3 ms·

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

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.
    - nradov 1y ago
      It's a lot harder to do clinical research in some areas than others just due to the availability of subjects. Like if you're developing a new drug to treat type-2 diabetes then it's a lot easier and cheaper to identify patients who meet the inclusion criteria than to find patients with some particular type of shoulder injury or whatever. And the study endpoints are also problematic since there are no clear objective signs; usually they have to rely on patient reported symptoms. Some specialist physicians have a deep knowledge of exercise for injury prevention and rehab. But it also helps to get input from a good physical therapist and/or personal trainer. As a patient it can be tough to discriminate the good ones from the quacks.

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.
  - nradov 1y ago
    It's a lot harder to do clinical research in some areas than others just due to the availability of subjects. Like if you're developing a new drug to treat type-2 diabetes then it's a lot easier and cheaper to identify patients who meet the inclusion criteria than to find patients with some particular type of shoulder injury or whatever. And the study endpoints are also problematic since there are no clear objective signs; usually they have to rely on patient reported symptoms. Some specialist physicians have a deep knowledge of exercise for injury prevention and rehab. But it also helps to get input from a good physical therapist and/or personal trainer. As a patient it can be tough to discriminate the good ones from the quacks.