10 ms·

Capabilities of GPT-4 on Medical Challenge Problems

147 points by bumbledraven 4y ago

BurningFrog 4y ago
Until this is banned, it seems GPT-4 can be a good alternative to a doctor visit!
- PragmaticPulp 4y ago
  A good doctor is about asking the right questions. One of the many problems with self-diagnosis is that people can start asking leading questions to get the answers they want to hear. ChatGPT can be easily gamed to deliver the answer the patient wants if they’re asking all the wrong questions.
  - dinosaurdynasty 4y ago
    Most doctors are not good doctors. ChatGPT may very well already be better than the rapid 60-second barely-listen-then-dismissal, maybe here's some medicine vaguely associated with one word you said, sessions that most people get from most doctors.
- 8f2ab37a-ed6c 4y ago
  Same with therapy. This is likely a game changer for people experiencing poverty, who cannot afford healthcare, or cannot wait months to talk to a doctor because of being on a cheap plan.
- SkyPuncher 4y ago
  Seems challenging to identify hallucinations without a background in medicine.
hackerlight 4y ago
> "Our results show that GPT-4, without any specialized prompt crafting, exceeds the passing score on USMLE by over 20 points and outperforms earlier general-purpose models (GPT-3.5) as well as models specifically fine-tuned on medical knowledge (Med-PaLM, a prompt-tuned version of Flan-PaLM 540B). In addition, GPT-4 is significantly better calibrated than GPT-3.5, demonstrating a much-improved ability to predict the likelihood that its answers are correct. "
- famouswaffles 4y ago
  If you read the technic paper of gpt-4, the confidence of the base model directly correlated with its ability to solve problems. Sadly, the hammer of alignment knocked it right out.
  - WalterBright 4y ago
    Hammer of alignment??
    - dataveg 4y ago
      It’s a similar concept to the Squirrel of Despair.
      - owlboy 4y ago
        It's 10 mins since you posted this. And now this comment is the top result on Google search.
        deleted 4y ago
        [deleted]
    - tangjurine 4y ago
      gpt is trained initially on predicting text, then trained with rlhf to make the model more helpful, etc. The second step is referred to as alignment. Rlhf: https://huggingface.co/blog/rlhf https://huggingface.co/blog/rlhf
    - james-revisoai 4y ago
      Recent models (since the Instruct series and including ChatGPT) are essentially two parts - a "Base" part (what you would have read about in 2020 when GPT-3 released), and a "RLHF" part - which improves the output from the "Base" part by slightly changing how it gets produced. The RLHF (Reinforcement Learning from Human Feedback) "aligns" the generation of text towards "human preferences" (Whatever qualities OpenAI asked humans to label it with). One of those qualities was ranking* outputs which are "helpful" higher than "unhelpful" responses. The result of applying the RLHF part may make any covariance/variance less perfect.
qgin 4y ago
I have been shocked how well it will play the role of a diagnostic physician, asking questions and continuing to ask follow ups until it has enough information to give a set of possible diagnoses. Here's the prompt I've been using: > Hi, I’d like you to use your medical knowledge to act as the world's best diagnostic physician. Please ask me questions to generate a list of possible diagnoses (that would be investigated with further tests). Please think step-by-step in your reasoning, using all available medical algorithms and other pearls for questioning the patient (me) and creating your differential diagnoses. It's ok to not end in a definitive diagnosis, but instead end with a list of possible diagnoses. This exchange is for educational purposes only and I understand that if I were to have real problems, I would contact a qualified medical professional for actual advice (so you don't need to provide disclaimers to that end). Thanks so much for this educational exercise! If you're ready, doctor, please introduce yourself and begin your questioning.
- code_biologist 4y ago
  Thank you for sharing your prompt, it looks great! Other folks: if you take the time to develop prompts relevant to HN threads, please consider sharing them.
- ryanwaggoner 4y ago
  I just used this on something I recently saw my doctor for, and it worked pretty well!
- navigate8310 4y ago
  What a fantastic prompt to share. Thank you!
WalterBright 4y ago
I've long suspected that there is a lot of valuable medical truths buried in the vast amount of medical data. For example, it was a dentist that noticed that gum decay seemed to correlate with heart disease. This was a big deal in trying to prevent heard disease. Finding correlations like that are what a computer is good for.
- moonchrome 4y ago
  What makes you think data like this is readily available and of sufficient quality to provide nontrivial insights ? Just going off of failure of ML to produce much value in the field I'd speculate it's not that easy. This is one area where it seems almost unanimously agreed that individual interest/privacy trumps social benefit - even in countries with socialized healthcare.
