6 ms·

I suffer from a yet unknown chronic illness and as everyone in my predicament knows, I have seen a staggering amount of medical professionals who ranged from ar

I suffer from a yet unknown chronic illness and as everyone in my predicament knows, I have seen a staggering amount of medical professionals who ranged from arrogant jerks who didn't listen not take you seriously to highly empathic and thorough people (who still failed to figure out what was wrong) and passing by overzealous specialists who sent me down completely wrong paths with copious amounts of anxiety. Last month I felt particularly low and desperate and decided to dump everything (medical history, doctor notes, irregular lab results, symptoms) into GPT4 and ask for help (did a bit of prompt tuning to get professional level responses). It was mind blowing: it identified 2 possible explanation that were already on my radar, 3 more that I had never considered of which one seems very likely and I am currently getting tested for, explained how each of those correlated with my symptoms and medical history, and asked why I had not had a specific marker tested (HLA b27) that is commonly checked for this type of disease (and indeed, my doctor was equally stumped - he just thought that test had been done already and didn't double-check). Bonus: I asked if the specific marker could be inferred from whole genome sequencing data (had my genome sequenced last year). He told me which tool I could use, helped me align my sequencing data to the correct reference genome expected by that tool, gave me step by step instructions on how to prepare the data and tool, and I'm now waiting for results of the last step (NGS data analysis is veery slow).

