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OpenAI’s o1 correctly diagnosed 67% of ER patients vs. 50-55% by triage doctors

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Re: OpenAI’s o1 correctly diagnosed 67% of ER patients vs. 50-55% by triage doctors

#41

I'll repeat my idea on how this MUST be done: 1. AI gets data about the patient and makes a diagnosis. This is NOT shown to doctor yet. 2. Doctor does their stuff, writes down their diagnosis. This diagnosis is locked down and versioned. 3. Doctor sees AI's diagnosis 4. Doctor can adjust their diagnosis, BUT the original stays in the system. This way the AI stays as the assistant and won't affect the doctor's decisio…

5. Private Equity uses this valuable data to stack rank doctors based on how correct / AI-aligned their diagnoses are over time

6. Rankings are used to periodically "trim the fact" thus delivering more optimized cash flows to clinics that have been saddled with toxic debt

7. Sensing an opportunity AI providers start selling a $200 / month Data Leakage as a Service subscription to overworked physicians so that they can avoid the PE guillotine

Re: OpenAI’s o1 correctly diagnosed 67% of ER patients vs. 50-55% by triage doctors

#42

> "An AI and a pair of human doctors were each given the same standard electronic health record to read" This is handicapping the human doctors abilities. There is a lot more information a human doctor can gather even with a brief observation of the patient.

This feels like a deeply important observation. Now also, would be interesting to include e.g. a short video or photograph for the AI to use as well.

Re: OpenAI’s o1 correctly diagnosed 67% of ER patients vs. 50-55% by triage doctors

#43

> "An AI and a pair of human doctors were each given the same standard electronic health record to read" This is handicapping the human doctors abilities. There is a lot more information a human doctor can gather even with a brief observation of the patient.

Agreed. I think the best use of this sort of tech is to use both to their strengths. Use AI to go over the record and suggest diagnoses which you have the doctor review after observing the patient.

The other thing is that common issues are common. I have to wonder how much that ultimately biases both the doctor and the LLM. If you diagnose someone that comes in with a runny nose and cough as having the flu you will likely be right most of the time.

Re: OpenAI’s o1 correctly diagnosed 67% of ER patients vs. 50-55% by triage doctors

#44
post #38

Earlier quoted context omitted.

I agree with you on this specific study, however, I can't really wrap my head about the fact that doctors will be better than AI models on the long-run. After all, medicine is all about knowledge, experience and intelligence (maybe "pattern recognition"), all those, we must assume that the best AI models (especially ones focusing solely in the medical field) would largely beat large majority of humans (aka doctors),…

But liability and ethics cannot be put aside. If treatments were free of cost and perfectly address problems, then a correct diagnosis would always lead to the optimal patient outcome. In that scenario, AI diagnosis will be like code generation and go asymptotic to perfection as models improve. But a doctor's job in the real world today is to navigate a total mess of uncertainty: about the expected outcome of treatme…

Isn't that conflating diagnosis and treatment plan?

Re: OpenAI’s o1 correctly diagnosed 67% of ER patients vs. 50-55% by triage doctors

#45
As a 37 year old male with 2 THRs I'm glad the AI was NOT used in my diagnosis. All the models that I used to look at my x-rays said nothing was wrong, even when adding symptoms. When adding age it said the patient was too young.

(I was ~3 months away from wheelchair bound in those x-rays).

The worst one was Gemini. Upload an x-ray of just the right hip, and it started to talk about how good the left hip looked like.

I think with AI taking over it's gonna be harder to get a solution when your problem isn't the run-of-the mill.

Re: OpenAI’s o1 correctly diagnosed 67% of ER patients vs. 50-55% by triage doctors

#46
post #11

I'd be very very hesitant to trust studies like this. It's very easy to mess up these benchmarks. See for example this recent paper where AI managed to beat radiologists on interpreting x-rays... when the AI didn't even have access to the x-rays: https://arxiv.org/pdf/2603.21687 (on a pre existing "large scale visual question answering benchmark for generalist chest x-ray understanding" that wasn't intentionally mess…

hallucination on steroids, wow. I had to read through the abstract to believe it:

"In the most extreme case, our model achieved the top rank on a standard chest Xray question-answering benchmark without access to any images."

