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A neurology ICU nurse on AI in hospitals

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Re: A neurology ICU nurse on AI in hospitals

#91

Post by eesmith »

parasense wrote: post #49

I did a bunch of research essays into medical uses of AI/ML and I'm not terrified, in fact the single most significant use of these technologies is probably in or around healthcare. One of the most cited uses would be expert analysis of medical imaging, especially breast cancer imaging. There is a lot of context to unpack around breast cancer imaging, or more sucinctly put, controversial drama! The fact is there is a…

> AI has proven to be better at looking at medical image, and in the case of breast cancer seems to out perform humans

FWIW, https://pmc.ncbi.nlm.nih.gov/articles/PMC11073588/ from 2024 Apr 4 ("Revolutionizing Breast Cancer Detection With Artificial Intelligence (AI) in Radiology and Radiation Oncology: A Systematic Review") says:

"Presently, when a pre-selection threshold is established (without the radiologist's involvement), the performance of AI and a radiologist is roughly comparable. However, this threshold may result in the AI missing certain cancers.

To clarify, both the radiologist and the AI system may overlook an equal number of cases in a breast cancer screening population, albeit different ones. Whether this poses a significant problem hinges on the type of breast cancer detected and missed by both parties. Further assessment is imperative to ascertain the long-term implications"

and concludes

"Given the limitations in the literature currently regarding all studies being retrospective, it has not been fully clear whether this system can be beneficial to breast radiologists in a real-time setting. This can only be evaluated by performing a prospective study and seeing in what situations the system works optimally. To truly gauge the system's effectiveness in real-time clinical practice, prospective studies are necessary to address current limitations stemming from retrospective data."

Re: A neurology ICU nurse on AI in hospitals

#92

Post by consteval »

wing-_-nuts wrote: post #68
cowmix wrote: post #54

This article feels “ripped from today’s headlines” for me, as my mother-in-law was recently in the ICU after a fall that caused head trauma. The level of AI-driven automated decision-making is unsettling, especially as it seems to allow large organizations to deflect accountability—“See? The AI made us do it!” I’m not entirely sure what guided her care—or lack thereof—but, as someone who frequently works in healthcar…

The article feels very much like a union rep fighting automation. If AI is provably worse, we should see that come up in the AI making 'bad calls' vs the human team. You would even see affects on health outcomes. One place I'd really like an all seeing eye AI overlord is in nursing home care. I have seen family members lie in filth with clear signs of an infection. I am confident, if we hadn't visited, seen this, and…

The reality is that our economy and entire understanding of human society relies on labor. If we free humans from labor, they just die. Like you're depriving them of oxygen.

Automation is great and all, and it's worked because we've been able to push humans higher and higher up the job ladder. But if, in the future, only highly specialized experts are valuable and better than AI, then a large majority of humanity will just be excluded from the economy all together.

I'm not confident the average Joe could become a surgeon, even given perfect access to education. And I'm not even confident surgery won't be automated. Where does that leave us?

Re: A neurology ICU nurse on AI in hospitals

#93

Post by A_D_E_P_T »

bangaroo wrote: post #77
A_D_E_P_T wrote: post #58

Earlier quoted context omitted.

"AI" is basically a vast, curated, compressed database with a powerful index. If the database reflects the current state of the art, it'll have better understanding than the majority of human practitioners. You may say it will "simulate understanding" -- but in this case the simulation would be indistinguishable from the real thing, thus it would be the real thing. (Really "indiscernible" in the philosophical sense o…

> "AI" is basically a vast, curated, compressed database with a powerful index. If the database reflects the current state of the art, it'll have better understanding than the majority of human practitioners. But it's not. You're missing the point entirely and don't know what you're advocating for. A dictionary contains all the words necessary to describe any concept and rudimentary definitions to help you string sen…

I think that your information is slightly out of date. (From Wolfram's book, perhaps?) LLM + plain vanilla RAG solves almost all of the problems you mentioned. LLM + agentic RAG solves them pretty much entirely.

