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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

#411

Post by Paracompact »

IanCal wrote: post #368
Paracompact wrote: post #360

Earlier quoted context omitted.

"On two occasions I have been asked [by members of Parliament], 'Pray, Mr. Babbage, if you put into the machine wrong figures, will the right answers come out?' I am not able rightly to apprehend the kind of confusion of ideas that could provoke such a question."

Off topic but I have always felt this seemed like his misunderstanding rather than theirs. It’s an odd question, but it’s a very sensible point to make if Babbage has just told you this will solve the problem of mistakes in calculations - humans being involved at the start means human error still plagues the output.

Looking into his biography, it seems that he was indeed pitching the engine not as a means of efficiency, but as a means of avoiding mistakes in mathematical tables. It would have done Babbage well to insist he couldn't possibly solve all classes of mistakes, but would have solved a great many of them! "Why yes Senator, you are quite intelligent and handsome and make a fair point, allow me to give you the finer picture..."

Would have also been a fair point if Babbage had channeled his inner techbro and insisted it would directly replace human calculators; simple machines like Babbage's will chug along blindly on obviously erroneous data, but humans for all their sloppiness can often backtrack on errors.

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

#412

Post by nicksergeant »

unholiness wrote: post #408
nicksergeant wrote: post #355

Earlier quoted context omitted.

Interestingly LLMs are extremely bad at chess position _images_. I have to imagine if you give it positions in text it'd be pretty great but when I was learning chess and pasting images of positions in for analysis I couldn't believe how wrong it was. I actually thought it was looking at the board in reverse but even when pointing out problems it seemed completely incapable of understanding what it was missing (of co…

> I have to imagine if you give it positions in text it'd be pretty great Not at all? LLMs are a terrible match for the kind of analysis a chess engine does (scaled deep search, deeply trained position evaluations). It's just not that kind of tool.

I suppose that's also a good point!

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

#413

Post by garciasn »

rylando wrote: post #397
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…

As a rad tech, YOU TELL ‘EM DOC! I do like some uses of AI I’ve seen that help patients advocate for themselves or understand basic things like blood panel numbers, but it’s really bad at glazing people and leading them down medical rabbit holes kind of like the OP. You would think that the AI would point out that calcium is best demonstrated on Radiographs/CT imaging vs Ultrasound or something to that effect.

Semi-related: my father has complications from a motorcycle accident ~25y ago that crushed arteries in his leg coupled with diabetes (insulin / kept sugar at ~100 and his A1C was kept under 6.7 for ~15y). 6w ago had to have his toes removed due to dry gangrene; they eventually (2.5w ago) had to remove his leg below the knee because of the severe blood flow issues below the knee.

Between the toes and the below the knee amputation, there were no less than 15 different doctors and PAs / related personnel who COULD NOT COME TO A CONSENSUS. They would just tell my mother and I (PoA) the details; they refused to come up with a singular plan of action moving forward, leaving it up to us to make 'an informed decision,' something that's IMPOSSIBLE when you have to take up to 15 different opinions into consideration.

What exactly are we supposed to do as patients/family members when medical personnel cannot give reasonable paths forward and instead just throw a bunch of shit over the fence at you and tell you, "you decide what to do from here," regardless of how many VERY DIRECT conversations I had w/the 'care team' on doing better to provide a limited array of options and reasons/likelihood of 'positive outcomes'.

I'm used to dealing with a wide variety of stakeholders/SMEs in decision-making; it's my job to apply my extensive industry experience to present our clients with their options, ranked and reasoned. Doctors, in my experience and most recently with my father, clearly do NOT do that (I assume due to liability; but, no real idea, honestly). So; when dealing with LIFE CHANGING circumstances, what are we supposed to do except rely on what might be able to offer more analysis and option narrowing w/AI?

I certainly don't want to make the job of medical staff more difficult by putting out crazy theories I found on the interwebbernets through my own research, etc; but, when we're having to deal with uncertainty and insanity, what else can we do?

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

#414

Post by aspenmartin »

operatingthetan wrote: post #353
FromTheFirstIn wrote: post #329

Earlier quoted context omitted.

To acquire new knowledge and build your understanding. They don’t understand so they can’t learn

Thank you for saying succinctly what I could not. If your consciousness and knowledge fundamentally does not change from your ongoing experience, then you are not learning. This is how the LLM currently functions.

You’re describing the problem of continual learning. As I said their “consciousness” for lack of a better term and knowledge does already change from ongoing experience in context which is another of saying for only a short window, today. They are ephemeral, sort of, but that’s a temporary limitation.

