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I used Claude Code to get a second opinion on my MRI

antoine.fi

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Re: I used Claude Code to get a second opinion on my MRI

#131

Post by lostlogin »

engeljohnb wrote: post #95
sxg wrote: post #6

I'm a radiologist but can't really weigh in without seeing the full 3D MRI dataset. Regarding this point: > They performed shockwave therapy on my shoulder even though a recent clinical practice guideline says clinicians should not use or recommend shockwave therapy for rotator-cuff tendinopathy without calcification; I was told during ultrasound that there was no calcification. Ultrasound isn't a great way to assess…

> I'm a radiologist Any comment that doesn't start with this or similar qulaification should be taken with a grain of salt (yes, including this one). Medical imaging is one of those things everyone thinks is simple because they don't know what they don't know. I'm a cardiac sonographer, and I have to assume radiologists hear at least as many eye-rolling takes on AI coming for their job as I do.

Ahh, AI is coming for your job.

Full sarcasm, is there one that’s that’s more immune?

Re: I used Claude Code to get a second opinion on my MRI

#132

Post by GTP »

suttontom wrote: post #113
rafterydj wrote: post #15

I feel like I'm going nuts. There are other commenters saying this is a good practice they've also done for other injuries. You are saying you are an actual radiologist and immediately clock the problems with its advice. I have seen this pattern over and over again. Anytime someone is an actual expert at anything, AI output appears insufficient or incomplete or outright misleading. It is only when you do not know wha…

Your instinct is correct, and in a lot of cases it's true. However, I've heard from enough doctors by now (a cardiologist, psychiatrist, and epidemiologist/former physician) that they use medical LLMs and find them extremely helpful, mostly as a way to either bring up knowledge they'd forgotten about or as a way to learn something new and then verify it. I'm extremely skeptical about LLMs in general and the connectio…

Probably this is the point, and it's a point that has been brought up a lot of times in the past, maybe less in recent times: you need to know the things you're applying an LLM to. In this way, you can keep the good outputs while having the expertise to discard the bad ones.

Re: I used Claude Code to get a second opinion on my MRI

#133

Post by darkwater »

nitwit005 wrote: post #86
willsmith72 wrote: post #64

Earlier quoted context omitted.

True, but this was a problem long before AI (read this article, met this guy at a conference who told me x, my boss said blah) AI probably exacerbates it but crappy managers exist regardless

Before maybe you had to deal with someone hiring schetchy consultants once in a while, but now the managers have a limitless well of dubious answers to draw on at any time.

But now you have a new tool in the upmanagement toolbox: subtlely tell them to implement their idea in prod with Claude Code, and see it for themselves.

Re: I used Claude Code to get a second opinion on my MRI

#134

Post by scrollop »

tiahura wrote: post #16
sxg wrote: post #6

I'm a radiologist but can't really weigh in without seeing the full 3D MRI dataset. Regarding this point: > They performed shockwave therapy on my shoulder even though a recent clinical practice guideline says clinicians should not use or recommend shockwave therapy for rotator-cuff tendinopathy without calcification; I was told during ultrasound that there was no calcification. Ultrasound isn't a great way to assess…

Why isn’t diagnostic ultrasound used in orthopedics? They inspect fetus hearts and other organs everyday, why not shoulders? Seems much cheaper and faster.

We order ultrasounds all the time for shoulders (for like soft tissue issues; for trauma, you'd start with an xray). For other joints, such as the knee, MRIs are a better choice (unless htere has been substantial trauma, in which case xray initially or further), though more expensive, unless you're excluding a Baker's cyst, in which case an ultrasound is fine.

Since MRIs are more expensive, private doctor's might order them instead of an ultrasounds.

(I'm a doctor)

Re: I used Claude Code to get a second opinion on my MRI

#135

Post by frereubu »

sxg wrote: post #61
whatever1 wrote: post #49

Earlier quoted context omitted.

So if you want to do a surgery but you don’t see any surgeons around you ask a grocery butcher to have his way?

In certain circumstances, the answer is yes. If an airplane's pilots are incapacitated, do you simply give up and crash the plane because there are no other pilots on board? Or would you rather have someone on the ground try to coach a passenger into at least attempting to land the plane?

That's an extreme edge case, which I don't think is in the context of the concerns in this thread.

Re: I used Claude Code to get a second opinion on my MRI

#136

Post by jancsika »

sxg wrote: post #61
whatever1 wrote: post #49

Earlier quoted context omitted.

So if you want to do a surgery but you don’t see any surgeons around you ask a grocery butcher to have his way?

In certain circumstances, the answer is yes. If an airplane's pilots are incapacitated, do you simply give up and crash the plane because there are no other pilots on board? Or would you rather have someone on the ground try to coach a passenger into at least attempting to land the plane?

You can choose a) a calm, level-headed passenger who knows they aren't a pilot, or b) a calm, level-headed passenger who almost has their pilots license but has a medical condition that prevents them from admitting when they lack certain knowledge.

Who do you choose to be coached by an expert on the ground?

Re: I used Claude Code to get a second opinion on my MRI

#137

Post by qnleigh »

rafterydj wrote: post #15

I feel like I'm going nuts. There are other commenters saying this is a good practice they've also done for other injuries. You are saying you are an actual radiologist and immediately clock the problems with its advice. I have seen this pattern over and over again. Anytime someone is an actual expert at anything, AI output appears insufficient or incomplete or outright misleading. It is only when you do not know wha…

Totally agree. I'm a scientist, and like most scientists I have some specialized skills that most of my colleages don't. AI has empowered them to learn and build things that they might have otherwise needed me for. But there have been quite a few cases where it led them very far down a wrong path. This has started happening way more often in the last few months.*

We've known since the beginning that AIs confidently say incorrect things. But now that they can speak confidently about very complex topics, and mostly say correct things, we are letting our guard down and lots of subtle falsehoods are slipping through.

*In one case, I was able to put things back on track because the AI suggested my colleague talk to me; somehow it figured out we were co-workers.

Re: I used Claude Code to get a second opinion on my MRI

#139

Post by lostlogin »

rasmus1610 wrote: post #116

As a radiologist I have found Claude and ChatGPT to be absolutely terrible at MRI and I would not trust it one bit. It has its merits if you need to research stuff that is more text based, but radiological images is just something that they cannot interpret good enough (yet)

AI makes up for its poor reporting by enhancing the images.

Current Siemens MR software ‘Deep Resolve’ makes up the signal (adding about 50%), then makes up every second pixel, and then, for 3D sequences, makes up every second slice. It’s locking about 59% of the time off each sequences. And it’s really really good. I’m an MR tech.

Re: I used Claude Code to get a second opinion on my MRI

#140

Post by close04 »

sxg wrote: post #61
whatever1 wrote: post #49

Earlier quoted context omitted.

So if you want to do a surgery but you don’t see any surgeons around you ask a grocery butcher to have his way?

In certain circumstances, the answer is yes. If an airplane's pilots are incapacitated, do you simply give up and crash the plane because there are no other pilots on board? Or would you rather have someone on the ground try to coach a passenger into at least attempting to land the plane?

A passenger crashing the plane while trying to avoid a certain crash doesn’t make things any worse. An incompetent doctor trying to save you from certain death can make things so much worse. It’s all about weighing the best/worst outcome compared to where you are now.
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