Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

antoine.fi

Post reply on HN
Print view View original

661–670 of 748 posts

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

#661

Post by kgeist »

ryan_n wrote: post #660
azan_ wrote: post #354

Earlier quoted context omitted.

How is it possible? You can't diagnose tuberculosis just based on imaging and tuberculosis hospital has to know that!

Yea I find a lot of stories on the web about doctors misdiagnosing things to have oddities like this that don't seem to make sense. It often seems like the author is leaving something out. Not saying OP is lying, but tb is a very, very weird conclusion to come to from just one radiology report...

See my answer in this same subthread. I was perplexed myself as to why I was diagnosed based on just one radiology report. But the moral of my story is that you can always try to obtain a second opinion from another doctor. I'm not saying doctors shouldn't be trusted in general.

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

#662

Post by dd8601fn »

Gigachad wrote: post #430
serial_dev wrote: post #363

Earlier quoted context omitted.

These tools can’t reliably fix a 4px misalignment on my icon, better ask them about a medical report… but honestly, I would do the same.

Tbh LLMs pulling data out of medical documents in it's training set and searchable online is likely a much easier task than fixing some weird CSS alignment issue.

Also most of them can’t actually see what they’re doing. It’s hard for me to get things pixel perfect while blindfolded, too.

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

#663

Post by jawilson2 »

riahi wrote: post #643
throwaway2037 wrote: post #622

Earlier quoted context omitted.

> 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 i…

I don't understand why this is still confusing to people. The second "L" in LLM is language; these things are AWESOME at producing things that SOUND like language, including code. They have so much training data that it is almost always grammatically correct, and often makes sense. Extending this, it has obviously been trained on data containing phrases like "acromial undersurface" and "thin bursal fluid", and "coracromipal arch", in the context of shoulder injury and related imaging. BUT IT DOES NOT KNOW HOW TO DIAGNOSE ANYTHING. So, it SOUNDS like a radiologist or specialist, and might be in the ballpark of correct-ish-ness, but ultimately is a fancy Markov model.

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

#664

Post by CyberDildonics »

YeGoblynQueenne wrote: post #377
sxg wrote: post #120

Earlier quoted context omitted.

We're discussing calcific tendinitis ( https://radiopaedia.org/articles/calcific-tendinitis?lang=us ). If you think you have it, you can see a doctor and consider shoulder radiographs to start.

If you think you have it, then you don't. If you have it, you won't think, you'll know. Spoiler: because it hurts like hell.

That doesn't make any sense, it would imply that anything that hurts would automatically be the same diagnosis.

Both inductive and abductive reasoning would say that just because something hurts that doesn't mean that everything that hurts is that thing.

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

#665

Post by linsomniac »

throwaway2037 wrote: post #631
linsomniac wrote: post #91

~2 years ago I used ChatGPT "deep research" to investigate a chronic sinus infection I'd been fighting for ~3 years. After seeing 3 GPs and 3 visits with an ENT, I fed all the observations I had into the AI. In particular, I couldn't get the ENT to explain why he visually saw, via a scope, evidence of allergic reaction in my sinuses, but then later concluded, after an allergy test, that it couldn't be treated via all…

> Let me just try taking a second-gen allergy tablet every day and see what happens. Stupid question: Why did you wait three years before trying this tactic?

Not stupid. Because it wasn't on my radar that it was allergy related until the ENT mentioned allergies.

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

#666

Post by dd8601fn »

ambicapter wrote: post #227
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…

> 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…

It’s funny that the answer to this has increasingly become “yes” over the last few decades.

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

#667

Post by kgeist »

shiandow wrote: post #542
azan_ wrote: post #354

Earlier quoted context omitted.

How is it possible? You can't diagnose tuberculosis just based on imaging and tuberculosis hospital has to know that!

Not only that, what is the point confining someone to prevent the spread of a disease about a quarter of the world is already infected with? I suppose there could be reasons, but I don't know them.

Some countries and jurisdictions still have laws that allow for the involuntary confinement of tuberculosis patients, I guess dating back to the times when tuberculosis was rampant in those countries? And most professionals seem to be okay with the policy:

https://theunion.org/news/is-involuntary-incarceration-of-tb...

>17% said that, as a matter of principle, the involuntary incarceration of TB patients was inappropriate on any grounds.

>Regionally, members from Europe Region had the highest percentage of respondents objecting to the policy as a matter of principle (26.2%) while the North America Region had the lowest (3%).

The emergence of multi-drug resistant tuberculosis in the 1990s is probably one of the reasons:

>Respondents most strongly supported the policy of incarceration for patients known to have multidrug-resistant TB (49.7%)

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

#668

Post by CodingJeebus »

engeljohnb wrote: post #615
kgeist wrote: post #341

A few years ago (before the AI craze), I was misdiagnosed with tuberculosis. I had a chronic cough, and an outsourced radiologist at a clinic found signs of tuberculosis. The findings were sent to the city's tuberculosis hospital, as required by the country's law. The doctors there took the radiologist's conclusion at face value and required me to stay at their hospital for at least 8 months under a strict, prison-li…

A second opinion is a smart move if one has doubts about their diagnosis. Doctors make mistakes, and even though I've worked with countless great doctors, I've never worked a job where there wasn't at least one who was undiscerning, or downright lazy and negligent. It's hard to tell people to trust their doctor when I know there are plenty of doctors out there like this. But AI as of right now is worse than any bad d…

The healthcare affordability crisis is only going to exacerbate the trend of using AI as a replacement for a real doctor. I went to urgent care a few months ago to get tested for COVID and two other flu strains and it came out to almost $500.

Anecdotally, several people in my life who embrace less traditional (and sometimes more conspiratorial) views on modern healthcare tend to be the ones that can't afford it. A confident-sounding chatbot to answer questions day and night about what's going on with your body is very seductive in a world where access to real healthcare is getting further and further out of reach.

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

#669

Post by spwa4 »

palata wrote: post #573
dirkt wrote: post #520

Earlier quoted context omitted.

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…

> What happened to VERIFYING an answer? Does nobody do that anymore? The problem with medical advice is that you may not be competent to verify the answer, right? I agree that asking 5 LLMs to vote and trusting the answer is totally the wrong approach, of course. But LLMs (and traditional material) can help getting more informed. For instance, instead of going to your doctor with the LLM diagnosis and trying to convi…

Or more specifically in this case: the patient was obviously insisting on a diagnosis and treatment based on ... a slightly hurting shoulder, with zero visible or detectable phenomena.

So the doctors gave him what he wanted: a treatment ... and Claude told him the treatment was a placebo. Correctly, I might add.

Yeah, it is absolutely not what the patient wanted to hear. BAD doctors! Except ... no, not really.

Does that explain what happened here?

Post reply on HN