9 ms·

A boy saw 17 doctors over 3 years for pain. ChatGPT found the right diagnosis

109 points by birriel 3y ago

elromulous 3y ago
https://archive.ph/TuI0Y https://archive.ph/TuI0Y
joe_guy 3y ago
It was Tethered Cord Syndrome. https://en.m.wikipedia.org/wiki/Tethered_spinal_cord_syndrome https://en.m.wikipedia.org/wiki/Tethered_spinal_cord_syndrom...
rowanG077 3y ago
Let's see how the AI haters here are going to spin this one...
- lcnPylGDnU4H9OF 3y ago
  It is a worthwhile practice to open one’s mind to disagreeable views to find where their disagreement lies. If you were to spin this against ChatGPT, would you really have nothing to say?
  - rowanG077 3y ago
    Yes it's very important to have an open mind. I'm very curious how the AI haters will spin chatGPT diagnosing a kid while 17 doctors could not in anything but a win for AI.
    - lcnPylGDnU4H9OF 3y ago
      I’m curious what you find so disagreeable. What arguments do you think are the strongest against AI in this context and why do you disagree?
- rafaelero 3y ago
  What explains people's knee jerk reaction to something as awesome as this? It's weird reading comments here.
  - rowanG077 3y ago
    Because everytime a positive AI article is posted people come out of the woodworks trying to paint the current state of AI in the most negative light possible.
    - Clubber 3y ago
      It's early, but I don't see any comments like that so far.
    - rafaelero 3y ago
      I feel bad for them.
- fungiblecog 3y ago
  One anecdote is not data. You need controlled trials that include both correct and incorrect diagnoses not just a headline
  - corethree 3y ago
    Wrong. One anecdote is one data point. If one person witnesses a murder that is a data point. The court doesn't just dismiss the data point because they need a sample size of 1000 witnesses for any statement to be meaningful. This article here says something meaningful about AI and it also says something damning about doctors. Also there have been studies: https://www.sciencedirect.com/science/article/abs/pii/S019606442300642X?dgcid=author#fig1 https://www.sciencedirect.com/science/article/abs/pii/S01960...
    - rvz 3y ago
      Wrong again. This is a case of reliability and just because there is one anecdote of the 'correct' diagnosis, it hardly means it is reliable overall. In fact you wouldn't use these AI systems and trust their judgement at face value without the involvement of human doctors because by default, you don't trust their outputs. This is on top of the fact that these AI systems are unexplainable black boxes which cannot transparently reason and explain their own decisions. It also appears that this 'research' study is quite frankly a surface level one with an extremely low sample size of 30 rather than the 1,000 sample size you suggested in your example. So I can only dismiss that study since it is not sufficient enough to result in conclusive evidence of reliability.
      - corethree 3y ago
        You are dismissing the study not because you need 1000 samples. You are dismissing it because you're biased. 30 witnesses to a murder is highly reliable. Any judge or court who denies that is biased. 17 doctors who couldn't diagnose a simple issue for 10 years is a demonstration of total unreliability.
        3y ago
smlavine 3y ago
What an irresponsible article. > “It’s a super high-powered medical search engine,” Beam says. NO IT IS NOT. THAT IS NOT WHAT IT IS AT ALL. How dare they publish this for a general audience. I'm sure Today will also publish all the stories of mothers who kill their kids because they use ChatGPT like those infamous lawyers did a few months ago. Shameful.
mjr00 3y ago
Not sure what's ChatGPT-specific here; patients discovering their own diseases has happened a lot since the internet has gone mainstream. Google has been the most prolific doctor of the 21st century. The only comparison given is > But both seem to work better than the average symptom checker or Google as a diagnostic tool. “It’s a super high-powered medical search engine,” Beam says. Which is, arguably, more of an indictment of how bad Google's search capabilities are in 2023 than anything else.
- warent 3y ago
  Bizarre take. Not sure what's ChatGPT-specific here They literally used ChatGPT, specifically. You may as well hear the story of William Kamkwamba building a wind turbine for his village and say "Not sure what's African-village specific here. People have been building wind turbines all over the world with various resources."
  - corethree 3y ago
    It's not bizarre at all. Tons of people are in denial of the capabilities of chatgpt. The current strategy is to position it as nothing more than an advanced search engine. Clearly chatGPT has flaws. Clearly it's more than a search engine. And clearly there's a large contingent of people who don't want to think it's anything more than a search engine. Probably was Bizarre when the hype first started but now these people in denial are a dime a dozen, as cliche as the people they want to bring down.
  - mjr00 3y ago
