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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

#551

Post by mindslight »

w10-1 wrote: post #322
ricardobayes wrote: post #7

That might be doctors new nightmare: people who second guess everything with AI. Previously it was "google your symptoms".

It's not just the second-guessing. It's the getting in the ballpark but striking out: explaining in detail why they are not correct. A little bit of patient knowledge requires a tremendous amount of doctor time to explain away the ignorance. It's a 180 for me: While I believe doctors should explain diagnosis or treatment decisions when asked, I don't believe they should be taxed with explaining away alternatives. In…

Explaining diagnosis and treatment recommendations decisions inherently involves explaining away the alternatives. In this world where patients are ultimately responsible for our own care, explaining your rationale is a straightforward part of the job - otherwise there is nothing for patients to base their decisions on apart from how the options make them feel. If visits haven't been allotted enough time to get the job done, then that is something you need to take up with health plan bureaucrats rather than taking it out on patients.

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

#552

Post by i4i »

"A 2026 Finnish study published in JAMA Internal Medicine that used magnetic resonance imaging (MRI) scans to look at patients’ shoulders found that 99% of Finnish adults over 40 have at least one rotator cuff abnormality." https://brainlenses.substack.com/p/abnormality

Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging https://jamanetwork.com/journals/jamainternalmedicine/fullar...

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

#553

Post by ricardobayes »

dheera wrote: post #456
tuvix wrote: post #42

Earlier quoted context omitted.

There’s more than two options here. It was already difficult to deal with self diagnosis for doctors, now we have a machine that outputs recommendations, and does it with confidence whether it’s correct or not. The same issues that were present with search-engine self diagnosis are still present with LLMs. If you provide Google with an incomplete list of symptoms and can’t interpret the information you find correctly…

Everyone on the internet loves to put doctors on a pedestal, but I think upwards of 30% of my doctor visits have been misdiagnosed. There's a reason I ask AI about absolutely everything medical and there's a reason I keep extra quantities of prescription medications around for emergencies. I've saved my own ass a lot more times than the doctors have, thanks to good doctors not being available.

That works in your case because you likely already have an analytical mindset, can reliably discard or research information further. Same thing why AI is in an enabler for people having already some skill. But it can be very dangerous or misleading for people blindly believing all output.

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

#554

Post by ricardobayes »

b800h wrote: post #340
weatherlite wrote: post #13

Earlier quoted context omitted.

Nightmare because they're always right and the A.I second guessing is always wrong, or because they just don't like to be second guessed?

Well it was a nightmare for my mother's do-nothing GP surgery in the UK. She had several conditions which were being handled completely separately without central coordination, and her health was in serious decline. We went in with a list of 20 AI-generated questions based on her conditions and treatment (which I was able to screen as I have a bio postgrad, but not medical training), including those related to NICE g…

UK has probably the worst healthcare in the developed world. In part perhaps due to UK blindly accepting any kind of medical degree (doctors and nurses) from all over the globe. Yes, you heard that right, they verify the validity of the degree but there is no formal standardized exam to sit to practice in the UK.

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

#555

Post by shiandow »

I read the article, I read the AI's verdict, I read the comments here, and I still don't know if OP does or does not have a tear in their tendon!

The AI doesn't present evidence I can understand, it doesn't even present a plausible explanation why someone could conclude it is a tear.

The main things that made OP suspicious are the possibly unnecessary shockwave therapy. Which seems harmless. And using a homeopathic gel that I would classify as more of a herbal medicine because it contains several ingredients I know people use for shoulder pain, and some even in concentrations that might even have an effect.

If this is the best rebuttal AI can come up with I would trust the diagnosis. But then OP never trusted the diagnosis and now they have several they cannot.

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

#556

Post by blitzar »

alistairSH wrote: post #129
throwforfeds wrote: post #100

I've seen a lot of friends and family members almost immediately get offered surgery for shoulder pain. It's just often the default for people that do surgeries for a living. I also had a pretty painful shoulder issue at one point, where the pain just wasn't subsiding for months. I tried massages and acupuncture as I didn't want to do surgery, but it wasn't helping at all. The thing that fixed it for me was just real…

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…

> the surgeon recommended months of physiotherapy before resorting to the knife

In my limited experience, "If all you have is a hammer, everything looks like a nail", rings particularly true with medical professionals.

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

#557

Post by yen223 »

tuxguy wrote: post #541
sizzle wrote: post #509

Earlier quoted context omitted.

Take the output to a Radiologist and verify the veracity of the statements.

there is often discordance between radiologists(& doctors in general) when reading the same scan(same case vignette) as well !

Do people here not realise that "second opinions" are a thing because humans disagree with each other when presented with the same case all the time? It's not just an LLM thing!

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

#558

Post by mettamage »

Delk wrote: post #468
mettamage wrote: post #152

Earlier quoted context omitted.

For me what helped is taking 7.5 mg of mirtazapine. At higher levels it's an anti-depressant but at lower levels it's an anti-histamine. It gets me drowsy. Together with 0.3 mg melatonin it knocks me out. I only take it 3 times per week max to not have habituation kick in. So 3 days out of 7 days I have guaranteed good sleep. The other 4 days are a toss up. But an average of 5 days of good sleep is much better than 3…

AFAIK mirtazapine shouldn't cause habituation the way actual "sleeping pills" or benzodiazepines do. That's one of the reasons it may be preferable as a sleeping aid, especially in the longer term. Anecdotally, when I took mirtazapine for sleeping problems, it did sometimes seem to have a stronger effect the first time I took it after not using it for a while. After that the effect stayed stable. Overall it shouldn't…

> After that the effect stayed stable. Overall it shouldn't cause habituation, and my doctor said as much.

Yea so this is where it gets murky for me. I experience some habituation actually. But my actual doctor went like "wtf is this?" and she didn't really mentioned what she knows about it. So on this particular pill my friend is my doctor. Not an ideal situation. I mean, he is an actual doctor but for him to be my doctor in this is a bit fucked up. He knows a lot more about mirtazapine than my GP though since he read up on it.

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

#559

Post by mettamage »

ricardobayes wrote: post #549
masklinn wrote: post #228

Earlier quoted context omitted.

Is the dutch healthcare system broadly against hypnotics? Culture (of the country or its medical system) can massively influence prescriptions or their lack thereof e.g. france is pretty famous for prescribing hypnotics very easily (and having a broad range of them), while the UK is generally a lot more reluctant.

True, for example in Switzerland you can't really get melatonin, even if you do it costs an absurd amount (like 100 chf). Doctors seem to be really against it in Switzerland.

I find Dutch over the counter melatonin to be really good, just FYI [1].

[1] https://www.kruidvat.nl/shiepz-melatonine-time-release-0-1mg... - Shiepz Melatonine Time Release 0,1mg Tabletten

I personally take 0.3 mg, two hours before bed. I've done this for about 2 years now. It still works. I know, anecdata, but as you can tell the dose is low.

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

#560

Post by mettamage »

dripdry45 wrote: post #394
masklinn wrote: post #228

Earlier quoted context omitted.

Is the dutch healthcare system broadly against hypnotics? Culture (of the country or its medical system) can massively influence prescriptions or their lack thereof e.g. france is pretty famous for prescribing hypnotics very easily (and having a broad range of them), while the UK is generally a lot more reluctant.

yeah, I’m surprised Trazodone didn’t get mentioned as a very low dose

Never got mentioned yea
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