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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

#741

Post by themantalope »

throwaway2037 wrote: post #620
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,…

No trolling here: Do you feel threatened by the advance of AI/LLMs with respect to your field? I would. I am a computer programmer, and it absolutely feels threatening.

I mostly do interventional radiology, which is more similar to a surgical specialty than a diagnostic radiology practice. We do a lot of procedures , see patients in our clinic, have a service that rounds on and follows up on patients etc. I don’t think AI will affect my job much in the next 10-20 years. Advancements in AI and robotics could potentially offload some of our work, but most of what’s out there is underwhelming, but we all know that can change fast.

Even for diagnostic, I’m not totally convinced AI is going to cause a lot of issues. From a medical-legal perspective I doubt AI companies are willing to take on the risk of misdiagnosis . When that happens, human rads will start to get phased out.

In the interim, I think the next 10 years could be a golden period for diagnostic rads. Rads will still be the ones doing the work and signing reports, but people who learn how to use the right combination of tools will become very productive and can make a great living. Eventually payers will re-align but early adopters who figure it out will have a leg up.

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

#742

Post by themantalope »

yfontana wrote: post #591
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,…

Yeah, medical computer vision is a (fascinating) field with a lot of ongoing research. SOTA models are highly specialized, and are only getting good enough to be used by actual doctors and patients. Using a general purpose LLM to do this is similar to giving a credit card to Openclaw and telling it to make you rich through the stock market & cryptos.

Somewhat. During residency I developed models for detecting liver tumors in MRI imaging. Like you said, highly specialized and a lot of manual work developing the dataset.

There are now open source open weight “foundation models” coming out of labs that are transformer or mamba based architectures. These will accelerate development.

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

#743

Post by themantalope »

Maro wrote: post #651
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 regu…

That’s a good question.

My understanding is that medical images are part of a patients record (so they must be available for the patient or other docs at the request of the patient) but whoever has collected the images does have some form of ownership. I’m not a lawyer and I have a cursory understanding of this. I believe it would be possible for an AI company to lease or get access to the data through a transaction but I suspect that it hasn’t happened (or happened publicly) due to fear of backlash.

For example I know that some companies like Tempus had access to imaging that corresponded to tumors which had been biopsies for sequencing and they were developing models in house.

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

#744

Post by themantalope »

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…

lol yea I wasn’t going to put in a full dictation on the internet but clearly a lot of misinterpretations from the AI

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

#745

Post by themantalope »

deaux wrote: post #565
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,…

Absolutely. It's very unfortunate that this post used the worst example possible of using LLMs for medical purposes. General-purpose LLMs are _fantastic_ at medical diagnosis that do not involve imaging. I am completely convinced that given enough information and time, frontier models already outperform >90% of doctors on initial diagnosis of internal issues and suggesting medical tests to further reject or confirm t…

Not to mention shoulder MRs can be hard to read. Findings can be subtle and have to be interpreted in context with the exam, symptoms etc.

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

#746

Post by ShinyLeftPad »

coderatlarge wrote: post #740
ShinyLeftPad wrote: post #699

Earlier quoted context omitted.

Slavery used to be super likely in the probability space, doesn't make it right...

if two llms independently cite the same law given a certain factual legal question then it generally makes it more likely that the law cited does, in fact, apply to the fact pattern in question ; i think you’re using “right” in a moral sense irrelevant to the comment i was responding to.

But that's the thing, legal stuff is not fully divorced from moral stuff and those things evolve with our morals

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

#747

Post by coderatlarge »

ShinyLeftPad wrote: post #746
coderatlarge wrote: post #740

Earlier quoted context omitted.

if two llms independently cite the same law given a certain factual legal question then it generally makes it more likely that the law cited does, in fact, apply to the fact pattern in question ; i think you’re using “right” in a moral sense irrelevant to the comment i was responding to.

But that's the thing, legal stuff is not fully divorced from moral stuff and those things evolve with our morals

your follow-up makes no difference to the main point under discussion : if you ask two different llms about a legal fact pattern and they independently reference the same law, then it is, in fact, more likely that the law is more relevant to the fact pattern than if only one llm mentioned it.

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

#748

Post by ShinyLeftPad »

coderatlarge wrote: post #747
ShinyLeftPad wrote: post #746

Earlier quoted context omitted.

But that's the thing, legal stuff is not fully divorced from moral stuff and those things evolve with our morals

your follow-up makes no difference to the main point under discussion : if you ask two different llms about a legal fact pattern and they independently reference the same law, then it is, in fact, more likely that the law is more relevant to the fact pattern than if only one llm mentioned it.

My point was that a human can say "sure laws say this but how about it's a screwed up thing and we change it for the better" and LLM will just do whatever is the highest in probability space
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