4 ms·

That argument isn't good enough. And I agree with you it really sucks in the usa. And maybe we all need to be talking to everyone else about fixing that. I'm do

That argument isn't good enough. And I agree with you it really sucks in the usa. And maybe we all need to be talking to everyone else about fixing that. I'm down for that conversation anytime any day. It is profoundly irresponsible to basically encourage people to self-diagnose. It's going to kill a number of them too. That's no joke.

bigyikes 3y ago
How about the opportunity cost of people dying because they don’t have access to any treatment? It can be very challenging to find a qualified professional, even if you have the necessary funds, insurance, and determination. LLM mental health treatment can’t come soon enough.
- ddingus 3y ago
  Yes, it is ugly! The thing is bad actors are essentially forcing arguably unethical tools onto people in need. Our current Healthcare struggle is completely unnecessary. A good percentage of our economic struggles are equally unnecessary. The only reason we are even having these discussions is too many people with means are not employing those means in ways that make it worth allowing said means at all. Greed, psychopaths, ignorance and more are the problem. People are saying: Basic health care can't come soon enough. Drug price reform can't... Mental health You get the idea. I get it. Lots of us are desperate. I lost a home over this health care shit. Basically traded more time with my wife for our home. Brutal as fuck. I currently pay close to $2k in premiums and have difficulty finding options because I fall into what Franken called the "doughnut hole." Have considered some sort of crime, or leaving the country many times too. Like I said, ugly.
- bugglebeetle 3y ago
  > LLM mental health treatment can’t come soon enough. If you think LLMs perform at a level that they can help resolve the mental health crisis in the US, you are very much a part of that problem. They can’t even always produce functional code without heavy steering, let alone negotiate the fraught domain of psychological and psychiatric health. Foisting people in crisis off on unpredictable text generation engines is IMO a textbook example of the fundamentally anti-social character of American society that produces so many of the mental health problems that this country faces.
  - xigency 3y ago
    > If you think LLMs perform at a level that they can help resolve the mental health crisis in the US, you are very much a part of that problem. Bogus. How do you know an LLM isn’t better than human led treatment because the patient can be honest and have privacy, free to discuss anything without data leaving their premises. Alternatively, how do you know that a high level of care is needed for all patients? There are waiting rooms filled with people trying to get a chance to talk to someone about their problems who will listen, and others who don’t come in at all because they have no insurance.
    - bugglebeetle 3y ago
      > Bogus. How do you know an LLM isn’t better than human led treatment because the patient can be honest and have privacy, free to discuss anything without data leaving their premises. This has the evidentiary burden entirely backwards. We have evidence for the efficacy of various forms of psychological and psychiatric interventions and none for that produced by LLMs. I’m not even sure if it’s possible or ethical to test them for this purpose, as it would require OpenAI levels of RLHF training to get them to adhere to current guidelines and standards of care.
      - xigency 3y ago
        I agree that this is unknown. In terms of finding the answer, I guess you’ll have to wait and see what optimistic or curious scientists, engineers, and doctors build and what they find. For ethics, how is this more dangerous than trials for a new heart medication that might kill patients? In fact, the only way to know for sure, is to try and see. In terms of early results, these kinds of toy projects will be the frontline since any lawyer would tell you to not touch this with a 10ft pole. But I doubt a Github project would face that scrutiny since it takes technical skills to setup which requires knowledge and intent on the part of the user.
        bugglebeetle 3y ago
        > how is this more dangerous than trials for a new heart medication that might kill patients? Clinical trials happen through an established regulatory framework to minimize harm to participants, for starters…
samueldyson10 3y ago
We can rely on AI just for basic preliminary advices just like we rely on Google Search. Google Search also contains lot of blog posts that are untrue. Do they kill a lot of people? No, Right? Similarly, AI can be used for basic guidance. After that one can consult psychiatrist if he/she is having money in their pocket.
- ddingus 3y ago
  "It won't happen to me." But it could! You may feel it makes sense. And for some of us it may make sense too. What happens when it doesn't and you do not know?
  - drsamuel507 3y ago
    Yes, you are right about it. It can happen to anyone. We need to cautiously develop AI models related to healthcare.
fnordpiglet 3y ago
I don’t know I have a side in this, but it does seem strange to take the side that “we should talk about people not getting health care” and “self diagnosis is going to kill them too.” So, passive death is better than active death? No one specifically being at fault is somehow morally superior to some LLM being at fault? Talking about something with no expectation of it being fixed is doing nothing, and people are still dying. If some people die due to bad advice from a machine, but some people survive, is that better then everyone dying due to inaction of any sort? We won’t get getting universal health care in the US. Maybe there’s something to a democratization of subpar, but at least available, medical advice and care?
- ddingus 3y ago
  Talking about it, sharing our stories, making sure people get just how shitty it really is happens to be a great way to set an expectation for change. And there is this: The change, if there is to be one, will have to come from us. A whole lot of us. Most great things do. This idea of using an LLM in some meaningful way is as laughable as watching the world burn while people squabble over baubles and trinkets is maddening.
  - fnordpiglet 3y ago
    Talking about it doesn’t help people who are sick. It’s something we’ve done for decades and we are no closer to universal health care. We can continue to talk and bemoan the state of things. But when you’re sick, you personally, the great mass talking about how shitty it is that you’re sick matters not one bit. No one doubts change would come from us - but if there is to be a change, it’ll be over a sea of misery. Sitting around taking a medical ethics stance that everyone must die unless a licensed medical professional billed you with correct billing codes to an insurance company is on the surface absurd. People received and gave medical advice and care without both of those things for almost all of humans existence, yet here we all are, the world didn’t end. It would be a hell of a lot better if medical care weren’t rationed by death panels, but it is rationed by the death panels of Congress. I take it you’re on the “LLM can’t do anything but hallucinate.” However an awful lot of folks use LLM for quite a lot successfully already. I’ve found in the space of medical advice GPT4 is already fairly sophisticated. I wouldn’t use it without double checking it’s output, but I can ask it fairly complex questions about physiology, biochemistry, medicines, and many other subjects and it almost always provides a concise, detailed, and insightful answer. I’ve not yet found it hallucinating so long as I don’t ask it questions that are essentially information retrieval questions (who wrote the paper about blah will often induce a wrong answer, while, say, what medicines shouldn’t be mixed with ibuprofen will not). I personally believe LLM’s are not the answer as well, but I believe LLMs are a major missing piece in the assembly of partial answers we’ve built to date. I think LLM’s combined with information retrieval, optimizers, constraints systems, goal based agents, and other classical AI and information techniques forms a powerful combination greater than the sum of its parts. And I definitely think the way to scale medical care is for most medical questions that don’t need an expert to be serviced by a machine. The vast majority of our medical systems time is taken up by people with colds, GERD, and other questions and conditions that can be handled without a human.