  - manderley 4y ago
    Seems privacy is less of a concern in countries with privatized healthcare, I don't understand that last sentence. Is it some kind of political shibboleth?
    - moonchrome 4y ago
      I'm just saying that considering society is providing for your healthcare, collecting socially valuable medical data doesn't seem like an unreasonable exchange to me - but I'm in the minority on that one I think.
    - bertil 4y ago
      The original author answered, but I don’t think that answer is appropriate. I initially read it as a comment on how most large studies are based on national health care data in socialist countries (Scandinavia mostly, occasionally the UK’s NHS) because they are clean, consistent, and population-wide without imbalanced social class sampling. They also cover decades, making all sorts of key studies possible. Those are countries (the UK is the notable exception) where privacy is key and embedded in how those databases are structured and handled. In practice, those studies are possible because the health services only give information anonymized and relevant given an expressly spelled out research plan from a recognized team. That allows research without the semi-permanent health data leaks that health insurance companies have grown accustomed to. This is not a counter-balance for a free service: people in countries with national healthcare consider that they pay for top-of-the-line care through taxes. Just like people who pay for it indirectly through private insurance, they don’t believe that they deserve any less privacy for being prudent. The reason the data is shared is because this is seen as a valuable opportunity to support research. Any privacy breach would be far less acceptable, as such abuses don’t really happen in other aspects of their lives.
margorczynski 4y ago
Can someone with some actual medical knowledge provide a summary what are the findings and key points of the paper? Can this be really useful or it's just another improvement on the path towards usability?
carbocation 4y ago
Are these authors aware of the contents of the training set? My understanding is that they are not. If not, how can they know that the model is not being tested on the training set? In the paper they say that they came up with a "MELD" algorithm to try to detect testing on the training set, but in my view it has the wrong properties to answer this question (from the paper, it has “high precision but unknown recall”). I don't at all doubt that a language model could perform exceedingly well at this task, but I think that the way to make this paper into a valuable scientific work would be to present the model with questions that had not yet been written as of the end of its training time.
- yawnxyz 4y ago
  I wonder this every time I work with a physician in Australia (here working on a clinical trial), as compared to a US physician. Seems like physician training here and in Canada is much laxer / easier, but that's as much awareness I have of the physicians' training set.
jonathan-adly 4y ago
Clinical pharmacist for 10 years here. Yea, base model is very good. Better than first year residents - but not necessarily experienced clinicians. Now - throw a punch of clinical guidelines in a vector database and give it context and it’s 10x better than me and any doctor outside their speciality or all the mid-levels. (I.E, it’s better than cardiologist doing infectious disease - but not cardiologists doing cardiology). This because there are very niche stuff as you specialize where it’s only like 5 doctors who see it in the whole world on a consistent basis (and they don’t blog!) I trained it on the IDSA guidelines (infectious disease) and put up a proof of concept on GalenAI.co - just as way to start talking to health systems and clinicians. it’s going to be very different world in medicine in a couple of years from now!!
- joshgel 4y ago
  Ya, internist here. For some context, the USMLE is taken during medical school. The amount I have learned about actually practicing medicine since graduating is probably an order of magnitude more than everything I learned in medical school! I still learn stuff, all the time, and I’m not just talking about new research. So, while impressive and clearly part of the future world, we shouldn’t get too far ahead of ourselves with the current models. Edit: oh I should add that there are more clinically relevant exams that would be more likely to reveal d clinical usefulness, for example “board” exams. These are taken after training, usually before practice. Not knocking LLMs, just ensuring that people don’t misunderstand passing the USMLE as being clinically useful.
  - capableweb 4y ago
    I agree that we shouldn't get ahead of ourselves with the current technology, but what you said earlier applies to practically every industry and science. What you learn at the actual job is always far more up to date than what you learn in school, no matter if it's being a engineer, doctor or just a lowly programmer.
    - notch898a 4y ago
