3 ms·

Happy to see this. I've struggled with an injury for the past five years. I've been to multiple sports-focused physicians, had various scans. Responses from doc

Happy to see this. I've struggled with an injury for the past five years. I've been to multiple sports-focused physicians, had various scans. Responses from doctors have ranged from "everything seems fine, can't really figure this out" to [completely wrong hypothesis]. Tried acupuncture. Tried a chiropractor. I remember one doctor, though, had an interesting thought that seemed to make sense - but I've been so discouraged from so many false starts or misplaced hope, I didn't bother following up. Finally I typed in my entire history into o3-deep-research and let it rip for a while. It came back with a theory for the injury that matched that one doctor, diagrams of muscle groups and even illustrations of proposed exercises. I'm not out of the woods yet, but I am cautiously optimistic for the first time in a long time.

Noumenon72 1y ago
I hope recent cuts to government science have managed to hit enough of the safetyists and industry captures who keep us from just trying out new healthcare approaches like this and learning. They'd like nothing better than to replace the help you got with "As a large language model, I am unable to offer medical advice."
candiddevmike 1y ago
Why would you trust a LLM over a battery of human experts? I find it hard to believe that the doctors never proposed exercises or some kind of physical therapy for you, at least in the US.
- BeetleB 1y ago
  I can't speak to the OP's condition, but having seen plenty of doctors and physical therapists in the US for over a decade: Yes, they propose exercises. No, they don't work. For certain (common) conditions, PT seems to have it nailed - the exercises really help. For the others, it's just snake oil. Not backed by much research. The current state of the art is just not good when it comes to chronic pain. So while I don't know if an LLM can be better than a battery of human experts, I do know that those human experts do not perform well. I'm guessing with the OP's case, that battery of human experts does not lead to a consensus - you just end up with 10 different treatments/diagnoses (and occasionally, one is a lot more common than the other, but it's still wrong).
- zeroxfe 1y ago
  I've never used LLMs for this, but as someone who's been through a lot of sports-related injuries, I find doctors more or less useless (except for prescribing painkillers and performing surgeries.) No doctor or physio has ever been able to fix my chronic issues, and I've always had to figure them out myself through lots of self-study and experimentation.
- n8henrie 1y ago
  Much of modern medicine's expertise is focused on areas that reimburse well (in some part because those industries subsidize the research). I would not expect most physicians to have a deep fund of literature-backed knowledge to draw from regarding exercise. Telling someone to do an exercise probably doesn't compensate well. That said, I'm also pretty negative about the availability of rigorous literature regarding much of nutrition, dentistry, podiatry, physical therapy, etc... you know, the things that affect the health of most human beings that have ever lived.
  - nradov 1y ago
    Sports medicine specialists do this all day every day. They don't hesitate to prescribe specific exercises if they think it will help, and as for compensation they get paid the same for that service as any other regular office visit (typically CPT code 99212 or similar). Because there is so much variability in individual injuries and physiology it's extremely difficult to do rigorous studies comparing different treatments. Like even something common like a rotator cuff tear isn't one single thing that can always be treated the same way. Patients and practitioners will often have to follow a trial-and-error process until they figure out what works in a particular case. Experienced providers who see a lot of cases eventually develop a lot of tacit knowledge about this in a way that's difficult to codify or explain.
    - n8henrie 1y ago
      Do you therefore agree that most physicians do not "deep fund of literature-backed knowledge to draw from regarding exercise"? > Because there is so much variability in individual injuries and physiology it's extremely difficult to do rigorous studies comparing different treatments. This is generally true of research in all areas of medicine; I don't see it as a fundamental reason why we wouldn't hope for equally powered and rigorous studies focusing on the issues that affect most of the population, even if there are not pharmaceutical or device companies that will profit from the recommended interventions. I'm only a decade in, but my clinical experiences in my area of expertise vary widely from those of my colleagues, which vary from those of other colleagues, in spite of years of shared experience in a fairly homogenous demographic. Expert opinion is not a level of evidence that carries much weight in my mind. It may be the best we have in many cases, I just wish we had something better.
scudsworth 1y ago
i mean it sounds like that doctor had it right then? i dont think this reads as a win for "online self-diagnosis", ai-empowered or otherwise.
- lcnPylGDnU4H9OF 1y ago
  From their story, it sounds like the one doctor had it right because the AI-empowered self diagnosis seems to agree. Or do I misunderstand?
mvdtnz 1y ago
You trusted known grifters acupuncturists and chiropractors, but not doctors. Then you trusted a computer known for telling lies. I think you should take a step back and re-assess your internal heuristics.
- BigGreenJorts 1y ago
  They literally said they saw sport focused physicians.
quantumwoke 1y ago
Sounds like you needed a good PT not a physician.
- trollbridge 1y ago
  Good DPT with a team of PTs and PTAs, and possibly also see a DO who can do osteopathic manipulation therapy (OMT). Start with a dedicated orthopaedic practice who will make referrals to the above and then order CATs/MRIs if the above isn’t helping and evaluate if surgery is necessary. One challenge is that it is hard to even know how to navigate all this. LLMs could actually help with that.
nradov 1y ago
You have to be realistic and assume that treating most major musculoskeletal injuries will be a lengthy trial-and-error process. Every injury is unique and imaging studies or other tests can only give limited clues about what's going on. There are patients in terrible pain whose scans look normal, and there are other patients whose scans indicate serious pathology yet they are pain-free and completely functional. Instead of getting discouraged, keep trying different modalities (except for the pseudo-science BS) until something works. In general a lot of those injuries will eventually heal on their own. So it's easy to fool yourself into believing that a particular treatment was effective even when the real cure was time.

