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Large Language Models Are Few-Shot Health Learners

arxiv.org

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Re: Large Language Models Are Few-Shot Health Learners

#21

Post by zarzavat »

haldujai wrote: post #15
ke88y wrote: post #11

Earlier quoted context omitted.

> they can't do mathematical calculations Tell me you never taught service courses for pre-meds without telling me you never taught service courses for pre-meds ;) > They hallucinate, They're incredibly good at being convincing, no matter what junk they are outputting Describes about a third of the doctors I've interacted with, tbh. > And the advice I got seemed useful, and helped kick off additional research and use…

> Lots of people are smart enough to learn and understand the bits of knowledge they need to accurately self-diagnose and understand tradeoffs of treatment options, then use a medical professional as a consultant to fill in the gaps and validate mental models. This is incredibly dangerous, lots of people are smart enough that they can research questions about their condition/care to discuss with their medical profess…

Doctors may have 10 years of medical training but they have very little time to apply that knowledge to any particular patient.

If you come to a doctor’s appointment with zero research then you will not be able to push back if your doctor attempts to misdiagnose you. It will be a unidirectional conversation.

If you have prepared for your appointment then the following conversation is more likely to happen:

Patient: I have symptoms X and Y

Doctor: You probably have condition A

Patient: But I don’t have Z, is it really likely that I have A?

Doctor: It’s also possible that you have condition B

In a perfect world, patients would get hour long appointments and doctors would explore the entire fault tree. For rich people this may actually be reality. But for us proles, every minute we get with a doctor is precious so we’d better study up so we can use them as medical oracles.

Re: Large Language Models Are Few-Shot Health Learners

#22

Post by tstrimple »

carbocation wrote: post #8

I find chat GPT to be very helpful for working with programming languages that I’m less comfortable using (shell, python). I know enough to evaluate correct code in these languages, but producing it from scratch is more difficult, which seems like a sweet spot for carefully using ChatGPT for code. As a physician, I would not be surprised if the medical use of these tools ends up having similar value.

I think the key here is that experts can take better advantage of tools like these because they have more ability to see when it's going off the rails. If you're a brand new programmer, you might be stumped if ChatGPT "hallucinates" a function which doesn't exist within an API. But an experience developer can pick up on the problem pretty quickly and either correct for it or know they need to pursue more traditional routes to solve the problem.

I recently used ChatGPT because my Google was failing to help me remember the name of the standard for securely sharing passwords between systems. My searches kept turning up end user password management related topics. ChatGPT got me to SCIM after one question and one correction.

I could absolutely see a doctor using something like a ChatGPT to help supplement their memory in a way I did. I don't think anyone recommends that doctors just trust ChatGPT, but to use it as a supplementary tool for their own expertise. Even if it's outside of their specific medical domain, it could help them get a basis for having a conversation with one of their specialist colleagues.

Re: Large Language Models Are Few-Shot Health Learners

#23

Post by haldujai »

zarzavat wrote: post #21
haldujai wrote: post #15

Earlier quoted context omitted.

> Lots of people are smart enough to learn and understand the bits of knowledge they need to accurately self-diagnose and understand tradeoffs of treatment options, then use a medical professional as a consultant to fill in the gaps and validate mental models. This is incredibly dangerous, lots of people are smart enough that they can research questions about their condition/care to discuss with their medical profess…

Doctors may have 10 years of medical training but they have very little time to apply that knowledge to any particular patient. If you come to a doctor’s appointment with zero research then you will not be able to push back if your doctor attempts to misdiagnose you. It will be a unidirectional conversation. If you have prepared for your appointment then the following conversation is more likely to happen: Patient: I…

As stated, being informed is encouraged. Self-diagnosis is not for anyone to do.

I think another issue here is your expectations out of a medical visit may be unrealistic. Physicians aren’t supposed to arrive at the correct diagnosis from the initial visit (for most things). We start with a suspected diagnosis and differential and refine it with investigations and multiple visits for temporality/evolution.

Note that in your hypothetical that probably and possible are not mutually exclusive. It’s entirely possible patient A’s right upper quadrant pain is a gallbladder cancer but it is also probably gallstones even if you tell me the pain isn’t triggered by fatty meals. Just because a preliminary diagnosis is stated as probable it doesn’t mean other potential causes aren’t being simultaneously investigated with that ultrasound. I also don’t need to be telling the patient about all of the potential possibilities from the get go as it may cause anxiety, this is a patient-specific judgement call.