Even as of right now, stock LLMs are much more accurate than medical students in licensing exam questions: https://mededu.jmir.org/2024/1/e63430

Thus your comment is basically at odds with reality. Not only have these models eclipsed what they were capable of in early 2023, when it was easy to dismiss them as "glorified autocompletes," but they're now genuinely turning the "expert system" meme into a reality via RAG-based techniques and other methods.

Re: A neurology ICU nurse on AI in hospitals

#94

Post by danudey »

chubot wrote: post #65
coliveira wrote: post #10

Everyone should be terrified. The "promise" of AI is the following: remove any kind of remaining communication between humans, because that is "inefficient", and replace it with an AI that will mediate all human interactions (in business and even in other areas). In a few years, AIs trained by big corps will run the show and humans will be required to interface with them to do anything of value. Similar to what they…

It's true, but corporate policies and insurance are already like "slow AI" They remove most of what's real in interactions I remember going for a routine checkup at Kaiser, and the doctor was literally checking boxes on her computer terminal, rather than looking, talking, listening. I dropped them after that -- it was pointless for me to go It seems like there are tons of procedures that already have to be followed,…

> I remember going for a routine checkup at Kaiser, and the doctor was literally checking boxes on her computer terminal, rather than looking, talking, listening.

This is also a doctor issue, to be clear. My primary care physician has a program he uses on his laptop; I'm not sure what program it is, but he's been using it since I started going to him around 2009 so it's definitely not something new. He goes through and checks off boxes, as you described your doctor doing, but he also listens and makes suggestions.

When I have an issue, he asks all the questions and checks off the boxes, but he's also listening to the answers. When I over-explain something, he goes into detail about why that is or is not (or may or may not) be relevant to the issue. He makes suggestions based on the medicine but also on his experiences. Seasonal affective disorder? You can get a lamp, you can take vitamin D, or you can go snowboarding up above the clouds. Exercise and sunlight both.

For my psych checkups (ADHD meds and antidepressants) he goes through the standard score questionnaire (which every doctor I've seen uses), then fills in the scores I got into his app. Because of that he can easily see what my scores were the last time we spoke (about once every three months), so it's easy to see if something has changed dramatically or if things are relatively consistent.

It seems as though it saves a lot of time compared to, say, paper charting, and while I have seen people complain on review sites that he's just checking stuff off on a form, I don't don't feel that it's actually impacting the quality of care I get, and it's good to know that he's going through the same process each time, making notes each time, and having all that information easily accessible for my next appointment.

I should probably have prefaced all this by saying I'm in Canada, and so he's not being mandated by a private insurance company to follow a list just because the bureaucracy won't pay for your treatment if he doesn't. Maybe that makes it different.

Re: A neurology ICU nurse on AI in hospitals

#95

Post by danudey »

coliveira wrote: post #79
tivert wrote: post #75

Earlier quoted context omitted.

> Everyone should be terrified. The "promise" of AI is the following: remove any kind of remaining communication between humans, because that is "inefficient", and replace it with an AI that will mediate all human interactions (in business and even in other areas). Kinda, that's the kind of enshittification customers/users can expect. The truly terrifying "promise" of AI is to free the ownership class from most of it…

> The worst outcome is Sam Altman builds an AGI Sam Altman doesn't need to build an AGI for this process to happen. Companies already demonstrate that they're satisfied with a lame AI that work just barely enough to replace most workers.

"It hallucinates facts and uses those to manufacture lies? How soon can we have it managing all of our customer interactions?"

Re: A neurology ICU nurse on AI in hospitals

#96

Post by danudey »

teeray wrote: post #62
coliveira wrote: post #10

Everyone should be terrified. The "promise" of AI is the following: remove any kind of remaining communication between humans, because that is "inefficient", and replace it with an AI that will mediate all human interactions (in business and even in other areas). In a few years, AIs trained by big corps will run the show and humans will be required to interface with them to do anything of value. Similar to what they…

> remove any kind of remaining communication between humans, because that is "inefficient", and replace it with an AI that will mediate all human interactions I imagine that call center operators are salivating at this prospect. They can have an AI customers can yell at and it will calmly and cheerfully tell them (in a more "human-esque" way) to try rebooting their modem again, or visit the website to view their bill…

They're going to be laughing all the way to the... settlement payments?

https://www.forbes.com/sites/marisagarcia/2024/02/19/what-ai...

