it to reply only in json.

This is also true in slightly less trivial ways: ask for a “description of X”, a “short description of X”, and a “one-sentence description of X”.

This continues to be true in increasingly more complex ways: Prompt it with a quote, a rating of that quote as 5/10 on complexity, and request it to give you two new quotes with ratings of 2/10 and 8/10 on complexity. Follow it up with a request for two more quotes at -5/10 and 20/10 ratings. Then try the whole process again but with metrics other than “complexity”: information content, eloquence, humour.

In this way, if there is a single correct output, there is a corresponding single best input prompt that most tightly constrains the output space to the smallest space that still contains the correct output.

Re: I’m a doctor: Here’s what I found when I asked ChatGPT to diagnose my patients

#162

I wonder if, instead of asking ChatGPT for a diagnosis, he could've got it to prompt for further questions he could ask? My thinking is that given the nature of LLMs of connecting related information, it might be a good way to figure out the gaps in the diagnostic process, rather than actually provide one.

I was thinking the same thing, the author may be a great doctor, but not a great prompt engineer (perhaps even intentionally so, to justify their job)

Instead of "Here are symptoms, what are possible diagnoses?"

They could have tried

"Here are symptoms, what are possible diagnoses, and what are some good questions an intelligent doctor might ask to be able to better diagnose their patient?"

Re: I’m a doctor: Here’s what I found when I asked ChatGPT to diagnose my patients

#163
post #34

Being a scifi geek and AI geek and neuroscience geek for pretty much the past 40 years, I've read countless predictions and scenarios and stories about society's response as "true" AI begins to emerge. So watching it play out for real is creating this bizarre sense of deja vu combined with fascination and frustration and also some anxiety. This article and the comments in this thread are right up that alley. I mean,…

But at the same time consider the problem, and if AI is even the tool for this job or if its total overkill. We are just matching symptoms to a diagnosis, you could get this utility from programming a simple dictionary with a fraction of the compute. Maybe even with a confidence estimate of the diagnosis this time. There's an old adage that rings true here I think: "keep it simple, stupid."

Diagnostic decision support systems have already existed for many years.

https://doi.org/10.1038/s41746-020-0221-y

Re: I’m a doctor: Here’s what I found when I asked ChatGPT to diagnose my patients

#164

Being a scifi geek and AI geek and neuroscience geek for pretty much the past 40 years, I've read countless predictions and scenarios and stories about society's response as "true" AI begins to emerge. So watching it play out for real is creating this bizarre sense of deja vu combined with fascination and frustration and also some anxiety. This article and the comments in this thread are right up that alley. I mean,…

I have case that 5 doctors so far can't explain. I fed in what was happening (generally speaking) and it provided a rather good list of what it "might" be. I then asked it to start describing each scenario and I was able to determine nope, that's not it or if it was plausible. Meeting with doctor no 6 tomorrow to talk about what it could be but at least I have a better insight at what the more obvious possibilities.…

How does it matter to the doctor if the car accident was the cause of your issues?

Re: I’m a doctor: Here’s what I found when I asked ChatGPT to diagnose my patients

#165

Earlier quoted context omitted.

>is bad at understanding the atypical. To be fair I've found most doctors require a lot of convincing if your problem atypical as well.

As they should. If you hear hooves, think horses not unicorns.

If you google around there's tons of stories of people with legitimate novel illnesses that are ignored or misdiagnosed for years.

Re: I’m a doctor: Here’s what I found when I asked ChatGPT to diagnose my patients

#166
post #90

I'm not really sure what he expected here, ChatGPT was not trained to be a doctor, it is far more general than that. Asking ChatGPT for medical advice is like asking someone who is very well read but has no experience as a doctor, and in that context it's doing very well. He also brings up one of the most salient points without really visiting it enough: ChatGPT does not ask for clarification, because it is not a kno…

"I'm not really sure what he expected here, ChatGPT ..." Doctoring is quite similar to ITing if you are careful with your similes. In medicals you look for indications and contraindications. In IT you look for magic beans and sometimes look at logfiles. I have no idea why we (IT) don't follow the medical way and have indications and contras (I do). They have been doing complicated diagnostics way longer than we have.…

> I have no idea why we (IT) don't follow the medical way and have indications and contras (I do).

Because we have logs. Ignoring them and focusing on the symptoms would be like doctors refusing to do examinations on their patients.

Re: I’m a doctor: Here’s what I found when I asked ChatGPT to diagnose my patients

#167

Earlier quoted context omitted.

ChatGPT's heuristic may lead it to emit a sequence of words that suggest to English speakers that they should provide clarification, but ChatGPT is congenitally incapable of determining that answering a question requires more information that was provided in the prompt and that clarification is needed. Rephrased, ChatGPT can ask for clarification, but only as a side effect of satisfying it's heuristic.

Calling it a "side effect" is really downplaying things. All of its behavior is just satisfying its heuristic. Just did this chat on 3.5. [Me] Boxes that are black with stars have gold inside. Black with circles means silver. Blue with squares means copper and blue with triangles means tin. Your job is to determine the contents of the box. If you need more information, ask for it. Example: User: I have a black box. A…

Interesting example. I wonder if it is building a small world model (a la SHRDLU), or if it is answering based on the most statistically likely words, or what.

Re: I’m a doctor: Here’s what I found when I asked ChatGPT to diagnose my patients

#168

>If my patient in this case had done that, ChatGPT’s response could have killed her. Not if she lived in a state where there's no longer any legal treatment for ectopic pregnancy.

Which states are you referring to?

Re: I’m a doctor: Here’s what I found when I asked ChatGPT to diagnose my patients

#169
EMT here. Sounds like ChatGPT ignored (or was never trained on) one of the cardinal rules of emergency medicine:

If the patient is under 60 and has a uterus and is complaining of abdominal pain, assume she's pregnant until proven otherwise.

This does not mean you should ignore possible appendicitis or gallstones or GERD or pancreatitis or a heart attack or any of 100 other causes. It means you must consider pregnancy until you have objective evidence to the contrary.

Re: I’m a doctor: Here’s what I found when I asked ChatGPT to diagnose my patients

#170

Earlier quoted context omitted.

What I didn't predict is so many AI boosters being so miffed at regular folks pointing out the obvious: a half-working system may be tremendously exciting to AI enthusiasts, but it's not that useful to society. Recently we've had all these people complaining of moving goalposts, when in fact most people never had goalposts for AI in the first place, and certainly never had goalposts that remotely resembled those that…

This is the self driving car argument applied to things it doesn’t fit. Sure, unless a self driving car is several 9’s reliable, it’s not terribly useful for society. That’s because there’s no way for a human to be safely in the loop at highway speed. But a LLM assisting a wide rage of professionals at even a low accuracy could be part of an efficient workflow, allowing for be doctor or lawyer to give quality service…

[deleted]
Post reply on HN