    A more apt comparison would be seeing one of the many "we rewrote our Python app in Go and improved performance by 100x" articles, and pointing out that most of the improvement comes from the rewrite and not the language. Similarly, the real moral of the article is that doctors miss things and doing independent research, whether that's ChatGPT, Google, Bing, Yandex, or reading research papers yourself is sometimes necessary.
    - warent 3y ago
JKCalhoun 3y ago
Whatever happened to "expert systems" from the 80's, 90's? They were supposedly going to be able to solve this exact problem — medical diagnosis. Perhaps this was the camp of AI that thought you could just build a decision tree (top down) ... that appears to have failed? Instead the bottom-up (neural networked) AI seems to be winning out. I wonder though if a ChatGPT would have been possible in 1985 with no rich internet to feed it data. I wonder if it would have been possible with even 2000 internet?
- jeffwiederkehr 3y ago
  I don't think anything close to the compute needed to train chatgpt or any of the other LLM's would be possible in 1985 or 2000
- OJFord 3y ago
  Decision tree is basically how doctors work, at least how they're trained to work. I think for a machine to be significantly better, for it to be impressive, it stands to reason it would work differently.
  - koolba 3y ago
    Not really. A programmatic decision tree will actually try out all the steps rather than glancing over the ones it thinks are not relevant. It also would not forget to test branches. If all a doctor is doing is following a flow chart, you can be damn sure that a machine programmed with the same flow chart would do it more effectively.
    - Arainach 3y ago
      If there was always (or, let's be honest, ever) time and resources to test every branch, then that would be a fair comparison.
      - KerrAvon 3y ago
        It’s not fair to the doctor, but it’s better for the patient.
kayodelycaon 3y ago
As much as I want to bash ChatGPT, this is actually a good use for it. It’s been possible to google this stuff for a long time but you need to know how to use a search engine. And the results have slowly been getting worse over time. ChatGPT adds another dimension to search. It’s not an oracle of truth but it can point you to things you would have thought of.
keyle 3y ago
LLM's are amazing. Truly amazing stuff. Let's not screw this up.
- mjhay 3y ago
  Articles breathlessly getting excited about anecdotal cases are a good way of doing just that. (It's good this article is on HN, but I don't like this reporting)
  - keyle 3y ago
    I agree, it reads like the doctors didn't do their job properly.
    - corethree 3y ago
      >I agree, it reads like the doctors didn't do their job properly. I'm sorry. But this is exactly what occured. Doctors failed to do their job. That mother payed money and wasted time and got nothing. That is unilateral and categorical failure of all Doctors involved. Are they refunding her money for failing? Are they refunding her insurance company? No? Then it's not just about doing their job properly. It's about theft. This is no different from a hospital charging 100k for 1 day of care. Tell it like it is, doctors aren't doing their job properly.
      - keyle 3y ago
        That's what, I wrote(?) Edit: no you don't know what I'm implying as I'm implying nothing here. Relax.
        corethree 3y ago
        You wrote: "I agree, it reads like the doctors didn't do their job properly." Implying as if doctors DID do their job properly and that the article reads with a sensationalist style like they didn't. I am saying you are completely wrong. The article is spot on on the failure of the doctors here.
Wohlf 3y ago
Says more about doctors really, even dealing with something as banal as back pain it took years and finally visiting a physical therapist to get the issue properly identified and resolved.
- vatican_banker 3y ago
  According to the article, it is difficult to diagnose babies/kids/toddlers because "[...] they can’t speak”. The article also mentions that the kid didn't have the symptoms or physical manifestations of spina bifida, complicating the diagnosis. This case reads as a genuinely difficult case to diagnose.
rafaelero 3y ago
This is amazing and we are only getting started.
behnamoh 3y ago
How about the other cases that ChatGPT misdiagnosed? We don't see them on media because, you know...
- corethree 3y ago
  We don't see it because chatgpt is garbage in terms of reliability. This article is on the media because Doctors claim they're good and effective. But when a unreliable product beats doctors it turns their claim on it's head. This article isn't saying anything about chatGPT we don't already know. It's saying something damning about doctors.
  - rafaelero 3y ago
    According to this study, they are as reliable as doctors (for ED's context)[1]. Also, Google has developed Med-PaLM 2, which they also say matches human doctors. So yeah, they may be unreliable. But they are as unreliable as humans. [1]https://www.sciencedirect.com/science/article/pii/S019606442300642X?dgcid=author#fig1 https://www.sciencedirect.com/science/article/pii/S019606442...
    - corethree 3y ago