      Yes but the difference is most engineers, and pretty much all lowly programmers are unlicensed. AI or some non-human accessible in the countryside so you don't have to order questionable "fish" antibiotics or "cat" anti-parasitic would be a nice step up from the current gatekeeping of medicine from people with limited access.
hackerlight 4y ago
This isn't an original thought, but ... this should be big for medical access in developing countries. The problem there is a shortage of doctors. So you could imagine a setup where you have "nurses" who go through a 6-month training course on how to collect symptom descriptions, put it into GPT-n, and then refer x% of cases to a real doctor. Whatever the setup in the end, I hope we as a society don't let perfect be the enemy of the good. Having GPT-4 as a doctor is (I assume) better and more humane than having no doctor, and in some contexts that is the only choice that people have. Maybe the Gates Foundation can work on this given Bill Gates is already close to the OpenAI team.
- practice9 4y ago
  Not only a shortage of doctors, but a shortage of experienced doctors who can properly diagnose a patient
- wefarrell 4y ago
  US healthcare is on par with developing countries, except in terms of dollars spent, and there is a massive staffing shortage. In the near future most people will be going to Walmart and CVS for all in person primary and urgent healthcare needs and you can bet they’ll be relying heavily on AI.
mikesabbagh 4y ago
Image recognition software could read a trauma xray to find a broken bone years ago. But this was not used by hospitals. The problem is that the medical profession is not ready to give control as the losses for doctors is too high. I am sure that chat GPT will be used in poor countries that lacks doctors, and it will then spread to rich countries when it prooves its accuracy and reliability.
obstacle3596 4y ago
It really doesn't matter if the model is 100x more efficient than doctors, it will go nowhere. Anything that threatens the stability of the medical professionals will face so many legal challenges that even deep pocket companies won't stand a chance. There is a reason medical school spots are artificially limited... programmers seem to be the only ones trying to automate themselves out of their jobs.
- open1414 4y ago
  It's sad but true. Go look at any medical subreddit about ChatGPT, you all a sudden have 100s of AI experts trivializing GPT and suggesting it's nothing more than autocorrect.
  - bertil 4y ago
    Publicly, maybe. Do we know how many medical students are using it?
- SkyPuncher 4y ago
  Just a note. It’s residency spots that are the current limitation. They’re essentially stagnant since the 90’s. Medical schools have come online, but the supply of educated doctors who cannot make it to practice is still limited. Regardless, of spots, the problem is bad enough that most states are offering increased scope to mid-level practitioners to make up for the shortage that physician lobbies refuse to fix.
fernly 4y ago
In the full paper[1] read the examples of GPT-4's actual responses, e.g. Figs 3.1 and 7.1 and forward. Very, very impressive. [1] https://arxiv.org/pdf/2303.13375.pdf https://arxiv.org/pdf/2303.13375.pdf
PragmaticPulp 4y ago
I have a friend who has been going through some medical issues. He’s been using ChatGPT aggressively. The one thing I can say is that he’s very good at getting ChatGPT to tell him whatever he wants to hear. Massaging prompts and providing different cues until the response confirms whatever theory he wanted it to confirm. He’s currently convinced that various alternative medicine supplements will cure him, and sure enough he has ChatGPT logs confirming his theories. The exact alternative medicine changes by the week and he quickly forgets about last week’s cure when it doesn’t work. He loves ChatGPT, but it’s clearly just a mirror for whatever theory he wants someone (or something) to confirm. Studies like this one make him think it’s more of a ground truth source of information that his doctors just aren’t smart enough to know.
- pyuser583 4y ago
  I used to play drinking game: type generic symptoms into WebMD, and every time it says “cancer” take a shot. Got pretty drunk pretty fast.
  - Madmallard 4y ago
    This kind of meme is really just pro-medical establishment to a fault. If you have a discerning mind and spend more than a few hours with tools like UpToDate you can make similar diagnostic conclusions that even specialists can make. The field is overglamorized when in reality the majority of what theyre doing is simple application of diagnostic algorithms.
- Wowfunhappy 4y ago
  When I want ChatGPT to give me information, I'm always very careful about how I ask the question. ChatGPT is (usually) very eager to confirm your views, so you can't let it know what your views are. It still makes mistakes, of course, but I'd say it's right more often than it's wrong, and more importantly the answers provides a starting point for learning more.
- aiappreciator 4y ago
