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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

#481

Post by marcus_holmes »

Aurornis wrote: post #167
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…

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…

In my day job we tried creating a credit assessor tool using LLM as the credit assessor.

It did great, generated a report on the assessed business that was incredibly detailed and plausible.

Then I started running tests and getting into the details, and found that if you ran the same report on the same data, it generated completely different, still very plausible, results. I could run the same source data through the assessment process 10 times and get 10 very different results. We had to can the project and go a different route.

LLMs are designed to produce plausible results, not factual results. We can fix this when using them for software dev by using linters and tests (though we've all had the experience where the LLM invents an API endpoint). I would not trust raw LLM output in any situation where that kind of testing and verification capability isn't present.

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

#482

Post by BrokenCogs »

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…

This comment sounds like it's written by someone who doesn't interact with real people very often

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

#483

Post by prirun »

mring33621 wrote: post #465
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.

i'm sorry, but AIs only "know" about stuff that they have been trained on. If we would allow AIs to be trained on the petabytes of medical data hidden in hospital systems, they would most likely be much better at diagnosing illnesses and conditions than the average doctor. (Justifiable) Privacy around medical records so far prevents this. You think you're cheering for humans, but in fact you are gatekeeping healthcar…

I dunno... if we gave an AI all of these medical records as training data, wouldn't it be trained to give the same answers as the doctors already gave, without knowing whether those diagnoses were correct or not?

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

#484

Post by scheme271 »

mrlongroots wrote: post #477
scheme271 wrote: post #472

Earlier quoted context omitted.

There's quite a few diseases and conditions that don't have definitive tests. For example, alzheimer's and parkinsons are diagnosed based on medical history and symptoms. With alzheimer's an autopsy can tell for sure but that's not much help for a patient. I'm sure there's other things out there with similar situations. Hard to come up with "the one true" diagnosis with an definitive way to determine it.

> With alzheimer's an autopsy can tell for sure but that's not much help for a patient. Ok let us unpack this statement. For your point to hold, I would have to be saying "all kinds of practical diagnostics are invented now. No progress can be made in better diagnostics". If Alzheimer's can be validated by slicing open a dead patient, there is a causal mechanical explanation for the disease. If we can not confirm tha…

There might be "one true diagnosis" but there's no reason to believe that we'll have practical diagnostic tools to get it. If we need to sample the brain chemistry to diagnose a neurochemical disorder, it's probably not too useful in a clinical setting. The world makes no guarantees that we will be able to differentiate between certain situations with tools that we can realistically access and build.

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

#485

Post by scheme271 »

Esophagus4 wrote: post #480
scheme271 wrote: post #317

Earlier quoted context omitted.

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.

I dunno, I could see it working. I do something similar with reviewing code: I have one agent write the code and another reviews it, then they go back and forth for a bit improving the code. Seems to yield better results than one agent alone. Seems like a similar principle.

The difference is that in the code situation, you can run unit tests on the code, compile it, etc. Unless your LLMs are ordering diagnostics and reviewing the results, there is no further information that the LLMs have on the situation. Having a second LLM review the first is counterproductive, if the 2nd LLM is better, why not use it directly? If not, then what prevents it from sending the first on some incorrect tangent?

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

#486

Post by linsomniac »

yosame wrote: post #426
linsomniac wrote: post #327

Earlier quoted context omitted.

You don't seem to need to worry, second gen tablets seem to be fine: https://claude.ai/share/9c6eaaa5-e734-4267-b540-ddc0188daf6b

Posting a claude chat is not actually helpful. The chat doesnt't even cite any sources. I think this post is a decent summary, the answer is a soft maybe: https://www.health.harvard.edu/mind-and-mood/should-i-worry-... Second-gen tablets might increase dementia risk by a small-to-medium amount (there's almost certainly still a small degree of CNS activity, and we don't know what causes dementia in the first place), b…

>Posting a claude chat is not actually helpful. The chat doesnt't even cite any sources.

You didn't read it very closely, I posted it specifically BECAUSE it cites sources (14 of them by my count).

edit: I sit corrected, if I open it in Incognito mode the citations are removed. That's not very useful.

edit 2: Here is a gist with the citations: https://gist.github.com/linsomniac/6d2bdeb0f63cf504354b067e2...

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

#487

Post by amluto »

linsomniac wrote: post #325
nostrebored wrote: post #97

Earlier quoted context omitted.

Daily allergy tablets are associated with huge increases in early onset Alzheimer’s. Glad you found something that works, but might be good to get some of the allergen injections :)

That seems to be only for first generation, drowsy-making, tablets. Second gen formulas don't cross over the blood/brain barrier. https://www.myalzteam.com/resources/zyrtec-and-alzheimers-me... There IS one year-old finding that suddenly stopping Zyrtec after daily 3-month use may lead to nasty itching, and if that happens you can re-start and then taper off. https://www.fda.gov/drugs/drug-safety-communications/fda-r…

Zyrtec/cetirizine is a weird one. Everyone seems to agree that it is a second-generation antihistamine. The FDA seems to play along. But there is no particular shortage of anecdotal evidence of people who find it quite sedating (hi there!), there are some papers questioning its status [0], and the FAA puts it in a category with diphenhydramine, not with loratadine and fexofenadine [1].

[0] https://pmc.ncbi.nlm.nih.gov/articles/PMC1118461/

[1] https://www.faa.gov/ame_guide/media/AllergyAntihistamineImmu...

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

#488

Post by BurningFrog »

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

Even if this is true, so what?

Idiots get sick at least as often as others, and the medical system needs to work as well as it can for that population too.

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

#489

Post by DrewADesign »

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…

I don’t think people are idiots if they don’t understand how a normally intelligent person might not intuit that. I do think they have a seriously underdeveloped theory of mind.

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

#490

Post by FromTheFirstIn »

aspenmartin wrote: post #417
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

“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

We’re in all the same threads lately!
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