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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

#311

Post by chasebank »

tsoukase wrote: post #207

Medical opinion will remain one of the last frontiers of LLMs. There so many critical factors that are inappropriate for them. They cannot perform a clinical exam, they have to collect the needed exams and most importantly a life might be at stake (OK, you cannot die from a shoulder problem but you can become handicapped forever). All that said, as a doctor I am totally open and even happy when a patient refers they…

Do you think you would ever use LLMs in tandem in your practice to help diagnose and treat?

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

#312

Post by operatingthetan »

aspenmartin wrote: post #304
operatingthetan wrote: post #281

Earlier quoted context omitted.

I think you're mildly obfuscating the issues at hand by diving too deeply into philosophical questions. It's quite simple, the agency that the LLM appears to have is actually your own. Without a prompt an LLM does nothing. It has no thoughts between prompts about you or your problems.

You are implying definitions that don't seem to be mainstream; thinking is internally manipulating information to reason, infer, plan, solve problems, and form judgments or beliefs. Also -- "Without a prompt an LLM does nothing. It has no thoughts between prompts about you or your problems." it sounds like you paint this like it's something fundamental? It isn't. Nothing is stopping you from streaming information to…

The machines have no driving force to act in the world. That is fundamental for humans.

Twice in your comment you suggest things that you think that I believe, please do not do this.

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

#313

Post by jstummbillig »

torben-friis wrote: post #106
jstummbillig wrote: post #87

Earlier quoted context omitted.

No, not anytime someone is an actual expert at anything, AI output appears insufficient. That is why experts in various fields use AI. Then to say "Aha, but all of that is AI psychosis" makes obviously no sense: Why would we trust experts when they offer critique but not when they say "this is helpful"? Overall: People are not insane. AI makes mistakes and, often, fails completely. AI also helps them do things better…

How many times have you seen an expert go "yeah these results are good consistently enough for a non expert to trust them without expert assistance"? There is a huge difference between having a chance of a good result, which can be useful for experts able to filter out the bullshit, and consistent success. I would generate code as a helper, I would never allow a guy from marketing to merge unreviewed AI code.

> How many times have you seen an expert go "yeah these results are good consistently enough for a non expert to trust them without expert assistance"?

But see now we are talking about something else entirely than the claim that I found dubious, which was: "Anytime someone is an actual expert at anything, AI output appears insufficient or incomplete or outright misleading."

Consistently good enough !== anytime insufficient

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

#314

Post by linsomniac »

braiamp wrote: post #251
linsomniac wrote: post #91

~2 years ago I used ChatGPT "deep research" to investigate a chronic sinus infection I'd been fighting for ~3 years. After seeing 3 GPs and 3 visits with an ENT, I fed all the observations I had into the AI. In particular, I couldn't get the ENT to explain why he visually saw, via a scope, evidence of allergic reaction in my sinuses, but then later concluded, after an allergy test, that it couldn't be treated via all…

Ok, there's a lot to unpack here and you really had the deck stacked against you. First, lets go from the top, once a test says X, disproving that X is really hard. And that's not unique to the medical profession, it's inherent to all humans and we suck at revisiting or revising our decisions, much less at looking at the possibility to even reverse it. Which moves us to the next two issues: liability and time. Any mo…

>before they even have a case with you

My problem is that I needed information from 2 ENT visits to feed into ChatGPT to get that study. On the first visit he scoped my sinuses and immediately said "I can see evidence of allergic reaction, see those white bumps?". On the second visit I got an allergy stick test and it came out negative.

Those helped lead to that NIH study. It would have been very hard to have walked in with that study in hand.

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

#315

Post by chiply314 »

operatingthetan wrote: post #286
aetherson wrote: post #279

Earlier quoted context omitted.

You're confusing the training method with the internal process. If I had you repeatedly attempt to learn how to make believable completions of partial documents about a given topic, you would eventually learn things about that topic and could use your knowledge to create more believable completions of documents about that topic.

LLMs do not learn. You put it out to pasture and create a new one. "Memory" in a session is essentially a context window party trick.

They already learned. A lot or basically everything evern written and available digital.

And context window work very well. You can 'teach' an llm a new programming lanuage and other things through it.

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

#316

Post by operatingthetan »

goodpoint wrote: post #307
aetherson wrote: post #279

Earlier quoted context omitted.

You're confusing the training method with the internal process. If I had you repeatedly attempt to learn how to make believable completions of partial documents about a given topic, you would eventually learn things about that topic and could use your knowledge to create more believable completions of documents about that topic.

believable != true

A very important callout. It's the crux of the whole thing really. Humans are easily susceptible to deception by statements that are structured to be believable.

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

#317

Post by scheme271 »

Esophagus4 wrote: post #287
Aurornis wrote: post #167

Earlier quoted context omitted.