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

#415

Post by fc417fc802 »

energy123 wrote: post #336
jeswin wrote: post #31

I would not trust AI on images. But I once had ChatGPT tell me that an MRI report was very likely to be incorrect based on the text, and offered a different diagnosis. Since it was semi insisting, I visited another doctor who made me do a retest. Long story short, ChatGPT was correct. Again, this is just one single person's experience. So not worth much.

Anecdote but I gave Gemini Pro an image of an individual with Herpes Zoster which the doctor said was something else. Gemini gave the correct diagnosis which allowed for correct treatment and cure. I don't understand why doctors don't prompt LLMs before saying wrong things. Is it ego? I can understand for radiology because you need a specialized convolutional network, but for more knowledge based things...

> I don't understand why doctors don't prompt LLMs before saying wrong things. Is it ego?

Either that or laziness I'd imagine. This isn't limited to LLMs. Expert digital assistant systems that you query have existed for a long time. A good physician will double check anything even slightly unexpected against one.

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

#416

Post by aspenmartin »

maxnevermind wrote: post #370
aspenmartin wrote: post #290

Earlier quoted context omitted.

It's not really a problem. We're out of natural tokens anyway. The future is synthetic verifiable traces (already the way we train coding agents).

> synthetic verifiable traces What does it mean, Is it like when somebody used some coding agent to develop a feature and later input prompts and a resulting PR can be used for training by a presumption that final PR was a correct implementation of a prompt?

Yea it’s rejection sampling, so you have an agent, you take a verifiable problem (people use lots of different verification signals but say unit tests etc) and have the agent attempt it K times. You accept the trajectories (all context, tool use etc, the entire log) that are positively verified and use these as training examples.

The trick is to find the examples that are just in between too difficult and too easy for the existing agent, these have the strongest training signals

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

#417

Post by aspenmartin »

FromTheFirstIn wrote: post #329
aspenmartin wrote: post #310

Earlier quoted context omitted.

That’s strange to me, what would you define as learning?

To acquire new knowledge and build your understanding. They don’t understand so they can’t learn

“They don’t understand” is a strong statement, maybe true but depends on what you mean by understand. What is your definition of this? I can’t think of a meaningful definition of “understand” that doesn’t apply to LLMs

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

#418

Post by aspenmartin »

operatingthetan wrote: post #312
aspenmartin wrote: post #304

Earlier quoted context omitted.

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.

“It sounds like you believe” is a question, inviting your clarification. I will continue doing that because it’s perfectly reasonable. Also “machines have no driving force to act in the world” is also a mysterious statement but because you reacted so badly to anyone questioning you I will just leave it at that

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

#419

Post by akoboldfrying »

ambicapter wrote: post #227
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…

> So an ultrasound report can state there are no calcifications while a plain radiograph can report the presence of calcifications without being inconsistent. Obviously very confusing to patients and people unfamiliar with medical jargon This is being overly nice, I think. Anyone who doesn't understand this is an idiot imo. You would have to assume that every type of diagnosis instrument has infinite clarity and is a…

> Anyone who doesn't understand this is an idiot imo

I disagree. A priori it's not obvious to a layperson whether or not a statement that uses unconditional phrasing is intended to be authoritative or conditional on something unspecified, like the resolution of the measuring device. This goes for any sufficiently technical field.

If you got the brakes checked on your car, and the mechanic did and told you there are no issues with them, and you then took your car to a different mechanic who did and told you there is a problem, you would not be an idiot for thinking that these conclusions contradict one another.

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

#420

Post by thewanderer1983 »

I was diagnosed with a rare blood disease called Essential Thrombocythemia (ET) which is part of a group of diseases called myeloproliferative neoplasms. This happened about three years ago. Recently, I decided to get a second opinion and my new specialist changed my diagnosis from ET to Polycythemia Vera (PV). She also highly recommended I quickly go and give blood to lower my haematocrit levels as it put me at a much higher risk of a blood clot. This is standard practice for people with PV but not people with ET. I decided to put the details into google AI in the same way that the original specialist used to diagnose me. Google AI predicted I very likely had PV instead of ET. I also asked Google AI how one could misdiagnose my condition with ET instead of PV and google correctly explained how. My specialist had used my high platelet count and blood test that came back with a JAK2 mutation then after a bone marrow biopsy to incorrectly diagnose me with ET. My high hemoglobin levels should of been checked by my first specialist as an indication of PV not ET. Only the second specialist picked up on this. Google AI took five seconds, and is free. The specialists costs $$$ and took weeks.
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