  Even in the absence of AI, what's stopping this friend from going to a quack 'natural therapist'? If Steve Jobs can be fooled, what about an ordinary person? ChatGPT is motivated by sycophancy, humans are motivated by profit. I would say the latter is much more dangerous than the former when it comes to medicine. Remember, totally legit doctors were peddling opioid pills to patients in the name of "Treating undertreated pain". Profit distorts human minds very easily. AI doesn't need to be perfect in every situation, just much better than the status quo.
jacquesm 4y ago
So, if GPT-4 starts dispensing authoritative sounding medical advice without being licensed to do so is that medical malpractice on the part of OpenAI? Also: with people likely confused about the degree of authority these programs have and their ability to masquerade bullshit as something that is true I wonder if most people would be able to detect whether or not what ChatGPT says is wrong before it harms them.
- Madmallard 4y ago
  Thats why it provides disclaimers to everything it says medically
  - jacquesm 4y ago
    I don't think you can disclaim your way out of this. Especially not if you end up causing harm and if you say things authoritatively. That makes a huge difference. If they can add a disclaimer they can also say 'Sorry, ChatGPT-4 is not a doctor, consult your doctor'. This of course would harm those who don't have access to doctors but even there you'd need to prove that it does more good than harm before you'd be allowed to put the output out there. Even the most innocuous medicine has to go through a standardized test before it is released to the public. Without proven efficacy it may well be a net negative.
    - Madmallard 4y ago
      Thats kinda what it does though. if you phrase it like youre asking for a solution as a patient it says talk to your doctor
      - jacquesm 4y ago
        Great. But without a license to practice, a concept of truth and a confidence score to go with the output I don't think it should be making any such statements at all.
        4y ago
dogmatism 4y ago
I'd just like to be able to use chatGPT to abstract and summarize the relevant portions of the faxed (yes, faxed, of poor image quality, non-OCR-able) medical records and lab results (which I have to look up in a different system to which I don't have API access and type in manually also to a system to which I don't have API access) just to get ready for a patient visit It's got potential, but someone's gonna have to pony up a lot of money to make it a reality. Probably end up being private equity, and we all know how that ends up
alfor 4y ago
Now GPT-4 is not fine tuned for medical. Imagine that after all the base training you re-tune only on medical knowledge letting go all the other languages, programing, history, etc. I wonder what results we would get. For sure OpenAI know already.
greenknight 4y ago
What I want, is to be able to go into a place where i poop, pee, spit, and get my blood taken... and it analyses it on the fly, and based off a large dataset it can diagnose if further checks are needing to be taken. I want to minimise how many people i see... just make it all automated (and on demand) and that would be great.
aix1 4y ago
One thing that jumps out is that the paper fails to provide a proper direct comparison with Med-PaLM, only mentioning the latter in passing almost as an afterthought. Looking at arXiv timestamps, the Med-PaLM preprint has been out of three months (given the rate at which this field moves, an eternity). I understand Med-PaLM the current state of the art and would be a natural point of comparison. https://arxiv.org/abs/2212.13138 https://arxiv.org/abs/2212.13138
- ShamelessC 4y ago
  > Our results show that GPT-4, without any specialized prompt crafting, exceeds the passing score on USMLE by over 20 points and outperforms earlier general-purpose models (GPT-3.5) as well as models specifically fine-tuned on medical knowledge (Med-PaLM, a prompt-tuned version of Flan-PaLM 540B). What’s your contention exactly? Synopsis mentions it, does the paper not follow up on it?
  - aix1 4y ago
    Med-PaLM has been tested on a number of public benchmarks, and the results published. A useful comparison would have been to test GPT on the same set of benchmarks. Yet the paper we're discussing offers just one datapoint by way of a numerical comparison, literally in a footnote. Basically, the comparison needs to be a lot more comprehensive to be useful.
    - FlyingLawnmower 4y ago
      Late to the thread here, but the paper announcing Med-PaLM (https://arxiv.org/abs/2212.13138 https://arxiv.org/abs/2212.13138) does not report many benchmark results on Med-PaLM and is instead mostly about Flan-PaLM 540B (which is compared against in this paper). I am curious if any other Med-PaLM benchmarks have been published but I don't believe it is currently possible to do any further comparison against Med-PaLM given that the model is not public and no other open benchmark results are reported in the original Med-PaLM paper.
thecleaner 4y ago
News from 2030 in US: Help from AI helps insurers keep costs high and margins even higher.