> In a perfect world, patients would get hour long appointments and doctors would explore the entire fault tree.

Honestly, outside of counseling type visits or complex oncology I’m not sure what I would spend an hour talking about. Why do feel we need to explore the entire fault tree in a single visit with missing investigations?

As a hypothetical: 50 y/o male patient comes in with first time rectal bleeding, I’ll ask a few questions and perform a physical exam but regardless of the fault tree or why this happened, this patient is getting a colonoscopy. Until we’ve excluded cancer and inflammatory bowel disease further discussion is moot.

Re: Large Language Models Are Few-Shot Health Learners

#24

Post by sroussey »

simonw wrote: post #18
deadmutex wrote: post #4

Earlier quoted context omitted.

> found myself using them for medical advice (for pets so far, not yet for humans) Which model did you use?

GPT-4 I like running "can my dog eat avocado?" through smaller models to see what happens.

For parrots, definitely not. Avocado will kill them.

Re: Large Language Models Are Few-Shot Health Learners

#25

Post by awestroke »

haldujai wrote: post #15
ke88y wrote: post #11

Earlier quoted context omitted.

> they can't do mathematical calculations Tell me you never taught service courses for pre-meds without telling me you never taught service courses for pre-meds ;) > They hallucinate, They're incredibly good at being convincing, no matter what junk they are outputting Describes about a third of the doctors I've interacted with, tbh. > And the advice I got seemed useful, and helped kick off additional research and use…

> Lots of people are smart enough to learn and understand the bits of knowledge they need to accurately self-diagnose and understand tradeoffs of treatment options, then use a medical professional as a consultant to fill in the gaps and validate mental models. This is incredibly dangerous, lots of people are smart enough that they can research questions about their condition/care to discuss with their medical profess…

You forgot to explain why it is so dangerous for people to self diagnose

Re: Large Language Models Are Few-Shot Health Learners

#26

Post by haldujai »

awestroke wrote: post #25
haldujai wrote: post #15

Earlier quoted context omitted.

> Lots of people are smart enough to learn and understand the bits of knowledge they need to accurately self-diagnose and understand tradeoffs of treatment options, then use a medical professional as a consultant to fill in the gaps and validate mental models. This is incredibly dangerous, lots of people are smart enough that they can research questions about their condition/care to discuss with their medical profess…

You forgot to explain why it is so dangerous for people to self diagnose

I assumed it was obvious like “only a fool has himself as a lawyer.”

Would you do your own code review?

It’s impossible to be objective regarding your own health. It’s an ethics violation and sanctionable for physicians to do so for themselves.

Re: Large Language Models Are Few-Shot Health Learners

#27

Post by sarchertech »

brucethemoose2 wrote: post #19
Baeocystin wrote: post #10

Earlier quoted context omitted.

Whatever else its ills, the bot actually will pay attention to the tokens you're submitting to it to formulate its answer. That puts it well ahead of a majority of the doctors I've seen over the years. I say this without snark- it is simply true. I should also mention that a good quarter of the medical care folks who have assisted me have gone above and beyond in exceptional ways. It is a field of extremes.

Most doctors/vets I've seen recently are just massively overbooked. You wait 3 hours, then you have 4 minutes of conversation time for one (out of multiple) ailments before you’re booted out the door. Its like you're on an assembly line and the workers can't even keep up.

Why are you waiting 3 hours? Are you going to an urgent care or ER?

Re: Large Language Models Are Few-Shot Health Learners

#28

Post by flangola7 »

rvz wrote: post #7
simonw wrote: post #3

I find the healthcare applications of this stuff so interesting. On the one hand, there are SO many reasons using LLMs to help people make health decisions should be an utterly terrible idea, to the point of immorality: - They hallucinate - They can't do mathematical calculations - They're incredibly good at being convincing, no matter what junk they are outputting And yet, despite being very aware of these limitatio…

I have been saying this for months for deep learning in general (and now the new hype in LLMs) in high risk situations such as medical, legal and financial advice and even transportation. The only common use-case which makes sense is summarization and even then, a human expert ends up reviewing the output before post it anyway. > There are plenty of medical topics which people find embarrassing, and would prefer to -…

At least for legal there is far more potential than just summarization. Harvey is already producing legal documents with error rates lower than humans.
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