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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

#391

Post by tiahura »

scrollop wrote: post #134
tiahura wrote: post #16

Earlier quoted context omitted.

Why isn’t diagnostic ultrasound used in orthopedics? They inspect fetus hearts and other organs everyday, why not shoulders? Seems much cheaper and faster.

We order ultrasounds all the time for shoulders (for like soft tissue issues; for trauma, you'd start with an xray). For other joints, such as the knee, MRIs are a better choice (unless htere has been substantial trauma, in which case xray initially or further), though more expensive, unless you're excluding a Baker's cyst, in which case an ultrasound is fine. Since MRIs are more expensive, private doctor's might ord…

Where are you? Pi and work comp attorney in medium US midwest metro. I've never seen one in 20y. Not from HCA ERs, medicaid er visits to univ affiliated er, nor prestige practices.

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

#392

Post by __MatrixMan__ »

bilsbie wrote: post #90
ricardobayes wrote: post #7

That might be doctors new nightmare: people who second guess everything with AI. Previously it was "google your symptoms".

It’s funny every profession deals with customers making their own guesses at diagnosis. I told my mechanic the film flam is broken but he said it was the rim ram. He fixed it and we all went in with our lives. But doctors insist on this God like status so it’s a “nightmare” when patients try to help themselves.

I dunno man, it's one thing to have your car still be broken because you were wrong, it's a different thing poison yourself on the basis of having done your own research. The mechanic can laugh at you, it hits a doctor differently.

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

#393

Post by light_hue_1 »

Go with your report back to your doctor.

A family member has cancer and we treat chatgpt as part of the team (our doctor's words). I ingest everything into it, work with it to make a good report. Then at the next visit we review it.

This gives you the best of both worlds. You get peace of mind and the doctor explains why and how the agent was right or wrong.

Twice now we've caught consequential mistakes (wrong pain medication and incorrect notation of the exact mutation that he has). Which have made a difference to his quality of life and treatment path.

Most of what the doctors have said is in line with the agent but when there have been disagreements they've been very reasonable. Sometimes the doctors have gone with the agent's version sometimes they've explained why that's inappropriate.

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

#394

Post by dripdry45 »

masklinn wrote: post #228
mettamage wrote: post #152

Earlier quoted context omitted.

For me what helped is taking 7.5 mg of mirtazapine. At higher levels it's an anti-depressant but at lower levels it's an anti-histamine. It gets me drowsy. Together with 0.3 mg melatonin it knocks me out. I only take it 3 times per week max to not have habituation kick in. So 3 days out of 7 days I have guaranteed good sleep. The other 4 days are a toss up. But an average of 5 days of good sleep is much better than 3…

Is the dutch healthcare system broadly against hypnotics? Culture (of the country or its medical system) can massively influence prescriptions or their lack thereof e.g. france is pretty famous for prescribing hypnotics very easily (and having a broad range of them), while the UK is generally a lot more reluctant.

yeah, I’m surprised Trazodone didn’t get mentioned as a very low dose

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

#395

Post by recursive »

backtoyoujim wrote: post #242
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…

Does radiology really make +$700,000.00 a year ? Someone on reddit claiming to be a radiologist claimed that. I wonder where the savings will go when those jobs are gone.

The savings go straight into patients' worse outcomes.

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

#396

Post by consensus1 »

swiftcoder wrote: post #56
consensus1 wrote: post #35

Earlier quoted context omitted.

But why should I care? If you demonstrated that a model can perform more accurate diagnoses than a doctor, but also it had this strange behavior when no image was presented, why should that deter me from using the model?

Because you don’t have any way of telling if it actually used the image presented, or based it’s conclusions on a different image it made up

I don't find that persuasive. This is not the error I worry about. Let's say that hypothetically the model just ignores the input image 1 in 10,000 runs. This really doesn't concern me because the output will be trivially detectable incorrect nonsense that doesn't match the symptoms at all. Such a contingency is easily handled by running the image through multiple models and distilling the output, anyway.

The error I worry about is where the model uses the image and comes to an incorrect but symptom matching diagnosis. But in this hypothetical the model is less likely to do so than a doctor, so the choice is either accept the risk of the model or accept a higher risk from a doctor.

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

#397

Post by rylando »

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…

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.

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

#398

Post by fc417fc802 »

Paracompact wrote: post #372
mrlongroots wrote: post #337

Earlier quoted context omitted.

Maybe I am missing something but I just find this wrong. Everything is a puzzle: there is one "Truth" or one diagnosis. You (a smart human) should be able to converge on it by cross-examining your LLMs. By themselves, they have no interest in revealing this, no stakes, which makes them tools only useful at the hands of a capable investigator.

> You (a smart human) should be able to converge on it by cross-examining your LLMs. What makes you think this is fundamentally different from cross-examining ELIZA? There is no guarantee that the LLM will help you converge on anything. Indeed actually calling out an LLM on BS tends to eventually produce an "I don't know and can't help you further" answer (as it should).

The same goes for a human expert. There's no guarantee of convergence and you could eventually end up at "I don't know".

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

#399

Post by microgpt »

uecker wrote: post #219
microgpt wrote: post #194

Earlier quoted context omitted.

Sorry? You use AI to hallucinate medical images and that's good?

It is not really the same as LLMs. I wouldn't call it AI. And I wouldn't say "makes up". I work in this field and this is certainly based also in part on my research.

Super-resolution is certainly distinct from hallucinating - it just rearranged data that was already there to make it easier for the human eye to see - but should be used with care. I can easily imagine that an upscaling algorithm makes it so a certain defect is clearly not present, when the source image is ambiguous (which the radiologist would have noticed), and in reality the defect is present.

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

#400

Post by XorNot »

scheme271 wrote: post #317
Esophagus4 wrote: post #287

Earlier quoted context omitted.

Have you ever let the LLMs “discuss” with each other to see if that would give better answers? You might end up with the answer from the most persuasive LLM, but you might also end up with better results. Wonder if there is a paper out there on this.

The problem is how do you know whether the answer is just the most persuasive or actually the most accurate one? It's hard to figure this out without domain knowledge.

Worse is that LLMs are trained to be persuasive by default. The "you're absolutely right..." stereotype is because these things are A/B tested on response quality and we know from studies people reliably rate vibes better then anything else - e.g. while the quality of hospital accomodations likely has some impact on patient outcomes, the view and decor of the room certainly did not fundamentally change the quality of the care provided but it is the largest determinant in how well people rate that care.
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