Noumenon72 1y ago

I hope recent cuts to government science have managed to hit enough of the safetyists and industry captures who keep us from just trying out new healthcare approaches like this and learning. They'd like nothing better than to replace the help you got with "As a large language model, I am unable to offer medical advice."

candiddevmike 1y ago

Why would you trust a LLM over a battery of human experts? I find it hard to believe that the doctors never proposed exercises or some kind of physical therapy for you, at least in the US.

BeetleB 1y ago
I can't speak to the OP's condition, but having seen plenty of doctors and physical therapists in the US for over a decade: Yes, they propose exercises. No, they don't work. For certain (common) conditions, PT seems to have it nailed - the exercises really help. For the others, it's just snake oil. Not backed by much research. The current state of the art is just not good when it comes to chronic pain. So while I don't know if an LLM can be better than a battery of human experts, I do know that those human experts do not perform well. I'm guessing with the OP's case, that battery of human experts does not lead to a consensus - you just end up with 10 different treatments/diagnoses (and occasionally, one is a lot more common than the other, but it's still wrong).
zeroxfe 1y ago
I've never used LLMs for this, but as someone who's been through a lot of sports-related injuries, I find doctors more or less useless (except for prescribing painkillers and performing surgeries.) No doctor or physio has ever been able to fix my chronic issues, and I've always had to figure them out myself through lots of self-study and experimentation.
n8henrie 1y ago
Much of modern medicine's expertise is focused on areas that reimburse well (in some part because those industries subsidize the research). I would not expect most physicians to have a deep fund of literature-backed knowledge to draw from regarding exercise. Telling someone to do an exercise probably doesn't compensate well. That said, I'm also pretty negative about the availability of rigorous literature regarding much of nutrition, dentistry, podiatry, physical therapy, etc... you know, the things that affect the health of most human beings that have ever lived.
- nradov 1y ago
  Sports medicine specialists do this all day every day. They don't hesitate to prescribe specific exercises if they think it will help, and as for compensation they get paid the same for that service as any other regular office visit (typically CPT code 99212 or similar). Because there is so much variability in individual injuries and physiology it's extremely difficult to do rigorous studies comparing different treatments. Like even something common like a rotator cuff tear isn't one single thing that can always be treated the same way. Patients and practitioners will often have to follow a trial-and-error process until they figure out what works in a particular case. Experienced providers who see a lot of cases eventually develop a lot of tacit knowledge about this in a way that's difficult to codify or explain.
  - n8henrie 1y ago
    Do you therefore agree that most physicians do not "deep fund of literature-backed knowledge to draw from regarding exercise"? > Because there is so much variability in individual injuries and physiology it's extremely difficult to do rigorous studies comparing different treatments. This is generally true of research in all areas of medicine; I don't see it as a fundamental reason why we wouldn't hope for equally powered and rigorous studies focusing on the issues that affect most of the population, even if there are not pharmaceutical or device companies that will profit from the recommended interventions. I'm only a decade in, but my clinical experiences in my area of expertise vary widely from those of my colleagues, which vary from those of other colleagues, in spite of years of shared experience in a fairly homogenous demographic. Expert opinion is not a level of evidence that carries much weight in my mind. It may be the best we have in many cases, I just wish we had something better.

scudsworth 1y ago

i mean it sounds like that doctor had it right then? i dont think this reads as a win for "online self-diagnosis", ai-empowered or otherwise.

lcnPylGDnU4H9OF 1y ago
From their story, it sounds like the one doctor had it right because the AI-empowered self diagnosis seems to agree. Or do I misunderstand?

mvdtnz 1y ago

You trusted known grifters acupuncturists and chiropractors, but not doctors. Then you trusted a computer known for telling lies. I think you should take a step back and re-assess your internal heuristics.

BigGreenJorts 1y ago
They literally said they saw sport focused physicians.

quantumwoke 1y ago

Sounds like you needed a good PT not a physician.

trollbridge 1y ago
Good DPT with a team of PTs and PTAs, and possibly also see a DO who can do osteopathic manipulation therapy (OMT). Start with a dedicated orthopaedic practice who will make referrals to the above and then order CATs/MRIs if the above isn’t helping and evaluate if surgery is necessary. One challenge is that it is hard to even know how to navigate all this. LLMs could actually help with that.

nradov 1y ago

You have to be realistic and assume that treating most major musculoskeletal injuries will be a lengthy trial-and-error process. Every injury is unique and imaging studies or other tests can only give limited clues about what's going on. There are patients in terrible pain whose scans look normal, and there are other patients whose scans indicate serious pathology yet they are pain-free and completely functional. Instead of getting discouraged, keep trying different modalities (except for the pseudo-science BS) until something works. In general a lot of those injuries will eventually heal on their own. So it's easy to fool yourself into believing that a particular treatment was effective even when the real cure was time.