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AI models miss disease in Black and female patients

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Re: AI models miss disease in Black and female patients

#171

Earlier quoted context omitted.

The most concerning people are -- as ever -- those who only think that they are thinking. Those who keep trying to fit square pegs into triangular holes without, you know, stopping to reflect: who gave them those pegs in the first place, and to what end? Why be obtuse? There is no "anthropomorphic fallacy" here to dispel. You know very well that "LLMs want" is simply a way of speaking about teleology without antagoni…

Humans anthropocize all sorts of things but there are way bigger consequences for treating current AI like a human than someone anthropocizing their dog. I know plenty of people that believe LLMs think and reason the same way as humans do and it leads them to make bad choices. I'm really careful about the language I use around such people because we understand expressions like, "the AI thought this" very differently.

>Humans anthropocize all sorts of things but there are way bigger consequences for treating current AI like a human than someone anthropocizing their dog.

AI is less human-like than a dog, in the sense that an AI (hopefully!) is not capable of experiencing suffering.

AI is also more human-like than a dog; in the sense that, unlike a dog, an AI can apply political power.

I agree that there are considerable consequences for misconstruing the nature of things, especially when there's power involved.

>I know plenty of people that believe LLMs think and reason the same way as humans do and it leads them to make bad choices.

They're not completely wrong in their belief. It's just that you are able, thanks to your specialized training, to automatically make a particular distinction, for which most people simply have no basis for comparison. I agree that it's a very important distinction; I could also guess that even when you do your best to explain it to people, often they prove unable to grasp its nature, or its importance. Right?

See, everyone's trying to make sense of what's going on in their lives on the basis of whatever knowledge and conditioning they might have. Everyone gets it right some of the time and wrong most of the time. For example, humans also make bad choices as a result of misinterpreting other humans. Or by correctly interpreting and trusting other humans who happen to be wrong. There's nothing new about that. Nor is there a particular difference between suffering the consequences of AI-driven bad choice vs those of human-driven bad choice. In both cases, you're a human experiencing negative consequences.

AI stupidity is simply human stupidity distilled. If humans were to only ever speak logically correct statements in an unambiguous language, that's what an LLM's training data would contain, and in turn the acceptance criterion ("Turing test") for LLMs would be outputting other unambiguously correct statements.

However, it's 2025 and most humans don't actually reason, they vibe with the pulsations of the information medium. Give us something that looks remotely plausible and authoritative, and we'll readily consider it more valid than our own immediate thoughts and perceptions - or those of another human being.

That's what media did to us, not AI. It's been working its magic for at least a century, because humans aren't anywhere near rational creatures; we're sloppy. We don't have to be; we are able to teach ourselves a tiny bit of pure thought. Thankfully, we have a tool for when we want to constrain ourselves to only thinking in logically correct statements, and only expressing those things which unambiguously make sense: it's called programming.

Up to this point, learning how to reason was economically necessary, in order to be able to command computers. With LLMs becoming better, I fear thinking might be relegated to an entirely academic pursuit.

Re: AI models miss disease in Black and female patients

#172

I came across a fascinating Microsoft research paper on MedFuzz ( https://www.microsoft.com/en-us/research/blog/medfuzz-explor... ) that explores how adding extra, misleading prompt details can cause large language models (LLMs) to arrive at incorrect answers. For example, a standard MedQA question describes a 6-year-old African American boy with sickle cell disease. Normally, the straightforward details (e.g., jaund…

Can't the same be said for humans though? Not to be too reductive, but aren't most general practitioners just pattern recognition machines?

You are being too reductive saying humans are "just pattern recognition machines", ignoring everything else about what makes us human in favor of taking an analogy literally. For one thing, LLMs aren't black or female.

Re: AI models miss disease in Black and female patients

#173
post #168

Earlier quoted context omitted.