      I wouldn't bet on that study. ChatGPT hallucinates. It can beat doctors but at the same time deliberately present wrong information. Doctors at least make a best effort.
      - rafaelero 3y ago
        I don't care about best effort. I care about getting the correct diagnosis. GPT-4 can already offer insightful information, even if it's just by augmenting the doctors diagnosis efforts. Not using it is just dumb.
        corethree 3y ago
        I hate doctors but at the same time you have to look at reality. Not every decision needs to be data driven, the qualitative aspects of hallucinations are very real and should not be ignored. I'm sure you know the hallucinations that pop out of chatGPT can get wild. Definitely use it, but do so with caution.
renewiltord 3y ago
A friend got the radiologist report for a musculoskeletal issue. Pasted into early GPT-4 and got a list of things to do, prognosis etc. I ran it by my dad (orthopaedic surgeon) and my friend asked his doc what to do. Matched almost exactly. My dad said it was very impressive. Great software.
ecommerceguy 3y ago
I wonder how https://www.drgupta.ai/ https://www.drgupta.ai/ would have performed...
andrewstuart 3y ago
Somehow we need to get to the point that patients expect doctors to use AI to assist their diagnosis. I think at the moment using AI would lead to the perception that the doctor is incompetent. But I would always rather a doctor who consulted AI and then overlaid their personal experience and expertise to rule in and out what the AI suggests. The idea that any/every doctor knows everything, or even could know everything is so false and wrong and out of date. There is probably a business opportunity in this somehow, for "AI first doctors" - their target customers being people who want the best human advice PLUS the best AI advice.
- corethree 3y ago
  The goal should not be to expect doctors to use AI to assist. The goal is to get AI to be superior to doctors such that AI replaces doctors. AI should augment your skill such that the doctor is no longer needed. The problem with the US medical system is that they hold your life hostage then rip you off. Make no mistake people attribute this to complexity and other bullshit but the money ends up in the pockets of administrators and doctors. You want to fix the system? Attack the root. Replace doctors.
  - radus 3y ago
    sed 's/doctor/programmer/g'
    - corethree 3y ago
      Yeah that's the downside of course. I still think US doctors and the entire US medical system unlike other occupations, deserves to be replaced. But the free market is the one that makes the rules here. If it can be replaced, it will, whether it deserves to be replaced is irrelevant.
    - salawat 3y ago
      Mission accomplished, bit only if everyone can use it, and no one is in a position to gatekeep anyone else's access. Which will never happen. Controlling access to power/information is too important.
kenjackson 3y ago
I had a similar experience where ICU doctors and nurses missed the diagnosis, but I put the info into ChatGPT and it found the right diagnosis. I just wish I had tried it 12 hours earlier -- it would have saved a lot of suffering.
theptip 3y ago
This is an ideal usecase for ChatGPT; synthesize a huge body of knowledge, and come up with some suggestions in an environment where a wrong answer doesn’t really hurt (since it’s either an answer she heard already, or a doctor shoots it down). I think we can safely bet that doctors will be using these systems to generate suggestions (human in the loop) very soon, but making the diagnosis reliable enough that you’d take the human out of the loop could be extremely challenging.
matt3210 3y ago
ChatGPT 4 won’t answer medical questions for me.
- highstep 3y ago
  Ask it to do a role play as a doctor, or maybe just rephrase your question so it's less of a request for advice, but instead a discussion of scientific data/facts. It should be easy to get around thus guardrail.
hn_throwaway_99 3y ago
I've used ChatGPT for medical diagnoses support, and I thought it was fantastic. I was most impressed that I could simply cut and paste lab results from a PDF, with its wonky formatting, and it still interpreted everything correctly.
manicennui 3y ago
And how much bad medical information has it given?
hervature 3y ago
> She scheduled an appointment with a new neurosurgeon and told her she suspected Alex had tethered cord syndrome. The doctor looked at his MRI images and knew exactly what was wrong with Alex Doesn't this kind of summarize the article? She went to 17 doctors who did not know about the illness. ChatGPT pointed her to a competent individual who immediately diagnosed it. My understanding is that ChatGPT's diagnosis is wrong because tethered cord syndrome typically occurs after a surgery to correct a spinal bifida which is what the neurosurgeon diagnosed.
jononomo 3y ago
One comment in the story struck me -- doctors have become so specialized now that no single doctor is able to see the big picture anymore.
RcouF1uZ4gsC 3y ago