Re: OpenAI’s o1 correctly diagnosed 67% of ER patients vs. 50-55% by triage doctors

#47

Earlier quoted context omitted.

I agree with you on this specific study, however, I can't really wrap my head about the fact that doctors will be better than AI models on the long-run. After all, medicine is all about knowledge, experience and intelligence (maybe "pattern recognition"), all those, we must assume that the best AI models (especially ones focusing solely in the medical field) would largely beat large majority of humans (aka doctors),…

> I can't really wrap my head about the fact that doctors will be better than AI models on the long-run. Nobody said that though? If the current trajectory continues and if advancements are made regarding automated data collection about patients and if those advancements are adopted in the clinic then presumably specialized medical models will exceed human performance at the task of diagnosis at some point in the fut…

Until medical models can contrive of unique diagnosis, this will not be true and cannot be true.

Medical models can absolutely get better at recognizing the patterns of diagnosis that doctors have already been diagnosing - which means they will also amplify misdiagnosis that aren't corrected for via cohort average. This is easy to see a large problem with: you end up with a pseudo-eugenics medical system that can't help people who aren't experiencing a "standard" problem.

Re: OpenAI’s o1 correctly diagnosed 67% of ER patients vs. 50-55% by triage doctors

#48

As a 37 year old male with 2 THRs I'm glad the AI was NOT used in my diagnosis. All the models that I used to look at my x-rays said nothing was wrong, even when adding symptoms. When adding age it said the patient was too young. (I was ~3 months away from wheelchair bound in those x-rays). The worst one was Gemini. Upload an x-ray of just the right hip, and it started to talk about how good the left hip looked like.…

All versions and levels of Gemini have terrible spatial reasoning. I don't know why. That kind of task seems to be simply outside of the abilities of the model.

Re: OpenAI’s o1 correctly diagnosed 67% of ER patients vs. 50-55% by triage doctors

#49
I'm surprised at both the article and the paper - both seem very hyperbolic. This is LLMs competing against doctors in a way that is heavily weighted in the LLMs favour, which does not represent clinical practice. These reasoning cases are not benchmarks for doctors, they are learning tools.

I think it's important to note that diagnosis also relies on accurate description of the patient in the first place, and the information you gather depends on the differential diagnosis. Part of the skill of being a doctor is gathering information from lots of different sources, and trying to filter out what is important. This may be from the patient, who may not be able to communicate clearly or may be non verbal, carers and next of kin. History-taking is a skill in itself, as well as examination. Here those data are given.

For pattern recognition from plain text, especially on questions that may be in the o1's training data, I'm not surprised at all that it would outperform doctors, but it doesn't seem to be a clinically useful comparison. Deciding which investigations to do, any imaging, and filtering out unnecessary information from the history is a skill in itself, and can't really be separated from forming the diagnosis.

Re: OpenAI’s o1 correctly diagnosed 67% of ER patients vs. 50-55% by triage doctors

#50
post #31

Earlier quoted context omitted.

I agree with you on this specific study, however, I can't really wrap my head about the fact that doctors will be better than AI models on the long-run. After all, medicine is all about knowledge, experience and intelligence (maybe "pattern recognition"), all those, we must assume that the best AI models (especially ones focusing solely in the medical field) would largely beat large majority of humans (aka doctors),…

> What is the specific capability (or combination of capabilities) that people believe will remain permanently (or at least for decades) where a top medical AI cannot match or exceed the performance of a good human doctor? Let's put liability and ethics aside, let's be purely objective about it. Being a human when a patient is experiencing what is potentially one of the worst moments of their life. AI could be a tool…

You commonly receive very close proxies for diagnoses through MyChart already when results come back from the lab.
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