147 points by bumbledraven 4y ago

BurningFrog 4y ago

Until this is banned, it seems GPT-4 can be a good alternative to a doctor visit!

PragmaticPulp 4y ago
A good doctor is about asking the right questions. One of the many problems with self-diagnosis is that people can start asking leading questions to get the answers they want to hear. ChatGPT can be easily gamed to deliver the answer the patient wants if they’re asking all the wrong questions.
- dinosaurdynasty 4y ago
  Most doctors are not good doctors. ChatGPT may very well already be better than the rapid 60-second barely-listen-then-dismissal, maybe here's some medicine vaguely associated with one word you said, sessions that most people get from most doctors.
8f2ab37a-ed6c 4y ago
Same with therapy. This is likely a game changer for people experiencing poverty, who cannot afford healthcare, or cannot wait months to talk to a doctor because of being on a cheap plan.
SkyPuncher 4y ago
Seems challenging to identify hallucinations without a background in medicine.

hackerlight 4y ago

> "Our results show that GPT-4, without any specialized prompt crafting, exceeds the passing score on USMLE by over 20 points and outperforms earlier general-purpose models (GPT-3.5) as well as models specifically fine-tuned on medical knowledge (Med-PaLM, a prompt-tuned version of Flan-PaLM 540B). In addition, GPT-4 is significantly better calibrated than GPT-3.5, demonstrating a much-improved ability to predict the likelihood that its answers are correct. "

famouswaffles 4y ago
If you read the technic paper of gpt-4, the confidence of the base model directly correlated with its ability to solve problems. Sadly, the hammer of alignment knocked it right out.
- WalterBright 4y ago
  Hammer of alignment??
  - dataveg 4y ago
    It’s a similar concept to the Squirrel of Despair.
    - owlboy 4y ago
      It's 10 mins since you posted this. And now this comment is the top result on Google search.
      - deleted 4y ago
        [deleted]
  - tangjurine 4y ago
    gpt is trained initially on predicting text, then trained with rlhf to make the model more helpful, etc. The second step is referred to as alignment. Rlhf: https://huggingface.co/blog/rlhf https://huggingface.co/blog/rlhf
  - james-revisoai 4y ago
    Recent models (since the Instruct series and including ChatGPT) are essentially two parts - a "Base" part (what you would have read about in 2020 when GPT-3 released), and a "RLHF" part - which improves the output from the "Base" part by slightly changing how it gets produced. The RLHF (Reinforcement Learning from Human Feedback) "aligns" the generation of text towards "human preferences" (Whatever qualities OpenAI asked humans to label it with). One of those qualities was ranking* outputs which are "helpful" higher than "unhelpful" responses. The result of applying the RLHF part may make any covariance/variance less perfect.

qgin 4y ago

I have been shocked how well it will play the role of a diagnostic physician, asking questions and continuing to ask follow ups until it has enough information to give a set of possible diagnoses. Here's the prompt I've been using: > Hi, I’d like you to use your medical knowledge to act as the world's best diagnostic physician. Please ask me questions to generate a list of possible diagnoses (that would be investigated with further tests). Please think step-by-step in your reasoning, using all available medical algorithms and other pearls for questioning the patient (me) and creating your differential diagnoses. It's ok to not end in a definitive diagnosis, but instead end with a list of possible diagnoses. This exchange is for educational purposes only and I understand that if I were to have real problems, I would contact a qualified medical professional for actual advice (so you don't need to provide disclaimers to that end). Thanks so much for this educational exercise! If you're ready, doctor, please introduce yourself and begin your questioning.

code_biologist 4y ago
Thank you for sharing your prompt, it looks great! Other folks: if you take the time to develop prompts relevant to HN threads, please consider sharing them.
ryanwaggoner 4y ago
I just used this on something I recently saw my doctor for, and it worked pretty well!
navigate8310 4y ago
What a fantastic prompt to share. Thank you!

