I don't understand what you're proposing. How would you design such a study in a way that would pass IRB?

dec0dedab0de 6 hours ago | parent | next [-]

I think the best would be an interface, where the patient isn't told if the doctor on the other end is human or AI. Tell them that they are going to do multiple remote exams with different care providers for the same illness in exchange for free treatment, and payment for the study.

If you're worried about not catching a legit emergency, as in something that can't wait a day or two for them to complete the different sessions, you could have a doctor monitor the interactions with the ability to raise a flag and step in to send them to the ER.

	▲	nradov 5 hours ago \| parent [-]
		I'm pretty sure that wouldn't pass IRB.

▲

SoftTalker 7 hours ago | parent | prev | next [-]

Feed it randomly selected case histories? See if it came up with the same diagnosis as the doctors?

▲

nradov 7 hours ago | parent [-]

I don't think that would tell us anything useful. The data quality in most patient charts is shockingly bad. I've seen a lot of them while working on clinical systems interoperability. Garbage in / garbage out. When human physicians make a diagnosis they typically rely on a lot of inputs that never appear in the patient chart.

And in most cases the diagnosis is the easy part. I mean we see occasional horror stories about misdiagnosis but those are rare. The harder and more important part is coming up with an effective treatment plan which the patient will actually follow, and then monitoring progress while making adjustments as needed. So a focus on the diagnosis portion of clinical decision support seems fundamentally misguided.

▲

qsera 6 hours ago | parent [-]

> When human physicians make a diagnosis they typically rely on a lot of inputs that never appear in the patient chart.

Yea, like how rich the patient is or if they are on insurance etc. I wish I was kidding.

	▲	PearlRiver 5 hours ago \| parent [-]
		This the real reason why some people go to chatGPT instead of a GP. I am glad to live in a country were going to the doctor is free.

▲

selridge 4 hours ago | parent | prev | next [-]

You could absolutely randomize care between a doctor and an AI under an IRB. I’d be stunned if there aren’t a dozen studies doing something like this already.

You have to justify it, but most places have sections in the document where you request review to justify it. It’s not any different from giving one patient heart medicine that you think works and another patient a sugar pill.

	▲	nradov 4 hours ago \| parent [-]
		Huh? Do you have any actual examples of such studies? I don't think you understand how IRB actually works. In actual heart medicine studies the control arm is typically treated with the current standard of care, not a placebo. So it seems pretty clear that you don't have any actual knowledge or experience in this area.

▲

dyauspitr 7 hours ago | parent | prev [-]

It’s all case histories and text no real person is affected by this.