wycy 3y ago
Could you share what sort of prompt you used (less all your private data, of course)?
- Ldorigo 3y ago
  Sure. Went like this (I have seen so many doctors that I already wrote down my complete history in french to save time at new visits. Didn't bother translating the history, didn't seem to phase ChatGPT): """ Here is the patient history (in french): • 2000-2010: ◦ ... • 2013: ... ... Additional Notes: - <Some additional observations and comments - patterns I noticed, family history, etc.> Patient is particularly worried about xxx and yyy. What are some possible causes explaining these symptoms and the overall history? Give detailed reasoning to support your hypotheses, include differential diagnosis, think about rare diseases (common causes have already been considered), consider possible combinations of diseases, and don't hesitate to ask follow-up questions to improve diagnosis. Please answer in English. Additional test results that are outside of normal ranges: - <list of abnormal results> Try to consider and explain as many of the blood tests in your work up, and ask for any missing information if necessary. """ The key was to address it as if I was a doctor asking for an opinion. If I asked it "as a patient", I got much lower quality and dumbed down answers.
astockwell 3y ago
When you say “He told me which tool I could use”, did you mean the doctor told you, or was that a typo and you meant that ChatGPT told you which tool and walked you through it? Seemed like the latter, but was too ambiguous to assume.
- ryanwaggoner 3y ago
  It seemed like the latter to me too, and if so, it's an interesting example of how easy it is to subconsciously anthropomorphize these AIs.
- Ldorigo 3y ago
  Yes, it. What it said. In my defense, my native language has no neutral nouns, and neural networks and language models are both masculine - so they're a "he".
  - astockwell 3y ago
    No problem and no defense needed, just wanted to ensure I understood you.
mial 3y ago
I also have a chronic yet unknown condition with a similar story as you, would you share privately your prompts? Contact me at Drgpt@altmails.com
- Ldorigo 3y ago
  I've shared the prompt here https://news.ycombinator.com/reply?id=35770196&goto=threads%3Fid%3DLdorigo%2335770196 https://news.ycombinator.com/reply?id=35770196&goto=threads%...
xwdv 3y ago
Given that doctors are basically inefficient data analysts focused on a single domain, I imagine GPT can replace most of the need to consult a doctor until some physical action needs to be taken. I think an AI that monitors daily vitals and symptoms and reports to you anything that seems alarming might help people live longer and more healthy.
jimsimmons 3y ago
Brainstorming rare diseases and making diagnosis and providing treatment using medical science are different things. If I ask GPT4 about some arcane math concept it’ll wax lyrical about how it has connections to 20 other areas of math. But it fails at simple arithmetic.
- gpm 3y ago
  Proof based higher math and being good at calculating the answers to arithmetical formulas are two pretty unrelated things that just happen to both be called "math". One of my better math professors in a very good pure math undergraduate program added 7 + 9 and got 15 during a lecture, that really doesn't say anything about his ability as a mathematician though.
  - jimsimmons 3y ago
    That’s sorta my point: diagnosing well studied diseases and providing precise treatment is different from speculating causes for rare diseases. Who knows, OP could be a paint sniffer and that’s their root issue. Brainstorming these things requires creativity and even hallucination. But that’s not what doctors do.
  - bloqs 3y ago
    I thought all math was similar due to the ability to work with it requiring decent working memory. Both mental math and conceptually complex items from theory require excellent working memory, which is a function of IQ
    - dinosaurdynasty 3y ago
      You still have to practice arithmetic to be good at it, and a lot of mathematicians don't
- jquery 3y ago
  Most humans fail at doing simple arithmetic in their head. At the very least I'd say GPT4 is superior to 99% of people at mental math. And because it can explain its work step by step it's easy to find where the flaw in its reasoning is and fix it. GPT-4 is capable of self-correction with the right prompts in my experience.
dennis_jeeves1 3y ago
I personally feel you're being overly optimistic. Genes, markers and all of that might seem like high tech medicine, but to the extent that I know there has not been much progress on that front, although it's been hyped a lot, and gets a lot of media coverage.
- makk 3y ago
  Even if this is right, something about this reply feels like it’s missing the magic of the moment we’re in. No empathy,
- alex_lav 3y ago
  What was the intent of this message?
- hcrisp 3y ago
  Indeed HLA-B27 only has a partial correlation with diseases such as AxSpa. "... about 7 percent of Americans are positive for HLA-B27 but only 5 to 10 percent of people with a positive HLA-B27 will have AS" https://creakyjoints.org/about-arthritis/axial-spondyloarthritis/axspa-overview/hla-b27-ankylosing-spondylitis/ https://creakyjoints.org/about-arthritis/axial-spondyloarthr...
  - Ldorigo 3y ago
    5 to 10 percent in the general population. If you already have many of the symptoms, but those symptoms are not specific enough to distinguish between similar autoimmune diseases, then the prior is widely different so a test like this becomes much more relevant.
- marpstar 3y ago
  I don't think it has to be about being "high tech medicine". In this case, the existing documentation of such things combined with the events in the GP's own medical history have been fed into a machine that can identify patterns that a human doctor should have, but for whatever reason has not, identified. I think the potential ramifications for this are huge.
throwbadubadu 3y ago
But that marker is not really indicative both ways (you can have it without the marker and be healthy with it) - find a good rheumatologist who usually sends you to a good radiologist and have some MRTs that identify it certain and quickly.
- Ldorigo 3y ago
  >you can have it without the marker and be healthy with it That is literally true of every marker in existence. It's not the most specific marker, no, but if you already have a strong prior for presence of autoimmune disease, then the presence or absence of that HLA subtype can point towards most likely root cause (autoimmune diseases are all incredibly similar in the early stages).
Buttons840 3y ago
> arrogant jerks who didn't listen [and would] not take you seriously Pride goeth before the fall. I wonder how many arrogant jerks will be humbled to see that they too are now inferior to a computer ("soon"). Humans will always be better at being human though, perhaps they will learn empathy is more important than they thought.
- vasco 3y ago
  Humans will be better at being humans, for sure, but the jury is still out as to if humans prefer to interact with other humans given a sufficiently reliable alternative. Hell is other people, after all.
- krisoft 3y ago
  > Humans will always be better at being human though What do you mean by that? If you mean humans will be always the best being the creature we call human then that goes by definition. If you mean humans will be always more compassionate/emotionaly understanding/better suited to deliver bad news then I am afraid that is unsubstantiated.
  - Buttons840 3y ago
    I meant that a human is valuable just because they are a human; this is not cold truth, but it is a moral value almost everyone shares (and I don't want to imagine a future without this value). In days past some have become arrogant because, let's say, they know more about health and medicine than everyone else; it's their source of self-worth. They may soon have to reassess their value and values.
- rep_lodsb 3y ago
  What you are calling empathy is just patterns of language statistically optimized to be convincing to the average person. And I might sound arrogant when I despair at being surrounded by morons who "buy it", but that is IMO still better than being a sociopath who enjoys it when others are easy to manipulate with pretty words. ChatGPT = artificial sociopathy
GreedClarifies 3y ago
One of the defining characteristics of LLMs is that their knowledge bases are shockingly wide. Anyone who has played with GPT (or similar) has experienced that the width of its knowledge is beyond most if not all humans. Medicine, and in particular diagnosis, is particularly difficult due to the width of knowledge required due to the span of possible diseases. It completely makes sense that GPT, or similar, would simply be better than doctors at diagnosis in time, and it is very plausible that the time is now. This is fantastic news for humanity. Humanity gets better diagnosis and we don't put high IQ people thought a grinder that is medical school and residency to do a job which is not suited to human cognition. It's an amazing win.
- GaryWilder 3y ago
  This is not yet a victory, but progress is already good. To really trust AI in medicine, we need to conduct an incredible amount of research and tests. I don’t think that today you can blindly believe its diagnoses.