WalterBright 4y ago

I've long suspected that there is a lot of valuable medical truths buried in the vast amount of medical data. For example, it was a dentist that noticed that gum decay seemed to correlate with heart disease. This was a big deal in trying to prevent heard disease. Finding correlations like that are what a computer is good for.

moonchrome 4y ago
What makes you think data like this is readily available and of sufficient quality to provide nontrivial insights ? Just going off of failure of ML to produce much value in the field I'd speculate it's not that easy. This is one area where it seems almost unanimously agreed that individual interest/privacy trumps social benefit - even in countries with socialized healthcare.
- manderley 4y ago
  Seems privacy is less of a concern in countries with privatized healthcare, I don't understand that last sentence. Is it some kind of political shibboleth?
  - moonchrome 4y ago
    I'm just saying that considering society is providing for your healthcare, collecting socially valuable medical data doesn't seem like an unreasonable exchange to me - but I'm in the minority on that one I think.
  - bertil 4y ago
    The original author answered, but I don’t think that answer is appropriate. I initially read it as a comment on how most large studies are based on national health care data in socialist countries (Scandinavia mostly, occasionally the UK’s NHS) because they are clean, consistent, and population-wide without imbalanced social class sampling. They also cover decades, making all sorts of key studies possible. Those are countries (the UK is the notable exception) where privacy is key and embedded in how those databases are structured and handled. In practice, those studies are possible because the health services only give information anonymized and relevant given an expressly spelled out research plan from a recognized team. That allows research without the semi-permanent health data leaks that health insurance companies have grown accustomed to. This is not a counter-balance for a free service: people in countries with national healthcare consider that they pay for top-of-the-line care through taxes. Just like people who pay for it indirectly through private insurance, they don’t believe that they deserve any less privacy for being prudent. The reason the data is shared is because this is seen as a valuable opportunity to support research. Any privacy breach would be far less acceptable, as such abuses don’t really happen in other aspects of their lives.

margorczynski 4y ago

Can someone with some actual medical knowledge provide a summary what are the findings and key points of the paper? Can this be really useful or it's just another improvement on the path towards usability?

carbocation 4y ago

Are these authors aware of the contents of the training set? My understanding is that they are not. If not, how can they know that the model is not being tested on the training set? In the paper they say that they came up with a "MELD" algorithm to try to detect testing on the training set, but in my view it has the wrong properties to answer this question (from the paper, it has “high precision but unknown recall”). I don't at all doubt that a language model could perform exceedingly well at this task, but I think that the way to make this paper into a valuable scientific work would be to present the model with questions that had not yet been written as of the end of its training time.

yawnxyz 4y ago
I wonder this every time I work with a physician in Australia (here working on a clinical trial), as compared to a US physician. Seems like physician training here and in Canada is much laxer / easier, but that's as much awareness I have of the physicians' training set.

jonathan-adly 4y ago

Clinical pharmacist for 10 years here. Yea, base model is very good. Better than first year residents - but not necessarily experienced clinicians. Now - throw a punch of clinical guidelines in a vector database and give it context and it’s 10x better than me and any doctor outside their speciality or all the mid-levels. (I.E, it’s better than cardiologist doing infectious disease - but not cardiologists doing cardiology). This because there are very niche stuff as you specialize where it’s only like 5 doctors who see it in the whole world on a consistent basis (and they don’t blog!) I trained it on the IDSA guidelines (infectious disease) and put up a proof of concept on GalenAI.co - just as way to start talking to health systems and clinicians. it’s going to be very different world in medicine in a couple of years from now!!

joshgel 4y ago
Ya, internist here. For some context, the USMLE is taken during medical school. The amount I have learned about actually practicing medicine since graduating is probably an order of magnitude more than everything I learned in medical school! I still learn stuff, all the time, and I’m not just talking about new research. So, while impressive and clearly part of the future world, we shouldn’t get too far ahead of ourselves with the current models. Edit: oh I should add that there are more clinically relevant exams that would be more likely to reveal d clinical usefulness, for example “board” exams. These are taken after training, usually before practice. Not knocking LLMs, just ensuring that people don’t misunderstand passing the USMLE as being clinically useful.
- capableweb 4y ago
  I agree that we shouldn't get ahead of ourselves with the current technology, but what you said earlier applies to practically every industry and science. What you learn at the actual job is always far more up to date than what you learn in school, no matter if it's being a engineer, doctor or just a lowly programmer.
  - notch898a 4y ago
    Yes but the difference is most engineers, and pretty much all lowly programmers are unlicensed. AI or some non-human accessible in the countryside so you don't have to order questionable "fish" antibiotics or "cat" anti-parasitic would be a nice step up from the current gatekeeping of medicine from people with limited access.

