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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

#431

Post by throwawayffffas »

lostlogin wrote: post #139
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.

Sure but claude and ChatGPT are not Siemens 'Deep resolve'.

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

#432

Post by alistairSH »

huhtenberg wrote: post #218
alistairSH wrote: post #129

Earlier quoted context omitted.

On the flip side, when I had rotator cuff issues, the surgeon recommended months of physiotherapy before resorting to the knife. And it worked. And by weight training regularly with a focus on correct shoulder movement, the pain stays away. It really seems like if you, as a patient, go looking for a quick fix, that’s what you’ll be offered. And if you educate yourself a bit and then go t for the best fix for you, you…

What did you have exactly? With calcifications, physio without the shockwave component definitely doesn't allow going back to the normal gym routine. It's just not enough.

Garden variety inflammation with some minor tearing, exacerbated by weakness/instability.

Strengthening with PT kept the joint stable enough to stop rubbing and allow the inflammation to clear.

And as long as I stick to a regular gym routine that includes rotator cuff work, it doesn’t recur (and did the few times I lapsed).

But absolutely, PT doesn’t fix everything. Bit for a lot of things, it’s worth trying - but it might also means a lifetime of altered habits to keep whatever injury/problem from recurring.

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

#433

Post by sota_pop »

microgpt wrote: post #194
lostlogin wrote: post #139

Earlier quoted context omitted.

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.

Sorry? You use AI to hallucinate medical images and that's good?

Most upscaling and super-resolution techniques I’ve seen use various implementations of interpolation; typically nearest-neighbor approaches. Although I don’t work in the medical field and haven’t checked in on the research at least since ViTs overtook CNNs for other areas of computer vision.

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

#434

Post by UltraSane »

AceJohnny2 wrote: post #117

> There's something incredibly peaceful about being in the hands of an expert you trust. [...] AI can absolutely shatter that feeling in an uncomfortable way [...] but I don't know if I can fully trust AI either. This really is key. We know we can't trust the AI, but at the same time we're also more comfortable asking the AI for clarifications or confronting it. Not having a time-bound appointment or paying by the ho…

> There's something incredibly peaceful about being in the hands of an expert you trust

This is the primary business model of enterprise IT and is why companies pay so much for 4 hour disk replacement.

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

#435

Post by alistairSH »

preg_match wrote: post #229
alistairSH wrote: post #129

Earlier quoted context omitted.

On the flip side, when I had rotator cuff issues, the surgeon recommended months of physiotherapy before resorting to the knife. And it worked. And by weight training regularly with a focus on correct shoulder movement, the pain stays away. It really seems like if you, as a patient, go looking for a quick fix, that’s what you’ll be offered. And if you educate yourself a bit and then go t for the best fix for you, you…

Physical therapy is very often under recommended in the US under the belief that insurance won’t cover it. They might. And, for anyone reading, you don’t even need a referral for the first 30 days in some states. Physical therapy is for more than just hip replacements and car accident trauma. Like regular therapy, a lot of “normal” people can benefit from it. It’s also not just stretching.

Interesting. I’ve never not had some PT coverage. The copays kinda suck, but major surgery tends to add up as well, so…

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

#436

Post by resonious »

garciasn wrote: post #413
rylando wrote: post #397

Earlier quoted context omitted.

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 kne…

This lines up with my experience with my mother, though it played out differently. In her case, she would switch doctors every ~5-10 years and each time they'd basically say everything the previous doctor said was wrong. First it was "you have Lupus", second it was "actually it's some other autoimmune disease", then it was "actually whatever you had has been in remission for some time now and you've been taking brain-numming medicine for no reason." Then it was "you have cancer", "it's a rare one", and "oh turns out the brain-numming meds have a correlation with rare cancers". The cancer part was handled well (albeit unsuccessful) though. After such a bad time with rheumatologists, I was shocked by how competent people were when it came to cancer.

All of the above was intertwined with brief stints with doctors that would just berate her for being a painkiller junkie, even though she hated the stuff and just wanted to find/fix the problem.

Kind of a rant, really. I'm not sure how to tie it back into AI. I do wish we had AI at the time so that we could at least cross-check, but I also understand that doctors are already sick of patients self-diagnosing on the web and that AI probably just makes that worse. At the same time, if our medical system could catch up a bit (more doctors? less corruption/paperwork? not sure what it needs) then maybe people would be less inclined to take matters into their own hands.

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

#437

Post by nkrisc »

MattyMc wrote: post #425
ambicapter wrote: post #227

Earlier quoted context omitted.

> 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 don’t think that’s true. Avoiding this mistake requires knowing that an ultrasound may not detect calcification. For a patient reading their own report, I don’t think that’s intuitive. I would expect most people to read “no calcifications” and assume that their joint has no calcifications.

Most people should have learned at a young age that absence of evidence is not evidence of absence. My 8 year old understands this. After all, you can rarely ever prove something does not exist, only that it is unlikely to exist.

If a report states that X was not found, it does not mean X did not exist, it means it was not found.

What may be lost on the layperson is the nuance and understanding of how thorough or not a particular scan is and how much weight to give the findings and thus the odds that the report is correct.

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

#438

Post by throwaway762 »

thewanderer1983 wrote: post #420

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 mu…

Interesting. I am also diagnosed with ET (from platelet counts, pathology report noting abnormal platelet morphology, and JAK2 mutation from a marrow biopsy). What made you seek a second opinion?

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

#440

Post by Eufrat »

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.

I feel like the promise of these models is to help people make more informed decisions. Improving the knowledge economy and general understanding.

The problem is these are just statistical models at the end of the day, so you need to know something to be able to identify the errors. You can’t let them really be autonomous and you also can’t really have people turn into glorified approvers. If the machine is correct 89% of the time, you cannot make people responsible for that 11%. It’ll just cause automation fatigue.

tl;dr: the actual use cases of these LLM (or generative AI in general) is rather limited, so it is offensive how much hay has been given to them eating the entire capitalist system. They are not fit for purpose.

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