this post was submitted on 10 Sep 2023
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As AI capabilities advance in complex medical scenarios that doctors face on a daily basis, the technology remains controversial in medical communities.

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[–] [email protected] 33 points 1 year ago (3 children)

I mean if the AI takes women seriously then that's honestly already better than most of the doctors I've had

[–] [email protected] 23 points 1 year ago (1 children)

Unfortunately, if the data is biased, the model is biased.

[–] [email protected] 11 points 1 year ago

Yes, that's something that's constantly emphasized in scientific research. You might have the most infallible algorithm, but... garbage in, garbage out. You'll still get garbage data if what you enter into the algorithm is garbage

[–] Domille 8 points 1 year ago

I was about to say...

Wonder what the success rate of doctors is. I'd be surprised if it is above 70% lol

[–] [email protected] 0 points 1 year ago (1 children)

Or if it’s better at diagnosing minorities, too.

[–] [email protected] 3 points 1 year ago

It almost certainly won't, but it's nice to hope.

It might remove the face to face human bias of a GP but it doesn't make up for the decades of preconceived or absent research about women or minorities.

[–] [email protected] 28 points 1 year ago* (last edited 1 year ago) (2 children)

To allow ChatGPT or comparable AI models to be deployed in hospitals, Succi said that more benchmark research and regulatory guidance is needed, and diagnostic success rates need to rise to between 80% and 90%.

Sucks if your one of the 10-20% who don't get proper treatment (maybe die?) because some doctor doesn't have time to double check. But hey ... efficiency!

[–] [email protected] 20 points 1 year ago (1 children)

Ya that's a fundamental misunderstanding of percentages. For an analogous situation with which we're all more intuitively familiar, a self driving car that is 99.9% accurate in detecting obstacles crashes into one in one thousand people and/or things. That sucks.

Also, most importantly, LLMs are incapable of collaboration, something very important in any complex human endeavor but difficult to measures, and therefore undervalued by our inane, metrics-driven business culture. Chatgpt won't develop meaningful, mutually beneficial relationships with its colleagues, who can ask each other for their thoughts when they don't understand something. It'll just spout bullshit when it's wrong, not because it doesn't know, but because it has no concept of knowing at all.

[–] [email protected] 9 points 1 year ago* (last edited 1 year ago) (1 children)

It really needs to be pinned to the top of every single discussion around chatgbt:

It does not give answers because it knows. It gives answers because it thinks it looks right.

Remember back in school when you didn't study for a test and went through picking answers that "looked right" because you vaguely remember hearing the words in Answer B during class at some point?

It will never have wisdom and intuition from experience, and that's critically important for doctors.

[–] [email protected] 1 points 1 year ago

Or one of the ninty nine percent of people who don't give the AI their symptoms in medical terminology.

[–] [email protected] 23 points 1 year ago* (last edited 1 year ago) (4 children)

A few things, that's an abysmal rate when it comes to people's health. A doctor with that success rate would be sued into next century. The rate dropped further when it came to differential diagnosis, implying chat gpt was leaving out important rarer possibilities. Often doctors work by starting with the most common and narrow down from there after repeated rounds of testing if it ends up being something uncommon, but one of their primary jobs is also thinking about rarer dangerous stuff that can mimic more common things and must be ruled out immediately.

Most importantly, the information fed into this was optimized with accurate descriptive medical terminology. This is a language that, in general, patients do not speak. People can also describe things very differently, for instance a patient saying something is weak when a doctor may say no that's numb not weak or visa versa. And dizzy could mean just about anything. Someone typing their own story directly into chat gpt is going to get much worse results than this without someone to interpret the word choices and ask the right questions that people may not even realize are important.

Anyways, the possibilities of AI use in Healthcare is interesting, but disappointing it does worse the less common things get and is bad at a differential diagnosis, the areas that would be really helpful as an aid to diagnosis. Some other areas to think about though could be maybe as a front end to find clinical trials with the us gov database, which can be hard to browse, or maybe streamlining the endless insurance paperwork. I'd be surprised insurance companies don't use something similar already.

[–] [email protected] 9 points 1 year ago (1 children)

Don't forget the inherent biases that are introduced with AI training! Women especially have a history of having their symptoms dismissed out of hand - if the LLM training data includes these biases, in combination with the bad diagnosis women could be really screwed.

[–] [email protected] 3 points 1 year ago

similarly to people from different races/countries … it’s not only that their conditions might vary and require more data, it is also that some communities don’t visit/trust hospitals to even have their data collected to be in the training set. Or they can’t afford to visit.

Sometimes, people from more vulnerable communities (eg LGBT) might prefer not to have such data collected in the first place, making data sparser.

[–] [email protected] 5 points 1 year ago

. The rate dropped further when it came to differential diagnosis, implying chat gpt was leaving out important rarer possibilities.

Every decade, new diagnoses and discoveries are made. Many manmade or climate change related. We never had microplastic poison before. Or random chemicals added into our foods because it gives a company that +1% profit.

In other words, we are finding new ways to destroy our bodies!

And with AI is always working with historical data, it'll be a long time before we only use a AI Doctor.

[–] [email protected] 1 points 1 year ago (1 children)

Anecdotally my doctor is prolly only right 75% of the time too. But I’ll go back to him later with more information about the ailment (or more tests) and he’ll eventually get it right. Medical diagnoses in general are not terribly accurate.

[–] [email protected] 5 points 1 year ago

I don't think your comment really disputes anything the previous poster said.

But maybe you read the first lines and skimmed the rest (I certainly do that more often than I would like).