I have multiple LLM subscriptions at any given time, plus an array of local models. When I ask a question outside of my domain of expertise I like to ask all of the LLMs I have access to. I also create separate sessions and ask the same question multiple ways. It’s revealing to see how many different and contradictory answers I get, most of which are presented confidently. The last time I ran a medical question throu…

Have you ever let the LLMs “discuss” with each other to see if that would give better answers? You might end up with the answer from the most persuasive LLM, but you might also end up with better results. Wonder if there is a paper out there on this.

The problem is how do you know whether the answer is just the most persuasive or actually the most accurate one? It's hard to figure this out without domain knowledge.

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

#318

Post by ForceBru »

operatingthetan wrote: post #281
ForceBru wrote: post #252

Earlier quoted context omitted.

What's "thinking"? What's "agency"? What's "human-like agency"? If "agency" is making decisions and performing corresponding actions in the real world, then LLMs most definitely LOOK LIKE they're making decisions (what's the next token? which tool to use? what's to say, in general? what idea to convey?) and performing actions (tool use). Can we tell whether they are ACTUALLY making decisions? Well, are the people aro…

I think you're mildly obfuscating the issues at hand by diving too deeply into philosophical questions. It's quite simple, the agency that the LLM appears to have is actually your own. Without a prompt an LLM does nothing. It has no thoughts between prompts about you or your problems.

Yes, I'm diving a bit too deeply because I don't really know what "thinking" is and therefore I don't understand how we can so confidently say that LLMs don't think, even though they definitely LOOK like they're thinking. They even have a "Thinking" section in their responses! If I say that a rock doesn't think, it's pretty convincing: does a rock look like it's thinking? No — it doesn't even do anything! But an LLM does look like it's thinking, at least while generating a response. When it's "offline" it's just a bunch of "dead" bytes, sure.

So when it's not active, not responding to a prompt, it's of course not thinking. I'm pretty sure nobody actually questions this. Is your computer "thinking" when it's powered off? Can a piece of metal think? Probably not. So there are no thoughts between prompts, this seems obvious.

Thus, this is a question of "discrete time vs continuous time". LLMs "live" from prompt to prompt. Humans are alive continuously. In some sense, we're prompted by a lot of things all the time. As I'm writing this, I'm seeing stuff, I'm hearing stuff, I can feel various parts of my body, I'm thinking about my problems, my goals, other people's problems and goals, etc. When I'm in a sensory deprivation tank, my brain keeps "entertaining" me by "self-prompting", like a recurrent neural network (I guess it literally is a massive RNN).

So it seems like your definition of "thinking" hinges upon the LLMs being discrete-time and single-threaded (can't think about multiple things in parallel).

IMO a more interesting question is whether an LLM is thinking WHILE IT'S GENERATING A RESPONSE, while it's "alive".

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

#319

Post by uecker »

lostlogin wrote: post #302
uecker wrote: post #219

Earlier quoted context omitted.

It is not really the same as LLMs. I wouldn't call it AI. And I wouldn't say "makes up". I work in this field and this is certainly based also in part on my research.

‘Makes up’ is inaccurate for sure. But it’s not strictly true to call it acquired data either. After years of collecting artifacts and errors, I have more and more respect for the tool. But it’s jarring. I open a sequence, decrease the acquired resolution, add the AI and get a scan that’s quicker and higher resolution. It’s an amazing time to be an MR tech.

It is amazing. It is the result of two decades of research in image reconstruction algorithms. The machine learning is part of it, but that it is sold as "AI" has probably more to do with marketing.

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

#320

Post by perching_aix »

appplication wrote: post #55
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…

This is the root of AI psychosis. There’s a lot of unpack here, and I won’t go too deep because you can’t really have a discussion with affected folks because their fundamental basis is not evidence, it’s belief. It is weirdly religious in a way, because if you were to present contrary evidence (e.g. experts in a field weighing in about how plausible sounding responses are bunk), you would only be told you don’t beli…

> There’s a lot of unpack here, and I won’t go too deep because you can’t really have a discussion with affected folks

Do you think it is any more possible to have a proper discussion with someone who preemptively paints the other person as mentally ill? Or someone who preemptively victimizes themselves?

Cause I don't think these are the hallmarks of an honest discussion. See also the entire past decade of political discourse.

Like, consider this:

> It is weirdly religious in a way, because if you were to present contrary evidence (e.g. experts in a field weighing in about how plausible sounding responses are bunk), you would only be told you don’t believe enough in the long term potential and capabilities.

A trivial counter to this is that you can just be an expert at something (e.g. your own work), use the damn thing yourself (professionally), and evaluate the outcomes for yourself. Then maybe remark "LLM good".

Now you come and remark "LLM bad", and point at random "evidence", either of outright other workloads, or even the one at hand: you're asking someone to reject the reality they've already experienced, entirely based on the assumption that they're "merely religious" or "in psychosis". You tell me if that's any more epistemically rigorous and sensible than their story.

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