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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

#491

Post by DrewADesign »

BrokenCogs wrote: post #482
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…

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

I’ll bet they’ve got a debilitating case of engineer’s disease, too.

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

#492

Post by themantalope »

Radiologist. I don’t read MR shoulder exams in my day to day practice, but from the few pictures shown , I can’t conclusively disagree with the original report.

These models are generally terrible at reading medical images. The amount of public training data on the internet compared to the number of scans a radiologist reads in training is minuscule. There’s obviously a ton of medical images in general but very few, and even fewer along with a report are available on the internet publicly for download.

There are vision language models coming out of research labs that are excellent in describing and localizing findings. Still at the level of a 1st or 2nd year radiology resident, but as we all say - this is the worst the models will ever be.

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

#494

Post by VoidWhisperer »

sxg wrote: post #26
tiahura wrote: post #16

Earlier quoted context omitted.

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

They do. Ultrasound in orthopedics is a relatively newer field, and there aren't quite as many sonography techs and radiologists experienced in reading these studies, which is likely why you don't see it offered more widely. Edit: I should mention that ultrasound is basically unusable for evaluating bones. Sound waves can't penetrate bone, and so you end up just seeing a huge black void. That's a huge orthopedics use…

Serious question: If the bones specifically show up as black on ultrasound but the surrounding (muscle, etc) don't, wouldn't that be an option that could be used to try to determine a broken/fractured bone without the radiation from an xray? Or are the gaps in those cases usually too small to pick up?

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

#495

Post by mrlongroots »

scheme271 wrote: post #484
mrlongroots wrote: post #477

Earlier quoted context omitted.

> 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.

Today's limits are known and undisputable. Tomorrow's limits are a promise: some promises over-deliver, others under-deliver. :)

Regardless, to bring the discussion back to the claim at hand: at all points in future, we will need the ability to reason under partial information. "Absolutely flawlessly complete diagnostics" is an asymptotic goal we get closer to but never reach. This is both very doable for a disciplined human, and very hard to outsource completely to an LLM. Treated as tools operatored by competent users, they are magical. But they can not outperform their user.

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

#496

Post by Fr0styMatt88 »

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.

Exactly. I was about to reply to the comment with “perfect example of not knowing what you don’t know” in terms of self-diagnosis.

My internal model is/was “if the scan wasn’t set up / can’t detect the thing, why would the statement be present at all?”.

That implicit assumption is really subtle.

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

#497

Post by Fr0styMatt88 »

aforwardslash wrote: post #451
nkrisc wrote: post #437

Earlier quoted context omitted.

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…

This is - by far - the most stupid stuff I've read on the internet the past few days. They didnt find cancer either (as well as a plethora of diseases that could be related to the symptoms), and afaik its not in the report. Yah you can argue that the tool is not ideal for that diagnostic, yadda yadda. I get it, and in the end I agree with the subtle difference you highlight, because it is something that makes sense t…

I think it’s the combined depth AND breadth of knowledge that can be captured by AI models that is going to make them way better than most humans at this kind of stuff.

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

#498

Post by simonreiff »

pickleRick243 wrote: post #153
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)

It's like people who expect ChatGPT to be really good at chess because chess engines with super-human performance have been around for decades, so obviously the latest frontier LLM that took billions to train should find the task trivial. Actually, I'm curious what ChatGPT 5.5's ELO is- I wouldn't be too surprised if it's 2000+ just from its basic understanding of chess principles from all the content it has digested…

ChatGPT is completely unplayable at chess on its own. It's unable to keep track of the state of the chess position and therefore will make an illegal move within about 10-12 moves. I would put GPT-5.5's rating at 400, since it can't even make legal moves reliably.

I've tried to pay chess with GPT-5.5, even played it again tonight, allowing it to use `python-chess` to keep track of the state of the position and to get a list of legal moves at each turn, so that it was fair. I also gave it blindfold odds, again to make it a fair fight, but it was not even close. GPT still isn't better than maybe 1000 Elo, maybe 1200 tops. Even with what amounts to being able to see the position and also being unable to make an illegal move, GPT-5.5 hangs material left and right, doesn't make a plan, and got smoked even when I gave it blindfold odds, to the point it's boring for me to play even under those conditions. I'm not sure it's better than whatever the GPT model was that was out about 8 months ago. I also thought it might be somewhat better than a beginner due to reading chess books, but no, it's complete garbage at playing chess, not even average-level skill.

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

#499

Post by Fr0styMatt88 »

Paracompact wrote: post #360
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…

"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."

Actually, I would be really pleased if a member of Parliament asked that. That shows a level of deeper consideration.

Isn’t there a saying about there being no stupid questions, only stupid answers or something?

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

#500

Post by Fr0styMatt88 »

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.

Your see this in coding agents too. The only times so far I’ve really seen Opus tie itself into a knot is where I’ve asked it to fix something that I thought was broken but actually wasn’t in the way I had described. It will bias towards your description (I’m guessing because that’s the most recent context it has?).
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