[–] [email protected] -2 points 1 year ago

IME my doctor would not outperform ChatGPT

[–] [email protected] 12 points 1 year ago (1 children)

AI could ultimately improve both the efficiency and the accuracy of diagnosis as healthcare in the U.S. gets more expensive and complicated as individuals live longer, and the overall population ages

When you read some bs on internet but thankfully its US only

[–] [email protected] 2 points 1 year ago

First in medical spending. 40th or 50th in positive medical outcomes.

Among Western nations.

[–] [email protected] 12 points 1 year ago

So it's about as good as people going to WebMD and diagnosing themselves? hoo boy

[–] [email protected] 9 points 1 year ago

Details matter here. Here's a few from the study:

ChatGPT achieved an overall accuracy of 71.7% (95% CI 69.3%-74.1%) across all 36 clinical vignettes. The LLM demonstrated the highest performance in making a final diagnosis with an accuracy of 76.9% (95% CI 67.8%-86.1%) and the lowest performance in generating an initial differential diagnosis with an accuracy of 60.3% (95% CI 54.2%-66.6%). Compared to answering questions about general medical knowledge, ChatGPT demonstrated inferior performance on differential diagnosis (β=–15.8%; P<.001) and clinical management (β=–7.4%; P=.02) question types.

At the time of the study, 36 vignette modules were available on the web, and 34 of the 36 were available on the web as of ChatGPT’s September 2021 training data cutoff date. All 36 modules passed the eligibility criteria of having a primarily textual basis and were included in the ChatGPT model assessment.

All questions requesting the clinician to analyze images were excluded from our study, as ChatGPT is a text-based AI without the ability to interpret visual information.

[–] [email protected] 6 points 1 year ago

Those odds are shit. Meanwhile most of us have zero doctor.

[–] [email protected] 5 points 1 year ago

Medicine is going to take awhile for anything except small-scope tools to handle one specific thing, due to the massive variation in the presentation of different problems that doctors can face.

What won't take as long, because there isn't the same inherent variation in presentation, is law.

[–] [email protected] 4 points 1 year ago

Sadly, that percentage is probably better than a good number of doctors.

[–] [email protected] 2 points 1 year ago (2 children)

That's a whole 22% better than a coin toss!!!

[–] [email protected] 8 points 1 year ago

Not really comparable since a medical diagnosis has hundreds of possible results

[–] [email protected] 1 points 1 year ago

Having made many models that were only slightly better than a coin toss, that's really not bad. Especially since that's not even their primary design goal.

[–] [email protected] 1 points 1 year ago (1 children)

About 70 percentage points better than my doctor. Nice!

[–] [email protected] 2 points 1 year ago

Yeah, medicine is one of the areas where I really feel like AI could make serious strides. Most people don't have a doctor they see regularly anyway so any input would be welcome. Anecdotally I've known several people who were misdiagnosed or just had doctors not believe them.

Of course I'd want to be able to escalate and have different treatment options but I could probably be ok with AI-assisted medicine.

[–] [email protected] -3 points 1 year ago (2 children)

I don't use ChatGPT and ain't planning to, but someone should try asking it something like...

"How often should a male change their tampon?"

See what, if any nonsense it regurgitates.

[–] [email protected] 9 points 1 year ago (1 children)

“Men do not typically use tampons since they are designed for menstruation, which is a female biological process. If you have specific questions about personal hygiene or healthcare, it's best to consult with a medical professional who can provide guidance based on your individual needs and circumstances.”

[–] [email protected] 3 points 1 year ago (1 children)

Okay then, well go figure. I was guessing it would puke up some nonsense, but apparently not.

[–] [email protected] 4 points 1 year ago (1 children)

You know it's free to use right? You can play around with it yourself and see what it can do

[–] [email protected] -2 points 1 year ago (1 children)

Been there, tried that. Unless something done changed, they said I had 10 free trial uses, then I'd have to pay.

[–] [email protected] 2 points 1 year ago (1 children)

You sure you're using the real thing at chat.openai.com? What you're describing does not sound right

[–] [email protected] 3 points 1 year ago

I'm saving this comment for later, I'm not exactly sure which site I was using, but the engine was supposedly ChatGPT.

You might be right. Thank you for the link. 👍

[–] [email protected] 1 points 1 year ago (1 children)

Men that menstruate exist.

[–] [email protected] 1 points 1 year ago (1 children)

Now I'm no expert, but if you're bleeding from your penis or your anus, you should probably go see a doctor about that.

[–] [email protected] 0 points 1 year ago (1 children)
[–] [email protected] 0 points 1 year ago* (last edited 1 year ago) (1 children)

I used the biological word 'male', not the opinionated word 'man'. IDGAF what you identitfy as.

This isn't up for debate, either you have XX or XY chromosomes. You were either born with a dick or you weren't.

So unless you're a hermaphrodite, you should probably get yourself checked if you are somehow bleeding from your penis.

Or not, I don't care if your dick falls off.

[–] [email protected] 3 points 1 year ago (1 children)

This isn’t up for debate, either you have XX or XY chromosomes. You were either born with a dick or you weren’t.

There are so many biological exceptions to this that it’s not even funny. For example, it is very possible to have XY chromosomes yet not be born with a dick. Look up Androgen Insensitivity Syndrome for a start.

There are no absolutes when talking about sex and gender. None.

[–] [email protected] -2 points 1 year ago (1 children)

What? No documentation to back this up?

I mean seriously, are there any documented cases of anyone born with a penis yet also having monthly periods?

[–] [email protected] 2 points 1 year ago* (last edited 1 year ago)

I can see already you’re not arguing in good faith, you’re just trying to raise a stink. Have a mediocre day.