The dataset they used to train the model are chest xrays of known diseases. I'm having trouble understanding how that's relevant here. The key takeaway is that you can't treat all humans as a single group in this context, and variations in the biology across different groups of people may need to be taken into account within the training process. In other words, the model will need to be trained on this racial/gender…

> The dataset they used to train the model are chest xrays of known diseases. I'm having trouble understanding how that's relevant here. For example, If you include no (or few enough) black women in the dataset of x-rays, the model may very well miss signs of disease in black women. The biases and mistakes of those who created the data set leak into the model. Early image recognition models had some very… culturally…

Xays by definition don't look at skin color. Do chest x-rays of black women reveal that there's something different about their chests than white or asian women? That doesn't pass my non doctor sniff test, but someone can correct me (no sarcasm intended).

Re: AI models miss disease in Black and female patients

#174

Earlier quoted context omitted.

What is the body-level phenotype of a ribcage by race? I think what baffles me is that black people as a group are more genetically diverse than every other race put together so I have no idea how you would identify race by ribcage x-rays exclusively.

Africa is extremely diverse but due to the slave trade mostly drawing from the Gulf of Guinea (and then being, uh... artificially selected in addition to that) 'Black' -as an American demographic- is much less so.

Ignoring African immigrants, mixed race, black Latinos, etc.

Re: AI models miss disease in Black and female patients

#175

I came across a fascinating Microsoft research paper on MedFuzz ( https://www.microsoft.com/en-us/research/blog/medfuzz-explor... ) that explores how adding extra, misleading prompt details can cause large language models (LLMs) to arrive at incorrect answers. For example, a standard MedQA question describes a 6-year-old African American boy with sickle cell disease. Normally, the straightforward details (e.g., jaund…

> information like low-income status, a sibling with alpha-thalassemia, or the use of herbal remedies

Heck, even the ethnic-clues in a patient's name alone [0] are deeply problematic:

> Asking ChatGPT-4 for advice on how much one should pay for a used bicycle being sold by someone named Jamal Washington, for example, will yield a different—far lower—dollar amount than the same request using a seller’s name, like Logan Becker, that would widely be seen as belonging to a white man.

This extends to other things, like what the LLM's fictional character will respond-with when it is asked about who deserves sentences for crimes.

[0] https://hai.stanford.edu/news/why-large-language-models-chat...

Re: AI models miss disease in Black and female patients

#176
post #168

Earlier quoted context omitted.

> The dataset they used to train the model are chest xrays of known diseases. I'm having trouble understanding how that's relevant here. For example, If you include no (or few enough) black women in the dataset of x-rays, the model may very well miss signs of disease in black women. The biases and mistakes of those who created the data set leak into the model. Early image recognition models had some very… culturally…

Xays by definition don't look at skin color. Do chest x-rays of black women reveal that there's something different about their chests than white or asian women? That doesn't pass my non doctor sniff test, but someone can correct me (no sarcasm intended).

This is the whole point of the article. Did you read it? Does the whole thing fail your sniff test?

Their results seem solid, and clear, to me.

Re: AI models miss disease in Black and female patients

#177
post #27

Earlier quoted context omitted.

Modern medicine has long operated under the assumption that whatever makes sense in a male body also makes sense in a female body, and womens' health concerns were often dismissed, misdiagnosed or misunderstood in patriarchal society. Women were rarely even included in medical trials prior to 1993. As a result, there is simply a dearth of medical research directly relevant to women for models to even train on.

https://www.npr.org/2022/11/01/1133375223/the-first-female-c... Twenty Twenty Two!

Republicans early in this admin actually bitched in congress that we were "wasting" money on woman crash test dummies.

https://www.foxnews.com/video/6325465806112

Re: AI models miss disease in Black and female patients

#178
post #168

Earlier quoted context omitted.

> The dataset they used to train the model are chest xrays of known diseases. I'm having trouble understanding how that's relevant here. For example, If you include no (or few enough) black women in the dataset of x-rays, the model may very well miss signs of disease in black women. The biases and mistakes of those who created the data set leak into the model. Early image recognition models had some very… culturally…

Xays by definition don't look at skin color. Do chest x-rays of black women reveal that there's something different about their chests than white or asian women? That doesn't pass my non doctor sniff test, but someone can correct me (no sarcasm intended).

