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- As a radiologist I have found Claude and ChatGPT to be absolutely terrible at MRI and I would not trust it one bit. It has its merits if you need to research stuff that is more text based, but radiological images is just something that they cannot interpret good enough (yet)by rasmus1610
- ~2 years ago I used ChatGPT "deep research" to investigate a chronic sinus infection I'd been fighting for ~3 years. After seeing 3 GPs and 3 visits with an ENT, I fed all the observations I had into the AI. In particular, I couldn't get the ENT to explain why he visually saw, via a scope, evidence of allergic reaction in my sinuses, but then later concluded, after an allergy test, that it couldn't be treated via allergy medication. I asked this question a few times and he just never answered.
ChatGPT surfaced a NIH study that concluded that 20% of people have allergic reactions that are isolated to a body location, and that shoulder "skin prick" testing may not reveal. I asked him about that and he said "that's not how allergies work". Full stop. He was unwilling to even look at the study.
He prescribed a CPAP and regular nebulizer treatments. Side story: the CPAP place sent me a SMS message that I couldn't recognize was not a phishing attempt, and when I reached out to inquire who they were they never replied.
So I decided: Let me just try taking a second-gen allergy tablet every day and see what happens.
My sinus infections have gone away. Previously I was getting a major sinus infection at least quarterly. Maybe he's right that allergies don't work that way, but allergy tablets have absolutely solved my problem. Which I'm thankful for because I tried a CPAP for a solid month a few years ago and I just could not get used to it, and was sleeping like crap.
by linsomniac - I've seen a lot of friends and family members almost immediately get offered surgery for shoulder pain. It's just often the default for people that do surgeries for a living.
I also had a pretty painful shoulder issue at one point, where the pain just wasn't subsiding for months. I tried massages and acupuncture as I didn't want to do surgery, but it wasn't helping at all. The thing that fixed it for me was just really focusing on doing pull-ups. I couldn't do them at all when I started, so I began with dead hangs and scapular pull-ups, eventually progressing to regular pull-ups, and then training with a "grease-the-groove" method once I could get a few per set. I stopped the training schedule once I was getting in around 17 pull-ups per set, and now just do 6 sets of about 7-8 pullups 3x per week spaced throughout the day. I'll also do some shoulder mobility drills [1].
Whenever I get lazy about keeping up with them inevitably discomfort will start arising again, but it goes away once I get back to strengthening.
by throwforfeds - It funny to see the community here expects the human body to be treated like a deterministic function: for input X expect output Y - and that transfers to diagnosis - people expect to receive the same diagnosis from different specialists for the same issue.
Given human body complexity, the diagnosis is a compound output of the experience, knowledge gained throughout the career and diagnosis methods/equipment, the title (like Dr) is a certification imposed by the state so its "safe" to let people practice since they passed "the bar" - but that doesn't imply everyone will be treating the same.
Some specialists update their knowledge monthly, some yearly and some don't do it at all, there are so many variables in play here (geo, politics, even weather haha).
Having said that, choosing the specialist is really important, getting opinions about their practice and their speciality, you can only maximize your chance of getting the right diagnosis, but don't expect to get it right just because somebody is called a Dr.
by piterrro - I'm a radiologist but can't really weigh in without seeing the full 3D MRI dataset. Regarding this point:
> They performed shockwave therapy on my shoulder even though a recent clinical practice guideline says clinicians should not use or recommend shockwave therapy for rotator-cuff tendinopathy without calcification; I was told during ultrasound that there was no calcification.
Ultrasound isn't a great way to assess for calcification. It'll find large calcification but easily miss small ones. Plain radiograph would be more helpful, but the MRI may have revealed it as well. Either way, shockwave therapy isn't harmful in the absence of calcification--it's just not helpful.
Edit: when a radiology report says something isn't present, there's always an implicit caveat that the finding isn't present within the context of the modality and images obtained. So an ultrasound report can state there are no calcifications while a plain radiograph can report the presence of calcifications without being inconsistent. Obviously very confusing to patients and people unfamiliar with medical jargon, but clarifying this in reports would make them sound even more qualified, "hedgey", and annoying to read than they already are.
by sxg - Radiologist. I don’t read MR shoulder exams in my day to day practice, but from the few pictures shown , I can’t conclusively disagree with the original report.
These models are generally terrible at reading medical images. The amount of public training data on the internet compared to the number of scans a radiologist reads in training is minuscule. There’s obviously a ton of medical images in general but very few, and even fewer along with a report are available on the internet publicly for download.
There are vision language models coming out of research labs that are excellent in describing and localizing findings. Still at the level of a 1st or 2nd year radiology resident, but as we all say - this is the worst the models will ever be.
by themantalope - A few years ago (before the AI craze), I was misdiagnosed with tuberculosis. I had a chronic cough, and an outsourced radiologist at a clinic found signs of tuberculosis. The findings were sent to the city's tuberculosis hospital, as required by the country's law. The doctors there took the radiologist's conclusion at face value and required me to stay at their hospital for at least 8 months under a strict, prison-like regime. There was no option to say no, because I was considered some kind of biohazard, and by law I had to comply.
Before I was admitted, I quickly found another radiologist, who diagnosed pneumonia instead. I sent his report to the chief doctor at the tuberculosis hospital, and after some deliberation they concluded that the original reading was wrong. Turns out the doctors there can't read scans at all and just believe whatever a radiologist says...
The funny thing is, they had already officially put me on the tuberculosis register and didn't want to admit they had made a mistake. So instead, they simply gave me another paper saying that I had been cured of tuberculosis by them... in 7 days. I'm probably the only person in the country to defeat tuberculosis in a week :)
So if you don't trust the radiologist/doctor, maybe find another doctor if you can afford it? You can compare their conclusions and see if they match. Two unrelated doctors or radiologists saying the same thing is probably about as close to the truth as you're going to get. I'm not sure though whether I should trust AI or humans more. AI can hallucinate, but I've been misdiagnosed by humans so many times too...
by kgeist - > There's something incredibly peaceful about being in the hands of an expert you trust. [...] AI can absolutely shatter that feeling in an uncomfortable way [...] but I don't know if I can fully trust AI either.
This really is key. We know we can't trust the AI, but at the same time we're also more comfortable asking the AI for clarifications or confronting it. Not having a time-bound appointment or paying by the hour helps a lot. But even then, more information doesn't necessarily help!
I once brought my 11-year-old car, a Civic with 150k miles, to multiple garages. I figured I'd play the "second opinion" game to correlate what the garages recommended to decide on what needed to be done...
I got 3 completely unrelated recommendations, including one that I knew was invalid! I felt worse off than when I started!
The solution to uncertain information isn't more information, which the AI can certainly provide, it's better information, and AI cannot currently provide that.
by AceJohnny2