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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

#651

Post by Maro »

themantalope wrote: post #492

Radiologist. I don’t read MR shoulder exams in my day to day practice, but from the few pictures shown , I can’t conclusively disagree with the original report. These models are generally terrible at reading medical images. The amount of public training data on the internet compared to the number of scans a radiologist reads in training is minuscule. There’s obviously a ton of medical images in general but very few,…

I don't have insider information, but: if one of the AI companies really wants their models to become really good at this and publicly available datasets are scarce, they can probably just buy anonymized X-ray/MRI scans paired with the human doctor's diagnosis, and train on them. I don't know what the legal story is around this, but AI companies have near infinite money, so I'm sure they can buy their way around regulations (eg. by buying them from a less regulated country).

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

#652

Post by malfist »

draftsman wrote: post #645
malfist wrote: post #367

Earlier quoted context omitted.

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?

My doc didn't do the full set of test/exam for an hEDS diagnosis, so technically it's just generalized hypermobility spectrum disorder based on past medical history and a near "perfect" beighton score. It could be hEDS though, as a lay person reading the diagnostic criteria I either fit it, or are borderline.

Injury was to my SI joint, I've historically always irritated it lifting, but I set a new PR for deadlifts and it was debilitating for 3 weeks before my other half made me stop being stubborn and see a doctor about it.

I've also had my left shoulder joint surgically repaired after multiple dislocations.

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

#653

Post by d1sxeyes »

drw85 wrote: post #602
d1sxeyes wrote: post #114

Earlier quoted context omitted.

Not quite. An LLM generates text that would likely follow. The sky is… “blue”. A patient in pain with a bone protruding from their shin has a… “broken leg”. The more training data, the more questions it can answer with a reasonable degree of probability of accuracy. Throwing away a potentially useful analysis just because it’s probabilistic seems a bit like throwing the baby out with the bath water.

But for obvious cases like this, you don't need a second or first opinion. This case is about handing a 3D imaging result to a text predictor and hoping for a valid second opinion.

Yes that’s my point. An LLM can clearly accurately predict obvious cases, so it’s reasonable to assume that it can predict less obvious cases with somewhat less accuracy.

The real question is where’s the cut-off point between accuracy and utility.

Remember: a second human opinion can also be wrong, and even a wrong opinion can still be useful (especially in medicine where differential diagnoses are a common practice - if the LLM gives you a useless opinion, you rule it out and move on).

I don’t think it’s particularly unreasonable to think that an LLM would have enough literature, or enough reasoning ability, to be able to generate a plausible interpretation of the data. A human can then review and say either “yeah that’s clearly not the case here” or “hmm, actually that could explain it, maybe we should order another test”.

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

#654

Post by malfist »

kerabatsos wrote: post #421
malfist wrote: post #367

Earlier quoted context omitted.

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

People put a lot of faith in human “guardrails”, standards, etc. But the same argument could be made that trusting human experts without discernment is as dangerous as trusting AI or Google or whatever other non-human source. It’s always been the case.

On the plus side, it's not like it was blind faith. Human judgement lead me to seek out another expert when I didn't like with the current PT was suggesting I do (no practicing hip hinge movements before moving to deadlift, advising against valsava for heavy lifts, ignoring feedback that a movement was causing pain, prescribing stretches to increase flexibility in a hypermobile person).

The LLM also gave me a bunch of questions to ask a new PT but I didn't have the understanding to judge the responses so I did more research. One of the things the LLM wanted me to ask about was questions about form and force closure and ideally would get a response about the oblique sling across the back. My PT didn't give me that exact response, but explained it in much more lay person terms, but because I had done my research I was able to validate their response was directionally correct. And so far, my experience with this PT has been much better. We're doing block pulls at 70% of my prior deadlift weight, next week we're going to go way back on weight and lower it some to get closer to proper deadlifting and work in some asymmetric loading exercises.

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

#655

Post by [deleted] »

bondarchuk wrote: post #641
marcus_holmes wrote: post #481

Earlier quoted context omitted.

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.

[deleted]

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

#656

Post by order-matters »

the more I think about what intelligence really is and what it is about humans that AIs seem unable to replicate, the closer I come to the conclusion that personality is a huge component of intelligence. Certain problem spaces have a structure such that personality differences are stripped away, like in math problems for example, but more and more I am genuinely starting to believe that personality drives intelligence.

There is an undeniable mechanical / logical / objective component to intelligence that acts as the machine to get answers, but I am becoming ever increasingly convinced that you cannot actually separate this machine from personality and still perform at the highest level it is capable of. Communication has its own intelligence limits, and I do not think the marketing angle of "putting intelligence on a meter for you to buy" is going to be an actual real application of intelligence. Not without also outsourcing your personality or being satisfied with a flanderized impersonator of yourself as part of the intelligence

it may seem like this sort of thing should be ignorable for analyzing an MRI, that it's an objective conclusion. But medicine is not really as black and white as it seems. Doctors often have different opinions and they are credible. scans are not oracles, interpretation is involved, as well as a measurement of faith in what the patients body is able to do on its own and what it cant. hard to describe in a simple comment, but the point is that medical diagnosis are not exaclty something that can be packaged into perfect products for consumption to turn into the 1 and only treatment that's best for you

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

#657

Post by lazide »

brokencode wrote: post #458
lazide wrote: post #443

Earlier quoted context omitted.

While completely ignoring the fundamental reason. Whoosh.

Not sure what point you’re trying to make.

That no one has actually solved the underlying problem at all, and the generation of the example LLM has no bearing on the nature of the fundamental problem.

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

#658

Post by parpfish »

Aurornis wrote: post #167
AceJohnny2 wrote: post #117

> There's something incredibly peaceful about being in the hands of an expert you trust. [...] AI can absolutely shatter that feeling in an uncomfortable way [...] but I don't know if I can fully trust AI either. This really is key. We know we can't trust the AI, but at the same time we're also more comfortable asking the AI for clarifications or confronting it. Not having a time-bound appointment or paying by the ho…

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…

LLMs are well suited to my (some would say annoyingly) curious nature.

when i get an answer, and my first instinct is to ask a ton of follow-ups and "what about"s. i've learned to tamp this down with fellow humans, but with LLMs its great because most of the time the response is "you're right, something doesn't add up... let me try again". i think we eventually converge on to something reasonably true

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

#659

Post by clates »

AceJohnny2 wrote: post #117

> There's something incredibly peaceful about being in the hands of an expert you trust. [...] AI can absolutely shatter that feeling in an uncomfortable way [...] but I don't know if I can fully trust AI either. This really is key. We know we can't trust the AI, but at the same time we're also more comfortable asking the AI for clarifications or confronting it. Not having a time-bound appointment or paying by the ho…

> The solution to uncertain information isn't more information, which the AI can certainly provide, it's better information, and AI cannot currently provide that.

Aside from the LLM-ism (it isn't foo, it's bar) - this is a thought terminating cliche. You definitionally don't know if some information is better or not given that you were uncertain about the information in the first case.

"I went to three mechanics and got three different answers" - your takeaway is just "Ah - I clearly need better informed mechanics."

Which is on it's face absurd because if you could clearly judge the ability of the mechanics you wouldn't need their evaluation. You'd just do the evaluation yourself.

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

#660

Post by ryan_n »

azan_ wrote: post #354
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…

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...
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