> “I went line by line of everything that was in his (MRI notes) and plugged it into ChatGPT,” she says. “I put the note in there about ... how he wouldn’t sit crisscross applesauce. To me, that was a huge trigger (that) a structural thing could be wrong.” >She eventually found tethered cord syndrome and joined a Facebook group for families of children with it. Their stories sounded like Alex's. She scheduled an appointment with a new neurosurgeon and told her she suspected Alex had tethered cord syndrome. The doctor looked at his MRI images and knew exactly what was wrong with Alex. Notice how it gets very vague about the timing and specificity. It seems not that ChatGPT diagnosed tethered cord as tethered cord but that it happened to come up in one of the many chat sessions that led to the mother doing a deeper investigation of that.
RScholar 3y ago
Maybe I'm just getting old, but my reaction to this article had nothing to do with LLMs but was instead that this is an indictment of the state of medicine in America. At each diagnostic milestone it seemed obvious that the conclusion didn't adequately explain the totality of the boy's condition and the search needed to continue for the real culprit. Instead it seems like each one of these diagnosticians felt they'd found the "real problem" and pushed ahead with treatment as such. Now I'm not saying that back in the day all doctors were Gregory House or holders of forgotten knowledge, but I have to think that the lower pressure to make medicine behave like a business and deeper ties one would form with their patients would've benefitted this family. For this to have gone on for three years without getting escalated to the attention of one of the real-life Dr. Houses out there is appalling. I feel like ChatGPT got the answer right because it allowed her to input all of the minor observations from the charts; perhaps had the doctors done likewise they'd have connected the dots as well. When I was growing up and in my early 20s you went to the doctor and they got you talking about your life, teasing out the observations you had on your own life and addressed things from there. Then about 15 years ago everything changed and doctor visits became this twisted form of speed dating where you never see the same person twice and any question or answer that takes longer than ten seconds to express is taboo. I hate it, and I can't believe that we keep moving along like it's acceptable.
- corethree 3y ago
  It stems from low supply of doctors. There aren't enough doctors because if there were more doctors they'd make less money.
  - salawat 3y ago
    More like hospitals refuse to self-fund residency slots. It's pretty bad when the number of doctors entering practice is fundamentally gated by residency positions funded by Congress.
    - corethree 3y ago
      https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/ https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope... The lack of residency positions is the result of lobbying by the AMA. What it the American medical association? In there words: "The American Medical Association, founded in 1847, represents more than 190 state societies and medical specialty associations, including internal medicine, family physicians, obstetricians and gynecologists, pediatric and emergency medicine. The AMA is the largest association of physicians—both MDs and DOs—and medical students in the U.S. Our mission is to “promote the art and science of medicine and the betterment of public health.” It's a doctors old boys club and you can join if you're a doctor. Here's more evidence: https://med.fsu.edu/sites/default/files/news-publications/print/USA%20Today%202002%20physician%20shortage%20article.pdf https://med.fsu.edu/sites/default/files/news-publications/pr... The low supply of doctors is not a free market phenomenon. It is the result of deliberate cartel policies of the AMA for self interest. Keep in mind an over supply of doctors is generally a good thing for society. Not a good thing for doctors who want to be super rich.
kumarvvr 3y ago
I wonder how many people used ChatGPT to find out their disease, got absurd results for their symptoms, and just shrugged it.
topspin 3y ago
Does your dichotomy matter? When the system that curates the supposedly existing sources is impenetrable they're as good as fiction. If it does matter then what might you propose? Hint: to be viable it must involve some professional class interest making bank.
sargenem 3y ago
It will be a shame if AI doesn’t become more mainstream in healthcare. AI and AR have the potential to disrupt the medical field. I am sure we are not getting rid of actual doctors anytime soon, but having AI as a “co-pilot” would be immensely beneficial.
Gunnerhead 3y ago
Anybody have a good starting prompt to prime ChatGPT to answer medical questions or diagnoses?
Engineering-MD 3y ago
Without knowing the MRI report it’s hard to interpret this. If the radiologist had missed the spinal bifida then all the other doctors would rely on this report. Then it’s all a single point of failure: a radiologists report. May be other things, but I suspect the report is the root cause of the issues here.
Fire-Dragon-DoL 3y ago
This is so terrifying and true.

