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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

#641

Post by bondarchuk »

marcus_holmes wrote: post #481
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…

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…

It's funny that if the LLMs had all given the same result each time (it sounds like) you would have considered it more valid, even though it might just be giving a single wrong answer more consistently.

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

#642

Post by cbg0 »

HPsquared wrote: post #583
senectus1 wrote: post #445

Earlier quoted context omitted.

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.

It's fairly obvious he's referring to 6.6.69, and I'd expect an LLM to make that assumption as well, unless prompted to be a pedantic HN commenter.

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

#643

Post by riahi »

throwaway2037 wrote: post #622
deaux wrote: post #565

Earlier quoted context omitted.

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 t…

> General-purpose LLMs are _fantastic_ at medical diagnosis that do not involve imaging. Can you share the reasons that you believe this? > At the same time, they're worse than useless at anything involving medical imaging. What is special about medical imaging that makes AI/LLMs specifically bad?

You can see it in just this PDF report.

It's multiple things. It never shows the subscapularis in the way that people actually look the tendon. It hyper fixates on the axial when I find the sagittal much more useful for subscapularis.

Figure 7. There's an arrow pointing "to the acromial undersurface". The arrow is not pointed to that location.

Figure 5. "thin bursal fluid". This is within physiologic variation, but is calling bursitis.

It keeps bringing up irrelevant normal things like the shape of the coracromipal arch, I assume because lots of websites have information about that as a patient focused possible cause for rotator cuff impingement.

I am reminded of the recent Stanford MIRAGE study which found that LLMs will happily hallucinate answers about medical images if the medical images are omitted.

https://arxiv.org/html/2603.21687v2

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

#644

Post by rylando »

garciasn wrote: post #413
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.

Semi-related: my father has complications from a motorcycle accident ~25y ago that crushed arteries in his leg coupled with diabetes (insulin / kept sugar at ~100 and his A1C was kept under 6.7 for ~15y). 6w ago had to have his toes removed due to dry gangrene; they eventually (2.5w ago) had to remove his leg below the knee because of the severe blood flow issues below the knee. Between the toes and the below the kne…

Keep in mind I’m not a doctor, just the guy who takes your images, but I believe it’s all liability. I really wouldn’t want to be a doctor from all the crazy stories of liability stuff I hear everyday.

I empathize with you as my grandmother is also being what feels like gaslit by several doctors being told her symptoms are dementia and not from the chronic UTI’s she suffers from, but when the UTI’s clear all of a sudden no symptoms. Our medical system is very frustrating, between doctors who don’t have the time needed for complicated cases, or the threat of every patient suing them causing them to be overly cautious.

I think as long as you’re aware of the pitfalls of AI, as you seem to be, it’s a solid tool for helping to understand medical situations with the right amount of double checking.

I don’t think our system will improve until 1) We increase the amount of doctors in our country and tell Congress to quit limiting the amount we can train yearly, and 2) the system of liability for doctors is changed to be more like New Zealand’s where their liability insurance is nationalized and they’re not at constant threat of losing everything to a lawsuit over a patient who wouldn’t take their meds and got worse (the cases are generally much more complex than that, but the idea is it’s not always the doctors fault as media would have us believe).

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

#645

Post by draftsman »

malfist wrote: post #367
wwweston wrote: post #350

Earlier quoted context omitted.

We have systems around humans that exist to manage expertise gaps, credibility signals, and accountability. This is part of what makes humans as good as they are, along with specialized training and some measure of meritocratic selection. We license and regulate and account and litigate to make a system that responds and improves. Some of this might be applicable to LLMs, but some isn’t and much of it would be resist…

I've been going through PT for a hypermobility disorder related injury and I've use an AI to help me figure out "interview questions" to see if a PT knows anything about hypermobility or is willing to learn. I found it helpful to select a new PT after my first PT I trusted made things worse by prescribing stretches and no load progression from rest and recovery back to deadlifts

May I ask, is the hypermobility disorder you refer to EDS? If so, what was the injury?

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

#647

Post by ambicapter »

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.

Not really, it just requires to assume an ultrasound has infinite, perfect resolution when you are faced with a different imaging tech which reports things that didn't appear in the first one. That's just stupid.

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

#648

Post by Maro »

Recently I was at the doctor for a very minor sports injury ("tennis leg"). The doctor — who was in his 50s — was explaining the degrees of the injury to me, and quoted ChatGPT as the source, along the lines of "ChatGPT usually says you have to rest for.." I thought it's quite funny, but after thinking about it, it's really no surprise that doctors also use AIs to look things up / clean up their diagnosis.

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

#649

Post by [deleted] »

sjducb wrote: post #599
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…

> Most people should have learned at a young age that absence of evidence is not evidence of absence. I’m fairly sure that there are no lions in my house. Lions are quite large and I’m capable of detecting lion sized objects with my eyes. To demonstrate that something is not present you first define the object, then come up with a test that will reliably detect the object. If the test comes back negative then the obj…

[deleted]

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

#650

Post by ambicapter »

DrewADesign wrote: post #489
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…

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.

> idiots

> seriously underdeveloped

What's the difference?

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