wycy 3y ago

Could you share what sort of prompt you used (less all your private data, of course)?

Ldorigo 3y ago
Sure. Went like this (I have seen so many doctors that I already wrote down my complete history in french to save time at new visits. Didn't bother translating the history, didn't seem to phase ChatGPT): """ Here is the patient history (in french): • 2000-2010: ◦ ... • 2013: ... ... Additional Notes: - <Some additional observations and comments - patterns I noticed, family history, etc.> Patient is particularly worried about xxx and yyy. What are some possible causes explaining these symptoms and the overall history? Give detailed reasoning to support your hypotheses, include differential diagnosis, think about rare diseases (common causes have already been considered), consider possible combinations of diseases, and don't hesitate to ask follow-up questions to improve diagnosis. Please answer in English. Additional test results that are outside of normal ranges: - <list of abnormal results> Try to consider and explain as many of the blood tests in your work up, and ask for any missing information if necessary. """ The key was to address it as if I was a doctor asking for an opinion. If I asked it "as a patient", I got much lower quality and dumbed down answers.

astockwell 3y ago

When you say “He told me which tool I could use”, did you mean the doctor told you, or was that a typo and you meant that ChatGPT told you which tool and walked you through it? Seemed like the latter, but was too ambiguous to assume.

ryanwaggoner 3y ago
It seemed like the latter to me too, and if so, it's an interesting example of how easy it is to subconsciously anthropomorphize these AIs.
Ldorigo 3y ago
Yes, it. What it said. In my defense, my native language has no neutral nouns, and neural networks and language models are both masculine - so they're a "he".
- astockwell 3y ago
  No problem and no defense needed, just wanted to ensure I understood you.

mial 3y ago

I also have a chronic yet unknown condition with a similar story as you, would you share privately your prompts? Contact me at Drgpt@altmails.com

Ldorigo 3y ago
I've shared the prompt here https://news.ycombinator.com/reply?id=35770196&goto=threads%3Fid%3DLdorigo%2335770196 https://news.ycombinator.com/reply?id=35770196&goto=threads%...

xwdv 3y ago

Given that doctors are basically inefficient data analysts focused on a single domain, I imagine GPT can replace most of the need to consult a doctor until some physical action needs to be taken. I think an AI that monitors daily vitals and symptoms and reports to you anything that seems alarming might help people live longer and more healthy.

jimsimmons 3y ago

Brainstorming rare diseases and making diagnosis and providing treatment using medical science are different things. If I ask GPT4 about some arcane math concept it’ll wax lyrical about how it has connections to 20 other areas of math. But it fails at simple arithmetic.

gpm 3y ago
Proof based higher math and being good at calculating the answers to arithmetical formulas are two pretty unrelated things that just happen to both be called "math". One of my better math professors in a very good pure math undergraduate program added 7 + 9 and got 15 during a lecture, that really doesn't say anything about his ability as a mathematician though.
- jimsimmons 3y ago
  That’s sorta my point: diagnosing well studied diseases and providing precise treatment is different from speculating causes for rare diseases. Who knows, OP could be a paint sniffer and that’s their root issue. Brainstorming these things requires creativity and even hallucination. But that’s not what doctors do.
- bloqs 3y ago
  I thought all math was similar due to the ability to work with it requiring decent working memory. Both mental math and conceptually complex items from theory require excellent working memory, which is a function of IQ
  - dinosaurdynasty 3y ago
    You still have to practice arithmetic to be good at it, and a lot of mathematicians don't
jquery 3y ago
Most humans fail at doing simple arithmetic in their head. At the very least I'd say GPT4 is superior to 99% of people at mental math. And because it can explain its work step by step it's easy to find where the flaw in its reasoning is and fix it. GPT-4 is capable of self-correction with the right prompts in my experience.