bigyikes 3y ago

How about the opportunity cost of people dying because they don’t have access to any treatment? It can be very challenging to find a qualified professional, even if you have the necessary funds, insurance, and determination. LLM mental health treatment can’t come soon enough.

ddingus 3y ago
Yes, it is ugly! The thing is bad actors are essentially forcing arguably unethical tools onto people in need. Our current Healthcare struggle is completely unnecessary. A good percentage of our economic struggles are equally unnecessary. The only reason we are even having these discussions is too many people with means are not employing those means in ways that make it worth allowing said means at all. Greed, psychopaths, ignorance and more are the problem. People are saying: Basic health care can't come soon enough. Drug price reform can't... Mental health You get the idea. I get it. Lots of us are desperate. I lost a home over this health care shit. Basically traded more time with my wife for our home. Brutal as fuck. I currently pay close to $2k in premiums and have difficulty finding options because I fall into what Franken called the "doughnut hole." Have considered some sort of crime, or leaving the country many times too. Like I said, ugly.
bugglebeetle 3y ago
> LLM mental health treatment can’t come soon enough. If you think LLMs perform at a level that they can help resolve the mental health crisis in the US, you are very much a part of that problem. They can’t even always produce functional code without heavy steering, let alone negotiate the fraught domain of psychological and psychiatric health. Foisting people in crisis off on unpredictable text generation engines is IMO a textbook example of the fundamentally anti-social character of American society that produces so many of the mental health problems that this country faces.
- xigency 3y ago
  > If you think LLMs perform at a level that they can help resolve the mental health crisis in the US, you are very much a part of that problem. Bogus. How do you know an LLM isn’t better than human led treatment because the patient can be honest and have privacy, free to discuss anything without data leaving their premises. Alternatively, how do you know that a high level of care is needed for all patients? There are waiting rooms filled with people trying to get a chance to talk to someone about their problems who will listen, and others who don’t come in at all because they have no insurance.
  - bugglebeetle 3y ago
    > Bogus. How do you know an LLM isn’t better than human led treatment because the patient can be honest and have privacy, free to discuss anything without data leaving their premises. This has the evidentiary burden entirely backwards. We have evidence for the efficacy of various forms of psychological and psychiatric interventions and none for that produced by LLMs. I’m not even sure if it’s possible or ethical to test them for this purpose, as it would require OpenAI levels of RLHF training to get them to adhere to current guidelines and standards of care.
    - xigency 3y ago
      I agree that this is unknown. In terms of finding the answer, I guess you’ll have to wait and see what optimistic or curious scientists, engineers, and doctors build and what they find. For ethics, how is this more dangerous than trials for a new heart medication that might kill patients? In fact, the only way to know for sure, is to try and see. In terms of early results, these kinds of toy projects will be the frontline since any lawyer would tell you to not touch this with a 10ft pole. But I doubt a Github project would face that scrutiny since it takes technical skills to setup which requires knowledge and intent on the part of the user.
      - bugglebeetle 3y ago
        > how is this more dangerous than trials for a new heart medication that might kill patients? Clinical trials happen through an established regulatory framework to minimize harm to participants, for starters…

