[HN Gopher] I'm an doctor: Here's what I found when I asked Chat...
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       I'm an doctor: Here's what I found when I asked ChatGPT to diagnose
       my patients
        
       Author : blago
       Score  : 20 points
       Date   : 2023-04-05 22:07 UTC (52 minutes ago)
        
 (HTM) web link (inflecthealth.medium.com)
 (TXT) w3m dump (inflecthealth.medium.com)
        
       | chimeracoder wrote:
       | > So after my regular clinical shifts in the emergency department
       | the other week, I anonymized my History of Present Illness notes
       | for 35 to 40 patients -- basically, my detailed medical narrative
       | of each person's medical history, and the symptoms that brought
       | them to the emergency department -- and fed them into ChatGPT.
       | 
       | It's quite wild that the doctor would openly admit to violating
       | HIPAA in such a brazen way.
       | 
       | HIPAA is _incredibly_ broad in its definition of protected health
       | information - if it 's possible to identify an individual from
       | data even through statistical methods involving other data that a
       | third party might already possess, it's considered protected.
       | It's inconceivable that the doctor would be able to sufficiently
       | anonymize the data in this capacity and still provide enough
       | detail for individual diagnoses.
        
       | suddenclarity wrote:
       | It does worry me what data people are sharing without seemingly
       | much though. He claims it anonymised but I'm a bit sceptical when
       | you input the medical history of 40 people. It's easy to slip up.
        
       | PaulKeeble wrote:
       | But it also gets around the common misdiagnoses for chronic
       | conditions. It has a great description of Long Covid and ME/CFS
       | for example whereas your typical Primary care is going to dismiss
       | that patient with a Psychology diagnosis as is happening daily
       | across the entire western world. Its less biased but its not
       | going to find the rare things especially where the patient has
       | missed something important.
       | 
       | Its a mixed bag just like it is with software. If you ask it to
       | solve something simple it often does a decent job, but something
       | complex and its confidently wrong. It doesn't show the self doubt
       | of expertise that it needs to be a reliable tool yet it still
       | requires the user has that expertise to be able to save time
       | using it.
        
       | gamesbrainiac wrote:
       | Which version though? 3.5 or 4? It does not state this
       | explicitly. There is a world of difference between 3.5 and 4.
        
       | maherbeg wrote:
       | Ah yes, the "everyone lies" House M.D. problem
        
         | SketchySeaBeast wrote:
         | Not even, ChatGPT, being an engine that figures out what's
         | right by finding out what is average, is bad at understanding
         | the atypical.
        
       | ChatGTP wrote:
       | It's funny because it's almost the exact same problem I have with
       | using it professionally for writing software.
        
         | throwbadubadu wrote:
         | Seconding.
        
       | zzzeek wrote:
       | "She had an ectopic pregnancy, in which a malformed fetus
       | develops in a woman's fallopian tube, and not her uterus.
       | Diagnosed too late, it can be fatal -- resulting in death caused
       | by internal bleeding. Fortunately for my patient, we were able to
       | rush her into the operating room for immediate treatment."
       | 
       | because this doctor is not practicing in Texas where such a
       | procedure might get you arrested
        
       | Turskarama wrote:
       | I'm not really sure what he expected here, ChatGPT was not
       | trained to be a doctor, it is far more general than that. Asking
       | ChatGPT for medical advice is like asking someone who is very
       | well read but has no experience as a doctor, and in that context
       | it's doing very well.
       | 
       | He also brings up one of the most salient points without really
       | visiting it enough: ChatGPT does not ask for clarification,
       | because it is not a knowledge base trying to find an answer. All
       | it does is figure out what character is statistically most likely
       | to come next, it has no heuristic to know that there is a task it
       | hasn't fully completed.
       | 
       | This is the same reason ChatGPT cannot yet write programs by
       | itself: in order to do so you'd need to specify the entire
       | program up front (which is exactly what code is).
       | 
       | As soon as we have agents that can do a proper feedback loop of
       | querying a LLM consecutively until some heuristic is reached then
       | the kind of AI doctors are looking for will emerge.
        
       | frognumber wrote:
       | There are two types of medical conditions
       | 
       | 1) Those you see a doctor for
       | 
       | 2) Those you don't
       | 
       | The line depends on where you live. In a poor village, 100% might
       | be the latter, while an executive in SFO will see a doctor for
       | anything serious, but might not if they cut themselves with a
       | kitchen knife.
       | 
       | What's underrated is the ability to have basic medical care and
       | information everywhere, all the time, for free.
       | 
       | That can be casual injuries below the threshold of visiting a
       | doctor (am I better heating or icing? immobilizing or
       | stretching?), or those can be settings where there are no
       | doctors.
       | 
       | Even more, doctors (like AIs) make mistakes, and it's often
       | helpful having a second opinion.
        
       | jhgg wrote:
       | I am curious if GPT-4 would have performed better.
        
       | preommr wrote:
       | It's amazing that it was that effective...
       | 
       | - It's a generalized language model; imagine how much more
       | effective it would be with a specialized ai that used a variety
       | of techniques that are better suited for logic and reasoning,
       | while using llms to interact with patients.
       | 
       | - It cost an order of magnitude less than the visit to a doctor.
       | 
       | - The potential in being able to constantly monitor a patient - a
       | point made in the post.
        
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       (page generated 2023-04-05 23:00 UTC)