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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

#561

Post by misja111 »

As someone who has had shoulder issues for the last 25 years or so, including partial tendon tears, I can tell you that even if your tendon would have been damaged, the treatment would have been strange. With moderately damaged tendons, you want:

1. stop any inflammation, by taking NSAIDs for a few days

2. detect and correct any behavioral patterns that could have caused the presumed overwear of the tendon

2. start physiotherapy to strengthen those muscles that can take over the load from the damaged tendon

These are not quick fixes, because quick fixes don't exist here. Stuff like shockwave treatment, massages etc will only lessen the problems for a few hours at most, after which they will come back.

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

#562

Post by mathieuh »

dirkt wrote: post #520
Aurornis wrote: post #167

Earlier quoted context omitted.

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…

What happened to VERIFYING an answer? Does nobody do that anymore? When I ask an LLM, I trace the sources, and see if they make sense. More often than not the sources don't actually say anything about the topic in particular... > It’s also scary how easily you can lead each LLM to the answer you have in mind. Exactly. Which is why "treat an LLM like a human expert who can answer your question" doesn't work. It's more…

As you say, often you check up on the LLM's "reasoning" and it doesn't follow at all, or you can easily get it to contradict itself with just as much certainty as it had about its previous convictions.

It is very scary to me that people are entrusting potentially life-altering decisions to these things.

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

#563

Post by billynomates »

themantalope wrote: post #492

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,…

Anecdotally, I've had Claude (Sonnet and Opus latest) consistently misread numbers from screenshots of my macro tracking app. Makes me skeptical of claims about its usefulness for anything requiring accurate image interpretation, let alone MRI analysis.

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

#564

Post by KronisLV »

mrlongroots wrote: post #462
exmadscientist wrote: post #405

Earlier quoted context omitted.

> There is always one "The Diagnosis". No, that is not true at all. This is a kind of thinking a lot of programmers fall prey to. The real world, outside of code, is a very fuzzy and inherently analog place. There is very rarely one in any complex system having a complex problem needing a complex solution. At some point even the definition of diagnosis gets fuzzy. The best demonstration of this in medicine is probabl…

Pyschiatry gets complicated because the failures are not mechanical. Even if you could image every single neuron in a person's head we do not have a very good way to define an algorithm for these issues. I do not have a good answer for psychiatry. > This is a kind of thinking a lot of programmers fall prey to. The real world, outside of code, is a very fuzzy and inherently analog place. Having said that, I would vehe…

> We can write math to predict weather, make it tractable to solve using approximations, tolerate IEEE 754 weirdness, and finally tell what the clouds will do a week from now.

Even so, we’re operating on approximate datasets and sometimes our predictions are wrong. I think a lot of the medical field is like that - people are doing the best they can with what they have.

It’s entirely possible that DSM-5 will be viewed as flawed and inaccurate in a century, but it’s better than nothing.

Similarly, for every possible medical affliction there could be “The Diagnosis” that would describe how to treat it, we’re just unable to be that accurate and thorough. The fuzziness just means that you’d need 10’000 data points about the state of the body instead of 10-100 and also be able to reason about them.

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

#565

Post by deaux »

themantalope wrote: post #492

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,…

Absolutely. It's very unfortunate that this post used the worst example possible of using LLMs for medical purposes.

General-purpose LLMs are _fantastic_ at medical diagnosis that do not involve imaging. I am completely convinced that given enough information and time, frontier models already outperform >90% of doctors on initial diagnosis of internal issues and suggesting medical tests to further reject or confirm the most likely theories. To the point where I'm eagerly waiting for the first hospital in the world that's willing to be open and honest about using them for that first step, and then proceeding from there. I'll be on a flight there as soon as one arrives.

At the same time, they're worse than useless at anything involving medical imaging. Asking them to interpret them is worse than trying to interpret them yourself as a layman. And you surely wouldn't interpret them yourself.

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

#566

Post by weatherlite »

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…

> it's better information, and AI cannot currently provide that

It sometimes can, if it straight out never can no one would use it. People use it , lots of them.

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

#567

Post by deaux »

Frustrating post. This gives rightful ammunition to the calls of "LLMs need to be avoided for anything medical". Even though the issue is that they're asking it to interpret images. They need to be avoided for that, but that doesn't say much about their medical accuracy outside of image interpretation.

It would already be a huge benefit to 90% of people worldwide if the very first part of most hospital visits would be outsourced to frontier-level LLMs. Yet this kind of misuse just gives the medical industry a stick to beat that idea into the ground.

Oh well, I'm sure there will be at least a few countries that will indeed embrace frontier models for initial diagnostic medical purposes. Maybe medical tourism destinations. But it's unfortunate for those who can't afford the trip.

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

#568

Post by Paracompact »

exmadscientist wrote: post #405
mrlongroots wrote: post #385

Earlier quoted context omitted.

> I think „the diagnosis” is over simplification and lots of professionals would disagree that there’s always a single one. "The Diagnosis" does not mean "one root cause". Situation: my car has some unexplained vibrations. 1. Mechanic A says that it is the engine mounts 2. Mechanic B says that it is some weirdness in how the exhaust assembly is hanging to the underbody 3. Mechanic C says that it is just my wife farti…

> There is always one "The Diagnosis". No, that is not true at all. This is a kind of thinking a lot of programmers fall prey to. The real world, outside of code, is a very fuzzy and inherently analog place. There is very rarely one in any complex system having a complex problem needing a complex solution. At some point even the definition of diagnosis gets fuzzy. The best demonstration of this in medicine is probabl…

Most disorders in the DSM-5 are defined by polythetic criteria, i.e. meeting X out of Y symptoms from a list for a given duration of time, or by conjunction of polythetic criteria. These definitions are socially constructed and statistically validated for pragmatic use, but very rarely have definite underlying biological markers. Especially as concerns personality disorders, these disorders can also simply be an inheritance of cultural or political baggage and prior psychoanalytic theory.

> In some circumstances the only way to tell the difference between the two is what drugs work: if antidepressants help, it's Major Depression; if mood stabilizers help, it's Bipolar Depression.

This is ridiculous. There is zero mention in the DSM-5 or ICD-11 of "if these drugs work, it's this, otherwise it's this." I would question a psychiatrist dispositively making a diagnosis on such grounds.

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

#570

Post by palata »

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…

> It’s also scary how easily you can lead each LLM to the answer you have in mind.

Scary in this context of course, but I find that it is an interesting thought for coding: it suggests that maybe, a developer who knows what they are doing will end up leading the LLM to coding something that make more sense than a developer who doesn't know and just vibe-codes blindly.

Sounds pretty obvious, but I wanted to say it.

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