samueldyson10 3y ago

We can rely on AI just for basic preliminary advices just like we rely on Google Search. Google Search also contains lot of blog posts that are untrue. Do they kill a lot of people? No, Right? Similarly, AI can be used for basic guidance. After that one can consult psychiatrist if he/she is having money in their pocket.

ddingus 3y ago
"It won't happen to me." But it could! You may feel it makes sense. And for some of us it may make sense too. What happens when it doesn't and you do not know?
- drsamuel507 3y ago
  Yes, you are right about it. It can happen to anyone. We need to cautiously develop AI models related to healthcare.

fnordpiglet 3y ago

I don’t know I have a side in this, but it does seem strange to take the side that “we should talk about people not getting health care” and “self diagnosis is going to kill them too.” So, passive death is better than active death? No one specifically being at fault is somehow morally superior to some LLM being at fault? Talking about something with no expectation of it being fixed is doing nothing, and people are still dying. If some people die due to bad advice from a machine, but some people survive, is that better then everyone dying due to inaction of any sort? We won’t get getting universal health care in the US. Maybe there’s something to a democratization of subpar, but at least available, medical advice and care?

ddingus 3y ago
Talking about it, sharing our stories, making sure people get just how shitty it really is happens to be a great way to set an expectation for change. And there is this: The change, if there is to be one, will have to come from us. A whole lot of us. Most great things do. This idea of using an LLM in some meaningful way is as laughable as watching the world burn while people squabble over baubles and trinkets is maddening.
- fnordpiglet 3y ago
  Talking about it doesn’t help people who are sick. It’s something we’ve done for decades and we are no closer to universal health care. We can continue to talk and bemoan the state of things. But when you’re sick, you personally, the great mass talking about how shitty it is that you’re sick matters not one bit. No one doubts change would come from us - but if there is to be a change, it’ll be over a sea of misery. Sitting around taking a medical ethics stance that everyone must die unless a licensed medical professional billed you with correct billing codes to an insurance company is on the surface absurd. People received and gave medical advice and care without both of those things for almost all of humans existence, yet here we all are, the world didn’t end. It would be a hell of a lot better if medical care weren’t rationed by death panels, but it is rationed by the death panels of Congress. I take it you’re on the “LLM can’t do anything but hallucinate.” However an awful lot of folks use LLM for quite a lot successfully already. I’ve found in the space of medical advice GPT4 is already fairly sophisticated. I wouldn’t use it without double checking it’s output, but I can ask it fairly complex questions about physiology, biochemistry, medicines, and many other subjects and it almost always provides a concise, detailed, and insightful answer. I’ve not yet found it hallucinating so long as I don’t ask it questions that are essentially information retrieval questions (who wrote the paper about blah will often induce a wrong answer, while, say, what medicines shouldn’t be mixed with ibuprofen will not). I personally believe LLM’s are not the answer as well, but I believe LLMs are a major missing piece in the assembly of partial answers we’ve built to date. I think LLM’s combined with information retrieval, optimizers, constraints systems, goal based agents, and other classical AI and information techniques forms a powerful combination greater than the sum of its parts. And I definitely think the way to scale medical care is for most medical questions that don’t need an expert to be serviced by a machine. The vast majority of our medical systems time is taken up by people with colds, GERD, and other questions and conditions that can be handled without a human.