109 points by birriel 3y ago

https://archive.ph/TuI0Y https://archive.ph/TuI0Y

It was Tethered Cord Syndrome. https://en.m.wikipedia.org/wiki/Tethered_spinal_cord_syndrome https://en.m.wikipedia.org/wiki/Tethered_spinal_cord_syndrom...

rowanG077 3y ago

Let's see how the AI haters here are going to spin this one...

lcnPylGDnU4H9OF 3y ago
It is a worthwhile practice to open one’s mind to disagreeable views to find where their disagreement lies. If you were to spin this against ChatGPT, would you really have nothing to say?
- rowanG077 3y ago
  Yes it's very important to have an open mind. I'm very curious how the AI haters will spin chatGPT diagnosing a kid while 17 doctors could not in anything but a win for AI.
  - lcnPylGDnU4H9OF 3y ago
    I’m curious what you find so disagreeable. What arguments do you think are the strongest against AI in this context and why do you disagree?
rafaelero 3y ago
What explains people's knee jerk reaction to something as awesome as this? It's weird reading comments here.
- rowanG077 3y ago
  Because everytime a positive AI article is posted people come out of the woodworks trying to paint the current state of AI in the most negative light possible.
  - Clubber 3y ago
    It's early, but I don't see any comments like that so far.
  - rafaelero 3y ago
    I feel bad for them.
fungiblecog 3y ago
One anecdote is not data. You need controlled trials that include both correct and incorrect diagnoses not just a headline
- corethree 3y ago
  Wrong. One anecdote is one data point. If one person witnesses a murder that is a data point. The court doesn't just dismiss the data point because they need a sample size of 1000 witnesses for any statement to be meaningful. This article here says something meaningful about AI and it also says something damning about doctors. Also there have been studies: https://www.sciencedirect.com/science/article/abs/pii/S019606442300642X?dgcid=author#fig1 https://www.sciencedirect.com/science/article/abs/pii/S01960...
  - rvz 3y ago
    Wrong again. This is a case of reliability and just because there is one anecdote of the 'correct' diagnosis, it hardly means it is reliable overall. In fact you wouldn't use these AI systems and trust their judgement at face value without the involvement of human doctors because by default, you don't trust their outputs. This is on top of the fact that these AI systems are unexplainable black boxes which cannot transparently reason and explain their own decisions. It also appears that this 'research' study is quite frankly a surface level one with an extremely low sample size of 30 rather than the 1,000 sample size you suggested in your example. So I can only dismiss that study since it is not sufficient enough to result in conclusive evidence of reliability.
    - corethree 3y ago
      You are dismissing the study not because you need 1000 samples. You are dismissing it because you're biased. 30 witnesses to a murder is highly reliable. Any judge or court who denies that is biased. 17 doctors who couldn't diagnose a simple issue for 10 years is a demonstration of total unreliability.
      - 3y ago

smlavine 3y ago

What an irresponsible article. > “It’s a super high-powered medical search engine,” Beam says. NO IT IS NOT. THAT IS NOT WHAT IT IS AT ALL. How dare they publish this for a general audience. I'm sure Today will also publish all the stories of mothers who kill their kids because they use ChatGPT like those infamous lawyers did a few months ago. Shameful.

mjr00 3y ago

Not sure what's ChatGPT-specific here; patients discovering their own diseases has happened a lot since the internet has gone mainstream. Google has been the most prolific doctor of the 21st century. The only comparison given is > But both seem to work better than the average symptom checker or Google as a diagnostic tool. “It’s a super high-powered medical search engine,” Beam says. Which is, arguably, more of an indictment of how bad Google's search capabilities are in 2023 than anything else.

warent 3y ago
Bizarre take. Not sure what's ChatGPT-specific here They literally used ChatGPT, specifically. You may as well hear the story of William Kamkwamba building a wind turbine for his village and say "Not sure what's African-village specific here. People have been building wind turbines all over the world with various resources."
- corethree 3y ago
  It's not bizarre at all. Tons of people are in denial of the capabilities of chatgpt. The current strategy is to position it as nothing more than an advanced search engine. Clearly chatGPT has flaws. Clearly it's more than a search engine. And clearly there's a large contingent of people who don't want to think it's anything more than a search engine. Probably was Bizarre when the hype first started but now these people in denial are a dime a dozen, as cliche as the people they want to bring down.
- mjr00 3y ago
  A more apt comparison would be seeing one of the many "we rewrote our Python app in Go and improved performance by 100x" articles, and pointing out that most of the improvement comes from the rewrite and not the language. Similarly, the real moral of the article is that doctors miss things and doing independent research, whether that's ChatGPT, Google, Bing, Yandex, or reading research papers yourself is sometimes necessary.
  - warent 3y ago

