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

antoine.fi

581–590 of 748 posts

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

#581
post #115

Why wouldn’t you as a doctor by standard run the images through a certified compliant LLM? The actual cost won’t be it and then you can see if you get any new ideas from it. See if it’s just wrong or that it spotted a little detail you missed? The LLM doesn’t need to be leading or whatever but then you can have a conversation with the patient. If their ChatGPT reports has differences it can be analyzed as well. It fe…

Because they might bias you. And because you have your own brain, training and experience

That does make sense but the order of it might be: doctor analysis. Then show LLM as double check to doctor. Doctor assesses and may keep en improve the doctors first analysis?

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

#582
post #523
post #509

Earlier quoted context omitted.

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

Why should a radiologist have to debunk AI slop? They have enough to do already. That's the same mentality that is frustrating open-source repositories with sloppy pull requests, and saying "here, sort this out for me".

Depending on the disease, even in cancer there's myeloma which may cause bone metastasis in many parts of the body with very focal lesions. Radiologists can't assess each and an every one of them, or even to find them all. So AI can definitely help in these scenarios.

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

#583
post #31

I would not trust AI on images. But I once had ChatGPT tell me that an MRI report was very likely to be incorrect based on the text, and offered a different diagnosis. Since it was semi insisting, I visited another doctor who made me do a retest. Long story short, ChatGPT was correct. Again, this is just one single person's experience. So not worth much.

mate the other day chatGPT (enterprise) told me that the kernel 7.0.2 was older than 6.69 you cant trust these toys at all . that doesn't make the useless, just untrustworthy.

6.69 hasn't been released yet, to be fair.

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

#584

> 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…

The best mechanic I ever had kept my ‘98 Subaru going past 200k miles. Once during a repair I asked him to do an inspection and tell me if there was anything else I should replace. He told me not to do that, and that any mechanic would always find something, but not necessarily the next thing to break. He said it better using an expression I hadn’t heard before or since, something like “don’t go looking for goats whe…

Exactly. Old parts of the system will be working if you leave them undisturbed. Mechanics have very good intuitions of this sort of thing.

I read about before there's proper engineering / physics theory about this too, it's like a car as a machine is a linear/smooth physics system with multiple weaknesses. Overtime longtime period of running many places might weaken but it still evolves into a slightly different smooth system, until you introduce a replacement which cause a mis-match of impedance or something like that.

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

#585

Earlier quoted context omitted.

agree, and I think we'll see more use of formal methods with LLMs for this reason

At a certain point it just feels like we're reinventing the concept of programming languages from first principles.

Hardly the first time we've done this - we had to do it with compilers too

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

#586

I don’t understand the negative reactions. Medical care as it exists requires the doctor and patient to have their brains switched on. I’ve almost never had a problem where a doctor provides me with a diagnosis and I go about my day. Most of the times that I have, I’ve been confident about the problem and known what I needed. The doctor was a barrier to accessing care. Dr. GPT is a good brainstorming tool. It helps s…

> I do think that people saying “doctors don’t know the state of the art” have a weaker case. This is kinda the case though. In Poland I met only one psychiatrist that knew about DSM-5. In this year. DSM-5 was a thing from 2013. Doctors are people just as us, not every single of them is good.

Why would you expect a Polish psychiatrist to understand the differences between different versions of a diagnostic manual used only in the US?

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

#587
post #520

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…

I've also noticed the opposite problem: Sometimes the LLM, when asked a detailed question (probably with some lead-in), pushes back in a way that betrays that they fell back to general tropes without really considering the nuances of your specific context.

This happens many times, and I usually have to lead the LLM through a chain of reasoning to prove to it that its objection, through generally sound, do not apply to my specific situation.

Someone not as well versed in the subject matter would think the LLM found a smoking gun (which they love to do), and be led on a wild goose chase.

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

#588
post #42

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?

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…

> It was already difficult to deal with self diagnosis for doctors

I get it. But the current system is also super difficult for the patient: getting time to ask questions, get clear answers, get the best possible diagnosis taking into account your history, symptoms etc and all that in 5-10 minute checkup when your doctor sees 50 patients a day and has very little time for you; this doesn't scale well. Patients run to A.I for a reason.

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

#589

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…

Personally I've always appreciated talking to nurses I know.

The respectable ones know they aren't doctors, but they've seen a lot more recoveries and cases where minimal intervention was required. As some people have said some surgeons like to cut people up.

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

#590
> My hope is that in a couple of model generations, we'll trust AI to review MRIs the way we trust it to proofread our emails.

the doctors may have financial motives to suggest unnecessary treatments. but i fear, by the time we'll have models powerful enough we'd be _theoretically_ able to trust their expertise, the financial motives will have shifted to the model creators.

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