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hyperpape 6 hours ago

> we must assume that the best AI models (especially ones focusing solely in the medical field) would largely beat large majority of humans (aka doctors), if we already have this assumption for software engineers, we should have it for this field as well,

This is a pretty wild leap. Code has a lot of hooks for training via hill-climbing during post-training. During post-training, you can literally set up arbitrary scenarios and give the bot more or less real feedback (actual programs, actual tests, actual compiler errors).

It's not impossible we'll get a training regime that does the "same thing" for medicine that we're doing for code, but I don't know that we've envisioned what it looks like.

DrewADesign 5 hours ago | parent | next [-]

Code is pretty much the perfect use case for LLMs… text-based, very pattern-oriented, extremely limited complexity compared to biological systems, etc.

I suspect even prose is largely considered acceptable in professional uses because we haven’t developed a sensitivity to the artifice, and we probably won’t catch up to the LLMs in that arms race for a bit. However, we always manage to develop a distaste for cheap imitations and relegate them to somewhere between the ‘utilitarian ick’ and ‘trashy guilty pleasure’ bins of our cultures, and I predict this will be the same. The cultural response is already bending in that direction, and AI writing in the wild— the only part that culturally matters— sounds the same to me as it did a year and a half ago. I think they’re prairie dogging, but when(/if) they drop that bomb is entirely a matter of product development. You can’t un-drop a bomb and it will take a long time to regain status as a serious tool once society deems it gauche.

The assumption that LLMs figuring out coding means they can figure out anything is a classic case of Engineer’s Disease. Unfortunately, this hubris seems damn near invisible to folks in the tech industry, these days.

sdwr 6 hours ago | parent | prev [-]

Emergency medicine is the coding of medicine. Fast feedback loop, requires broad rather than deep judgement, concrete next steps.

The AI coding improvement should be partially transferrable to other disciplines without recreating the training environment that made it possible in the first place. The model itself has learned what correct solutions "feel like", and the training process and meta-knowledge must have improved a huge amount.

dghlsakjg 5 hours ago | parent [-]

I would argue that the ED is the least similar to code. You have the most unknowns, unreliable data and history, non deterministic options and time constraints.

An ER staff is frequently making inferences based on a variety of things like weather, what the pt is wearing, what smells are present, and a whole lot of other intangibles. Frequently the patients are just outright lying to the doctor. An AI will not pick up on any of that.

TurdF3rguson 4 hours ago | parent [-]

> An AI will not pick up on any of that.

It will if it trains on data like that. It's all about the training data.

n8henrie 4 hours ago | parent | next [-]

Unfortunately the training data is absolute garbage.

Diagnostic standards in (at least emergency, but I think other specialties) medicine are largely a joke -- ultimately it's often either autopsy or "expert consensus."

We get to bill more for more serious diagnoses. The amount of patients I see with a "stroke" or "heart attack" diagnosis that clearly had no such thing is truly wild.

We can be sued for tens of millions of dollars for missing a serious diagnosis, even if we know an alternative explanation is more likely.

If AI is able to beat an average doctor, it will be due to alleviating perverse incentives. But I can't imagine where we could get training data that would let it be any less of a fountain of garbage than many doctors.

Without a large amount of good training data, how could AI possibly be good at doctoring IRL?

TurdF3rguson an hour ago | parent [-]

You just get 1M doctors to wear body cams for a year. Now you have a model that has thousands of times your experience with patients, encyclopedic knowledge of every ailment including ones that never present in your geography, read all the latest papers, etc..

I don't understand how you think this doesn't win vs a human doctor.

xarope 22 minutes ago | parent [-]

In healthcare, HIPAA/GDPR equivalent would block this. Let's be realistic in our discussion; this is not the same as google buying up a library worth of books, scanning and destroying them

mrbungie 4 hours ago | parent | prev [-]

The user will be adversarial and probably learn new tricks to trick the machine, this is not solvable (only) via training data.

bonesss 39 minutes ago | parent [-]

We have that expression “garbage in, garbage out.

My sense is that doctors and AI would be doing a lot better if they were just doing medicine, not being a contact surface for failures of housing, mental health and addiction services, and social systems. Drug seeking and the rest should be non-issues, but drug seekers are informed and adaptive adversariesz