JKCalhoun 3y ago

Whatever happened to "expert systems" from the 80's, 90's? They were supposedly going to be able to solve this exact problem — medical diagnosis. Perhaps this was the camp of AI that thought you could just build a decision tree (top down) ... that appears to have failed? Instead the bottom-up (neural networked) AI seems to be winning out. I wonder though if a ChatGPT would have been possible in 1985 with no rich internet to feed it data. I wonder if it would have been possible with even 2000 internet?

jeffwiederkehr 3y ago
I don't think anything close to the compute needed to train chatgpt or any of the other LLM's would be possible in 1985 or 2000
OJFord 3y ago
Decision tree is basically how doctors work, at least how they're trained to work. I think for a machine to be significantly better, for it to be impressive, it stands to reason it would work differently.
- koolba 3y ago
  Not really. A programmatic decision tree will actually try out all the steps rather than glancing over the ones it thinks are not relevant. It also would not forget to test branches. If all a doctor is doing is following a flow chart, you can be damn sure that a machine programmed with the same flow chart would do it more effectively.
  - Arainach 3y ago
    If there was always (or, let's be honest, ever) time and resources to test every branch, then that would be a fair comparison.
    - KerrAvon 3y ago
      It’s not fair to the doctor, but it’s better for the patient.

kayodelycaon 3y ago

As much as I want to bash ChatGPT, this is actually a good use for it. It’s been possible to google this stuff for a long time but you need to know how to use a search engine. And the results have slowly been getting worse over time. ChatGPT adds another dimension to search. It’s not an oracle of truth but it can point you to things you would have thought of.

keyle 3y ago

LLM's are amazing. Truly amazing stuff. Let's not screw this up.

mjhay 3y ago
Articles breathlessly getting excited about anecdotal cases are a good way of doing just that. (It's good this article is on HN, but I don't like this reporting)
- keyle 3y ago
  I agree, it reads like the doctors didn't do their job properly.
  - corethree 3y ago
    >I agree, it reads like the doctors didn't do their job properly. I'm sorry. But this is exactly what occured. Doctors failed to do their job. That mother payed money and wasted time and got nothing. That is unilateral and categorical failure of all Doctors involved. Are they refunding her money for failing? Are they refunding her insurance company? No? Then it's not just about doing their job properly. It's about theft. This is no different from a hospital charging 100k for 1 day of care. Tell it like it is, doctors aren't doing their job properly.
    - keyle 3y ago
      That's what, I wrote(?) Edit: no you don't know what I'm implying as I'm implying nothing here. Relax.
      - corethree 3y ago
        You wrote: "I agree, it reads like the doctors didn't do their job properly." Implying as if doctors DID do their job properly and that the article reads with a sensationalist style like they didn't. I am saying you are completely wrong. The article is spot on on the failure of the doctors here.

Wohlf 3y ago

Says more about doctors really, even dealing with something as banal as back pain it took years and finally visiting a physical therapist to get the issue properly identified and resolved.

vatican_banker 3y ago
According to the article, it is difficult to diagnose babies/kids/toddlers because "[...] they can’t speak”. The article also mentions that the kid didn't have the symptoms or physical manifestations of spina bifida, complicating the diagnosis. This case reads as a genuinely difficult case to diagnose.

rafaelero 3y ago

This is amazing and we are only getting started.

behnamoh 3y ago

How about the other cases that ChatGPT misdiagnosed? We don't see them on media because, you know...