Re: A neurology ICU nurse on AI in hospitals

#97

Post by 015a »

qgin wrote: post #87
015a wrote: post #84

Earlier quoted context omitted.

Ok, fine, but how do you vibe your sense of "automation and AI will help drive down the cost of healthcare" with the absolute undeniable reality that healthcare has been adopting automation for decades, and over the decades it has only gotten (exponentially) more and more expensive? While outcomes are stagnating or getting worse? Where is the disconnect between your sense of how reality should function, and how it is…

Outcomes have been getting worse for decades?

Not the best source, but its at least illustrative of the point: https://www.statista.com/statistics/1040079/life-expectancy-...

Re: A neurology ICU nurse on AI in hospitals

#98

Post by marcuskane2 »

consteval wrote: post #92
wing-_-nuts wrote: post #68

Earlier quoted context omitted.

The article feels very much like a union rep fighting automation. If AI is provably worse, we should see that come up in the AI making 'bad calls' vs the human team. You would even see affects on health outcomes. One place I'd really like an all seeing eye AI overlord is in nursing home care. I have seen family members lie in filth with clear signs of an infection. I am confident, if we hadn't visited, seen this, and…

The reality is that our economy and entire understanding of human society relies on labor. If we free humans from labor, they just die. Like you're depriving them of oxygen. Automation is great and all, and it's worked because we've been able to push humans higher and higher up the job ladder. But if, in the future, only highly specialized experts are valuable and better than AI, then a large majority of humanity wil…

> Where does that leave us?

Free to pursue our desires in a utopia.

Humans used to work manual labor to produce barely enough food to survive, with occasional famines, and watch helplessly as half of their children died before adulthood.

We automated farm labor, mining, manufacturing, etc so that one worker can now produce the output of 10, 100 or 100,000 laborers from a generation or two ago. Now those people work in new jobs and new industries that didn't previously exist.

Today we're seeing the transition from automating physical labor to automating mental labor. Just as before, we'll see those workers move into new jobs and new industries that didn't exist before.

Our society already spends 1000x more resources on children, elderly, disabled, unemployed, refugee, etc than would have been possible in the 1800s. The additional societal wealth creation from AI will mean that we can dedicate just a tiny portion of the surplus to provide universal basic income to everyone. (Or call it disability payments or housing assistance or welfare or whatever term if UBI doesn't resonate politically)

Re: A neurology ICU nurse on AI in hospitals

#99

Post by andy_ppp »

luxcem wrote: post #57
andy_ppp wrote: post #30

Earlier quoted context omitted.

If you are autistic (for example) I'm guessing human interaction can be extremely difficult and very stressful and triggering. Machines are much more amenable and don't have loads of arbitrary unwritten rules the way humans do. Maybe the idea of being entrapped by bureaucracy introduced by machines will be better than the the bureaucracy introduced by humans?

> Machines are much more amenable and don't have loads of arbitrary unwritten rules I'm sure system prompts of the most famous LLM are just that

They are not as arbitrary as body language for example.

Re: A neurology ICU nurse on AI in hospitals

#100

Post by andy_ppp »

add-sub-mul-div wrote: post #50
andy_ppp wrote: post #30

Earlier quoted context omitted.

If you are autistic (for example) I'm guessing human interaction can be extremely difficult and very stressful and triggering. Machines are much more amenable and don't have loads of arbitrary unwritten rules the way humans do. Maybe the idea of being entrapped by bureaucracy introduced by machines will be better than the the bureaucracy introduced by humans?

The difference between a standard human-written algorithm and machine learning is exactly that inability to find the rules transparent, predictable, and not arbitrary.

I can see this but I think humans are much more random than most LLMs - they lie, they have egos, they randomly dislike other humans and make things difficult for them. Never mind body language, networks of influence, reputation destruction and all the other things that people do to obtain power.

I think LLMs are much more predictable and they will get better.

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