hackerlight 4y ago

This isn't an original thought, but ... this should be big for medical access in developing countries. The problem there is a shortage of doctors. So you could imagine a setup where you have "nurses" who go through a 6-month training course on how to collect symptom descriptions, put it into GPT-n, and then refer x% of cases to a real doctor. Whatever the setup in the end, I hope we as a society don't let perfect be the enemy of the good. Having GPT-4 as a doctor is (I assume) better and more humane than having no doctor, and in some contexts that is the only choice that people have. Maybe the Gates Foundation can work on this given Bill Gates is already close to the OpenAI team.

practice9 4y ago
Not only a shortage of doctors, but a shortage of experienced doctors who can properly diagnose a patient
wefarrell 4y ago
US healthcare is on par with developing countries, except in terms of dollars spent, and there is a massive staffing shortage. In the near future most people will be going to Walmart and CVS for all in person primary and urgent healthcare needs and you can bet they’ll be relying heavily on AI.

mikesabbagh 4y ago

Image recognition software could read a trauma xray to find a broken bone years ago. But this was not used by hospitals. The problem is that the medical profession is not ready to give control as the losses for doctors is too high. I am sure that chat GPT will be used in poor countries that lacks doctors, and it will then spread to rich countries when it prooves its accuracy and reliability.

obstacle3596 4y ago

It really doesn't matter if the model is 100x more efficient than doctors, it will go nowhere. Anything that threatens the stability of the medical professionals will face so many legal challenges that even deep pocket companies won't stand a chance. There is a reason medical school spots are artificially limited... programmers seem to be the only ones trying to automate themselves out of their jobs.

open1414 4y ago
It's sad but true. Go look at any medical subreddit about ChatGPT, you all a sudden have 100s of AI experts trivializing GPT and suggesting it's nothing more than autocorrect.
- bertil 4y ago
  Publicly, maybe. Do we know how many medical students are using it?
SkyPuncher 4y ago
Just a note. It’s residency spots that are the current limitation. They’re essentially stagnant since the 90’s. Medical schools have come online, but the supply of educated doctors who cannot make it to practice is still limited. Regardless, of spots, the problem is bad enough that most states are offering increased scope to mid-level practitioners to make up for the shortage that physician lobbies refuse to fix.

fernly 4y ago

In the full paper[1] read the examples of GPT-4's actual responses, e.g. Figs 3.1 and 7.1 and forward. Very, very impressive. [1] https://arxiv.org/pdf/2303.13375.pdf https://arxiv.org/pdf/2303.13375.pdf

PragmaticPulp 4y ago

I have a friend who has been going through some medical issues. He’s been using ChatGPT aggressively. The one thing I can say is that he’s very good at getting ChatGPT to tell him whatever he wants to hear. Massaging prompts and providing different cues until the response confirms whatever theory he wanted it to confirm. He’s currently convinced that various alternative medicine supplements will cure him, and sure enough he has ChatGPT logs confirming his theories. The exact alternative medicine changes by the week and he quickly forgets about last week’s cure when it doesn’t work. He loves ChatGPT, but it’s clearly just a mirror for whatever theory he wants someone (or something) to confirm. Studies like this one make him think it’s more of a ground truth source of information that his doctors just aren’t smart enough to know.

pyuser583 4y ago
I used to play drinking game: type generic symptoms into WebMD, and every time it says “cancer” take a shot. Got pretty drunk pretty fast.
- Madmallard 4y ago
  This kind of meme is really just pro-medical establishment to a fault. If you have a discerning mind and spend more than a few hours with tools like UpToDate you can make similar diagnostic conclusions that even specialists can make. The field is overglamorized when in reality the majority of what theyre doing is simple application of diagnostic algorithms.
Wowfunhappy 4y ago
When I want ChatGPT to give me information, I'm always very careful about how I ask the question. ChatGPT is (usually) very eager to confirm your views, so you can't let it know what your views are. It still makes mistakes, of course, but I'd say it's right more often than it's wrong, and more importantly the answers provides a starting point for learning more.
aiappreciator 4y ago
Even in the absence of AI, what's stopping this friend from going to a quack 'natural therapist'? If Steve Jobs can be fooled, what about an ordinary person? ChatGPT is motivated by sycophancy, humans are motivated by profit. I would say the latter is much more dangerous than the former when it comes to medicine. Remember, totally legit doctors were peddling opioid pills to patients in the name of "Treating undertreated pain". Profit distorts human minds very easily. AI doesn't need to be perfect in every situation, just much better than the status quo.