dennis_jeeves1 3y ago

I personally feel you're being overly optimistic. Genes, markers and all of that might seem like high tech medicine, but to the extent that I know there has not been much progress on that front, although it's been hyped a lot, and gets a lot of media coverage.

makk 3y ago
Even if this is right, something about this reply feels like it’s missing the magic of the moment we’re in. No empathy,
alex_lav 3y ago
What was the intent of this message?
hcrisp 3y ago
Indeed HLA-B27 only has a partial correlation with diseases such as AxSpa. "... about 7 percent of Americans are positive for HLA-B27 but only 5 to 10 percent of people with a positive HLA-B27 will have AS" https://creakyjoints.org/about-arthritis/axial-spondyloarthritis/axspa-overview/hla-b27-ankylosing-spondylitis/ https://creakyjoints.org/about-arthritis/axial-spondyloarthr...
- Ldorigo 3y ago
  5 to 10 percent in the general population. If you already have many of the symptoms, but those symptoms are not specific enough to distinguish between similar autoimmune diseases, then the prior is widely different so a test like this becomes much more relevant.
marpstar 3y ago
I don't think it has to be about being "high tech medicine". In this case, the existing documentation of such things combined with the events in the GP's own medical history have been fed into a machine that can identify patterns that a human doctor should have, but for whatever reason has not, identified. I think the potential ramifications for this are huge.

throwbadubadu 3y ago

But that marker is not really indicative both ways (you can have it without the marker and be healthy with it) - find a good rheumatologist who usually sends you to a good radiologist and have some MRTs that identify it certain and quickly.

Ldorigo 3y ago
>you can have it without the marker and be healthy with it That is literally true of every marker in existence. It's not the most specific marker, no, but if you already have a strong prior for presence of autoimmune disease, then the presence or absence of that HLA subtype can point towards most likely root cause (autoimmune diseases are all incredibly similar in the early stages).

Buttons840 3y ago

> arrogant jerks who didn't listen [and would] not take you seriously Pride goeth before the fall. I wonder how many arrogant jerks will be humbled to see that they too are now inferior to a computer ("soon"). Humans will always be better at being human though, perhaps they will learn empathy is more important than they thought.

vasco 3y ago
Humans will be better at being humans, for sure, but the jury is still out as to if humans prefer to interact with other humans given a sufficiently reliable alternative. Hell is other people, after all.
krisoft 3y ago
> Humans will always be better at being human though What do you mean by that? If you mean humans will be always the best being the creature we call human then that goes by definition. If you mean humans will be always more compassionate/emotionaly understanding/better suited to deliver bad news then I am afraid that is unsubstantiated.
- Buttons840 3y ago
  I meant that a human is valuable just because they are a human; this is not cold truth, but it is a moral value almost everyone shares (and I don't want to imagine a future without this value). In days past some have become arrogant because, let's say, they know more about health and medicine than everyone else; it's their source of self-worth. They may soon have to reassess their value and values.
rep_lodsb 3y ago
What you are calling empathy is just patterns of language statistically optimized to be convincing to the average person. And I might sound arrogant when I despair at being surrounded by morons who "buy it", but that is IMO still better than being a sociopath who enjoys it when others are easy to manipulate with pretty words. ChatGPT = artificial sociopathy

GreedClarifies 3y ago

One of the defining characteristics of LLMs is that their knowledge bases are shockingly wide. Anyone who has played with GPT (or similar) has experienced that the width of its knowledge is beyond most if not all humans. Medicine, and in particular diagnosis, is particularly difficult due to the width of knowledge required due to the span of possible diseases. It completely makes sense that GPT, or similar, would simply be better than doctors at diagnosis in time, and it is very plausible that the time is now. This is fantastic news for humanity. Humanity gets better diagnosis and we don't put high IQ people thought a grinder that is medical school and residency to do a job which is not suited to human cognition. It's an amazing win.

GaryWilder 3y ago
This is not yet a victory, but progress is already good. To really trust AI in medicine, we need to conduct an incredible amount of research and tests. I don’t think that today you can blindly believe its diagnoses.