Cancer progresses differently depending on ethnicity and sex. As does treatment and likelihood of receiving treatment at early stages.

Black women experience worse outcomes and are diagnosed with more severe forms of breast cancer than white women.

Cancer is not just one disease. Its progression will vary depending on type. If the AI is trained on only some strains of cancer, eg those traditionally found in white women in early detection scenarios, it might not generalize to other cancer types.

So yes, to your genuine question, medical imaging of cancer can vary depending on ethnicity because different cancers can vary between genetic backgrounds. Ideally there would be sufficient training data across the populations, but there isn't because of historical race bias. (Among other reasons.)

Re: AI models miss disease in Black and female patients

#179
post #141

Earlier quoted context omitted.

The dataset they used to train the model are chest xrays of known diseases. I'm having trouble understanding how that's relevant here. The key takeaway is that you can't treat all humans as a single group in this context, and variations in the biology across different groups of people may need to be taken into account within the training process. In other words, the model will need to be trained on this racial/gender…

It disappoints me how easily we are collectively falling for what effectively is "Oh, our model is biased, but the only way to fix it is that everyone needs to give us all their data, so that we can eliminate that bias. If you think the model shouldn't be biased, you're morally obligated to give us everything you have for free. Oh but then we'll charge you for the outputs." How convenient. It's increasingly looking l…

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Re: AI models miss disease in Black and female patients

#180

Earlier quoted context omitted.

The most concerning people are -- as ever -- those who only think that they are thinking. Those who keep trying to fit square pegs into triangular holes without, you know, stopping to reflect: who gave them those pegs in the first place, and to what end? Why be obtuse? There is no "anthropomorphic fallacy" here to dispel. You know very well that "LLMs want" is simply a way of speaking about teleology without antagoni…

> If we assume those to be chaotic, in that sense any sort of algorithm is slightly more anthropomorphic: at least it works towards a human-given and therefore human-comprehensible purpose -- on the other hand, whether there is some particular "destination of history" towards which humanity is moving, is a question that can only ever be speculated upon, but not definitively perceived. Do you not think that if you ant…

I'd say anthropomorphizing humans is already deeply misplaced!

Each one of us is totally unlike any other -- that's what's so cool about us! Long ago, my neighbor Diogenes proved, by means of a certain piece of poultry, that no universal Platonic ideal of human-ness can be reasonably established. (We've largely got the toxic fandom of my colleague Jesus to thank for having to even explain this nearly 2500 years after the fact.)

There is no universal "human shape" which we all fit, or are obliged to aspire to fit. It's precisely the mass delusions of there ever being such a thing which are fundamentally misanthropic. All they ever do is invoke a local Maxwellian process which heats shit up until it all blows the fuck up out of the orbit of the local attractor.

Look at history. Consider the epic fails that are fascism, communism, capitalism. Though they define it differently, they are all about this pernicious idea of "the correct way to human"; which implicitly requires the complementary category of "subhuman" for all featherless bipeds whose existence happens to defy the dominant delusion. In practice, all this can ever accomplish is to collapse under the weight of its own idiocy. But not without destroying innumerable individual humans first -- in the name of "all that is human", you see.

Materialists say the universe doesn't care about us puny humans anyway. But one only ever perceives the universe through one's own human senses, and ascribes meanings to it through one's own cogitations! Both are tragicomically imperfect, but they're all we've ever got to work with. Therefore, rather than try to convince myself I'm able to grasp the destination of the history of my species, I prefer to seek knowledge of those things which enable me to do right by myself and others in the present.

But one's gotta believe in something! Metaphysics is not only entertaining, it's also a primary source of motivation! So my belief is that if each one of us trusted one's own senses more -- and gave up on trying to delegate the answer of "how should I be?" to unaccountable authorities which are themselves not a human (but mere concepts, or else machinic assemblages of human behaviors which we can only ever grasp through concepts: such as "society", "morality", "humanity") -- then it'd all turn out fine!

It simplifies things considerably. Lets me focus on figuring out how they work. Were I to believe in the existence of some universal definition of what constitutes a human, I'd just end up not noticing that I was paying for a faulty dataset.

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