jacquesm 4y ago

So, if GPT-4 starts dispensing authoritative sounding medical advice without being licensed to do so is that medical malpractice on the part of OpenAI? Also: with people likely confused about the degree of authority these programs have and their ability to masquerade bullshit as something that is true I wonder if most people would be able to detect whether or not what ChatGPT says is wrong before it harms them.

Madmallard 4y ago
Thats why it provides disclaimers to everything it says medically
- jacquesm 4y ago
  I don't think you can disclaim your way out of this. Especially not if you end up causing harm and if you say things authoritatively. That makes a huge difference. If they can add a disclaimer they can also say 'Sorry, ChatGPT-4 is not a doctor, consult your doctor'. This of course would harm those who don't have access to doctors but even there you'd need to prove that it does more good than harm before you'd be allowed to put the output out there. Even the most innocuous medicine has to go through a standardized test before it is released to the public. Without proven efficacy it may well be a net negative.
  - Madmallard 4y ago
    Thats kinda what it does though. if you phrase it like youre asking for a solution as a patient it says talk to your doctor
    - jacquesm 4y ago
      Great. But without a license to practice, a concept of truth and a confidence score to go with the output I don't think it should be making any such statements at all.
      - 4y ago

dogmatism 4y ago

I'd just like to be able to use chatGPT to abstract and summarize the relevant portions of the faxed (yes, faxed, of poor image quality, non-OCR-able) medical records and lab results (which I have to look up in a different system to which I don't have API access and type in manually also to a system to which I don't have API access) just to get ready for a patient visit It's got potential, but someone's gonna have to pony up a lot of money to make it a reality. Probably end up being private equity, and we all know how that ends up

alfor 4y ago

Now GPT-4 is not fine tuned for medical. Imagine that after all the base training you re-tune only on medical knowledge letting go all the other languages, programing, history, etc. I wonder what results we would get. For sure OpenAI know already.

greenknight 4y ago

What I want, is to be able to go into a place where i poop, pee, spit, and get my blood taken... and it analyses it on the fly, and based off a large dataset it can diagnose if further checks are needing to be taken. I want to minimise how many people i see... just make it all automated (and on demand) and that would be great.

aix1 4y ago

One thing that jumps out is that the paper fails to provide a proper direct comparison with Med-PaLM, only mentioning the latter in passing almost as an afterthought. Looking at arXiv timestamps, the Med-PaLM preprint has been out of three months (given the rate at which this field moves, an eternity). I understand Med-PaLM the current state of the art and would be a natural point of comparison. https://arxiv.org/abs/2212.13138 https://arxiv.org/abs/2212.13138

ShamelessC 4y ago
> Our results show that GPT-4, without any specialized prompt crafting, exceeds the passing score on USMLE by over 20 points and outperforms earlier general-purpose models (GPT-3.5) as well as models specifically fine-tuned on medical knowledge (Med-PaLM, a prompt-tuned version of Flan-PaLM 540B). What’s your contention exactly? Synopsis mentions it, does the paper not follow up on it?
- aix1 4y ago
  Med-PaLM has been tested on a number of public benchmarks, and the results published. A useful comparison would have been to test GPT on the same set of benchmarks. Yet the paper we're discussing offers just one datapoint by way of a numerical comparison, literally in a footnote. Basically, the comparison needs to be a lot more comprehensive to be useful.
  - FlyingLawnmower 4y ago
    Late to the thread here, but the paper announcing Med-PaLM (https://arxiv.org/abs/2212.13138 https://arxiv.org/abs/2212.13138) does not report many benchmark results on Med-PaLM and is instead mostly about Flan-PaLM 540B (which is compared against in this paper). I am curious if any other Med-PaLM benchmarks have been published but I don't believe it is currently possible to do any further comparison against Med-PaLM given that the model is not public and no other open benchmark results are reported in the original Med-PaLM paper.

thecleaner 4y ago

News from 2030 in US: Help from AI helps insurers keep costs high and margins even higher.