corethree 3y ago
We don't see it because chatgpt is garbage in terms of reliability. This article is on the media because Doctors claim they're good and effective. But when a unreliable product beats doctors it turns their claim on it's head. This article isn't saying anything about chatGPT we don't already know. It's saying something damning about doctors.
- rafaelero 3y ago
  According to this study, they are as reliable as doctors (for ED's context)[1]. Also, Google has developed Med-PaLM 2, which they also say matches human doctors. So yeah, they may be unreliable. But they are as unreliable as humans. [1]https://www.sciencedirect.com/science/article/pii/S019606442300642X?dgcid=author#fig1 https://www.sciencedirect.com/science/article/pii/S019606442...
  - corethree 3y ago
    I wouldn't bet on that study. ChatGPT hallucinates. It can beat doctors but at the same time deliberately present wrong information. Doctors at least make a best effort.
    - rafaelero 3y ago
      I don't care about best effort. I care about getting the correct diagnosis. GPT-4 can already offer insightful information, even if it's just by augmenting the doctors diagnosis efforts. Not using it is just dumb.
      - corethree 3y ago
        I hate doctors but at the same time you have to look at reality. Not every decision needs to be data driven, the qualitative aspects of hallucinations are very real and should not be ignored. I'm sure you know the hallucinations that pop out of chatGPT can get wild. Definitely use it, but do so with caution.

renewiltord 3y ago

A friend got the radiologist report for a musculoskeletal issue. Pasted into early GPT-4 and got a list of things to do, prognosis etc. I ran it by my dad (orthopaedic surgeon) and my friend asked his doc what to do. Matched almost exactly. My dad said it was very impressive. Great software.

ecommerceguy 3y ago

I wonder how https://www.drgupta.ai/ https://www.drgupta.ai/ would have performed...

andrewstuart 3y ago

Somehow we need to get to the point that patients expect doctors to use AI to assist their diagnosis. I think at the moment using AI would lead to the perception that the doctor is incompetent. But I would always rather a doctor who consulted AI and then overlaid their personal experience and expertise to rule in and out what the AI suggests. The idea that any/every doctor knows everything, or even could know everything is so false and wrong and out of date. There is probably a business opportunity in this somehow, for "AI first doctors" - their target customers being people who want the best human advice PLUS the best AI advice.

corethree 3y ago
The goal should not be to expect doctors to use AI to assist. The goal is to get AI to be superior to doctors such that AI replaces doctors. AI should augment your skill such that the doctor is no longer needed. The problem with the US medical system is that they hold your life hostage then rip you off. Make no mistake people attribute this to complexity and other bullshit but the money ends up in the pockets of administrators and doctors. You want to fix the system? Attack the root. Replace doctors.
- radus 3y ago
  sed 's/doctor/programmer/g'
  - corethree 3y ago
    Yeah that's the downside of course. I still think US doctors and the entire US medical system unlike other occupations, deserves to be replaced. But the free market is the one that makes the rules here. If it can be replaced, it will, whether it deserves to be replaced is irrelevant.
  - salawat 3y ago
    Mission accomplished, bit only if everyone can use it, and no one is in a position to gatekeep anyone else's access. Which will never happen. Controlling access to power/information is too important.

kenjackson 3y ago

I had a similar experience where ICU doctors and nurses missed the diagnosis, but I put the info into ChatGPT and it found the right diagnosis. I just wish I had tried it 12 hours earlier -- it would have saved a lot of suffering.

theptip 3y ago

This is an ideal usecase for ChatGPT; synthesize a huge body of knowledge, and come up with some suggestions in an environment where a wrong answer doesn’t really hurt (since it’s either an answer she heard already, or a doctor shoots it down). I think we can safely bet that doctors will be using these systems to generate suggestions (human in the loop) very soon, but making the diagnosis reliable enough that you’d take the human out of the loop could be extremely challenging.

matt3210 3y ago

ChatGPT 4 won’t answer medical questions for me.

highstep 3y ago
Ask it to do a role play as a doctor, or maybe just rephrase your question so it's less of a request for advice, but instead a discussion of scientific data/facts. It should be easy to get around thus guardrail.

hn_throwaway_99 3y ago

I've used ChatGPT for medical diagnoses support, and I thought it was fantastic. I was most impressed that I could simply cut and paste lab results from a PDF, with its wonky formatting, and it still interpreted everything correctly.

manicennui 3y ago

And how much bad medical information has it given?

hervature 3y ago

> She scheduled an appointment with a new neurosurgeon and told her she suspected Alex had tethered cord syndrome. The doctor looked at his MRI images and knew exactly what was wrong with Alex Doesn't this kind of summarize the article? She went to 17 doctors who did not know about the illness. ChatGPT pointed her to a competent individual who immediately diagnosed it. My understanding is that ChatGPT's diagnosis is wrong because tethered cord syndrome typically occurs after a surgery to correct a spinal bifida which is what the neurosurgeon diagnosed.

jononomo 3y ago

One comment in the story struck me -- doctors have become so specialized now that no single doctor is able to see the big picture anymore.

RcouF1uZ4gsC 3y ago

> “I went line by line of everything that was in his (MRI notes) and plugged it into ChatGPT,” she says. “I put the note in there about ... how he wouldn’t sit crisscross applesauce. To me, that was a huge trigger (that) a structural thing could be wrong.” >She eventually found tethered cord syndrome and joined a Facebook group for families of children with it. Their stories sounded like Alex's. She scheduled an appointment with a new neurosurgeon and told her she suspected Alex had tethered cord syndrome. The doctor looked at his MRI images and knew exactly what was wrong with Alex. Notice how it gets very vague about the timing and specificity. It seems not that ChatGPT diagnosed tethered cord as tethered cord but that it happened to come up in one of the many chat sessions that led to the mother doing a deeper investigation of that.

RScholar 3y ago

Maybe I'm just getting old, but my reaction to this article had nothing to do with LLMs but was instead that this is an indictment of the state of medicine in America. At each diagnostic milestone it seemed obvious that the conclusion didn't adequately explain the totality of the boy's condition and the search needed to continue for the real culprit. Instead it seems like each one of these diagnosticians felt they'd found the "real problem" and pushed ahead with treatment as such. Now I'm not saying that back in the day all doctors were Gregory House or holders of forgotten knowledge, but I have to think that the lower pressure to make medicine behave like a business and deeper ties one would form with their patients would've benefitted this family. For this to have gone on for three years without getting escalated to the attention of one of the real-life Dr. Houses out there is appalling. I feel like ChatGPT got the answer right because it allowed her to input all of the minor observations from the charts; perhaps had the doctors done likewise they'd have connected the dots as well. When I was growing up and in my early 20s you went to the doctor and they got you talking about your life, teasing out the observations you had on your own life and addressed things from there. Then about 15 years ago everything changed and doctor visits became this twisted form of speed dating where you never see the same person twice and any question or answer that takes longer than ten seconds to express is taboo. I hate it, and I can't believe that we keep moving along like it's acceptable.

corethree 3y ago
It stems from low supply of doctors. There aren't enough doctors because if there were more doctors they'd make less money.
- salawat 3y ago
  More like hospitals refuse to self-fund residency slots. It's pretty bad when the number of doctors entering practice is fundamentally gated by residency positions funded by Congress.
  - corethree 3y ago
    https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/ https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope... The lack of residency positions is the result of lobbying by the AMA. What it the American medical association? In there words: "The American Medical Association, founded in 1847, represents more than 190 state societies and medical specialty associations, including internal medicine, family physicians, obstetricians and gynecologists, pediatric and emergency medicine. The AMA is the largest association of physicians—both MDs and DOs—and medical students in the U.S. Our mission is to “promote the art and science of medicine and the betterment of public health.” It's a doctors old boys club and you can join if you're a doctor. Here's more evidence: https://med.fsu.edu/sites/default/files/news-publications/print/USA%20Today%202002%20physician%20shortage%20article.pdf https://med.fsu.edu/sites/default/files/news-publications/pr... The low supply of doctors is not a free market phenomenon. It is the result of deliberate cartel policies of the AMA for self interest. Keep in mind an over supply of doctors is generally a good thing for society. Not a good thing for doctors who want to be super rich.

kumarvvr 3y ago

I wonder how many people used ChatGPT to find out their disease, got absurd results for their symptoms, and just shrugged it.

topspin 3y ago

Does your dichotomy matter? When the system that curates the supposedly existing sources is impenetrable they're as good as fiction. If it does matter then what might you propose? Hint: to be viable it must involve some professional class interest making bank.

sargenem 3y ago

It will be a shame if AI doesn’t become more mainstream in healthcare. AI and AR have the potential to disrupt the medical field. I am sure we are not getting rid of actual doctors anytime soon, but having AI as a “co-pilot” would be immensely beneficial.

Gunnerhead 3y ago

Anybody have a good starting prompt to prime ChatGPT to answer medical questions or diagnoses?

Engineering-MD 3y ago

Without knowing the MRI report it’s hard to interpret this. If the radiologist had missed the spinal bifida then all the other doctors would rely on this report. Then it’s all a single point of failure: a radiologists report. May be other things, but I suspect the report is the root cause of the issues here.

Fire-Dragon-DoL 3y ago

This is so terrifying and true.