ChatGPT Saved My Life (no, seriously, I'm writing this from the ER)
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It seems like having that scribe also review lab results wouldn’t be far off, but we are still not ready to let the AI system interpret and inform the patient without human intervention.
The problem here wasn’t that a human missed the low platelet count, it’s just that it wasn’t reviewed yet. Both a doctor and an AI system would haven spotted the issue immediately.
I am not saying this isn’t a great result, but the AI intervention must come from the patient side, not the care providers side. The providers have too much at risk, while the patient is able to pick and choose their own AI and decide what levels of risk they are able to accept.
Yes I'm sure a human doctor would have noticed the low platelet count -- if they bothered to look at it. Which they didn't (or at least hadn't got around to yet).
There's a systemic failure that a computer wasn't already flagging up the low count for immediate follow-up.
What I find interesting is that AI (or more specifically LLMs / chat-GPT ) has had such an impact it's broken down barriers from people who previously would be against any computer involvement or automation. People have gone from, "You must not automate anything" to "We should feed everything into chat GPT"..
And from someone who has in the past been interested in statistical modelling, it's dizzying. It's as if statistics were seen as boring and fallible, but "AI" is exciting and wonderful.
So now you need an extra on-call doctor just to filter out the false positives, or the on-call doctor gets notification fatigue and ignores them.
Or in the best case you send a lot of people to ER in the middle of the night for no reason. Again thanks to liability concerns, but this time on the part of the primary care practice.
Or a PA or CRN. They are cheaper. As the last resort you can have an AI doing it :-)
Having someone on-call to deal with routine lab results that just happen to catch a possible imminent threat would be an enormous waste of resources.
AI is more flexible and can make up requirements on the go, that is, based on information it has it "knows" that a low platelet count is bad and what the recommended course of action is.
Of course, search engines and public websites do the same thing - "what should I do if I have a low platelet count" or "low platelet count and red skin dots" are valid search queries.
> I was told I’d receive a response in 2-3 business days
2-3 "business days"? Yea, I can see how LLMs are going to be super helpful in patients taking their health more in their own hands.
Source: resident in a few months
Almost no one refuses.
I do NOT want a transcription ERROR in my medical records.
I bet if she says something like "AI will transcribe" then there will be more hesitation, although maybe not more refusals because most people don't know how it can make mistakes.
Are they informed that their personal medical information will be shared with an unknown set of third parties / LLMs subject to manual QA / cloud services with telemetry?
Honestly sounds like she's opening herself up to massive lawsuits (depending on State law). I would reach out to the legal department if any doctor pulled this kind of shit on me.
Also, I guarantee you signed a paper when you first were enrolled with your PCP giving them permission to share your medical records with third parties when needed (subject to HIPAA compliance of course).
I should be a able to put a few drops of each of my bodily fluids into a set of disposable receptacles or strips and it should be able to test for hundreds of thousands of issues initially and millions of issues in the future. A pocket fictional Dr. House so to speak. This would distribute the testing workload to the people at home or work and give doctors something better to start with than only perceived symptoms and would allow prioritizing patients during triage. It should find everything from the obvious emergencies to the most obscure anomalies that could be addressed at a later time. It should also be able to tell me what to start or stop eating.
There should also be a high-risk-accepted mode where the device can make guesses about what is occurring based on all the data it gathered even if it does not have 100% of the scientific data to do so. All this in a sub $1000 device I can buy online without a prescription. This device must not have any way to leak patient data. Connect it to a printer via USB and it just makes a hard copy to hand to a doctor or they could just read this device with their eyeballs. No cell phone required. No wifi or bluetooth. No dial home. No uploading to LLM's. No cloud. Patients can download an updated OS and firmware image for updated medical data and update using a thumb-drive or micro-SD.
The LLM _HAS_ empowered the patient to act on his own health, which is undeniably a good thing.
Not sure about seeing the LLM as a companion.
In this case, lab result analysis was entirely based around standard care protocols that LLM is really good at regurgitating back to you.
Yeah sure, anyone could probaly promt feed this into a homeopathy solution which would have killed the patient as per their own predisposed will. You could argue a standard programmatic diagnostic evaluation would be better but its not entirely clear wether human decision making improves based on webMD above an agitated Chatgpt urging you to seek professional help.
And now that I think about it more, no one except doctors and AI could reliably improve diagnosis based on a picture and lab results side by side. So if your healthcare system doesn't provide a response then chatgpt might actually be the closest neighbour in time of need.
Indeed the victory for the AI here is the ability to convince the author to take immediate action. The second win for the AI is the concise one liner the author tells the triage nurse so that her further diagnosis and treatment may proceed. A regular human being would be likely to start with a long form story of not feeling well for some time.
People don't want to admit this because of the massive concentration of power that becomes clear after you accept this.
I don't understand why the argument continues to be we will have a rich ecosystem of base open source models; unlike opensource ai which is individuals donating time, opensource ai requires someone to donate very large amounts of capital.
I feel like this is an area where AI/LLMs/whatever can actually help triage test results to tell doctors "hey you really should look at this test result first, it looks concerning" - this would happen in a way that you can't do with other bloodwork (which returns numbers on a scale).
Most radiology reports are just written words, so LLMs could potentially use that to triage and help alert the care provider to prioritize it, so patients aren't sitting there worried for days on end until a doc analyzes it.
They are also written with a particular medicolegal perspective, which the intended audience will appreciate.
I often give my patients copies of their results/reports, which gives me an opportunity to explain them.
If we are going to send reports to patients directly, maybe they need to be written differently? Who should pay for that different report to be written/checked?
We already have AI tools for prioritising the order some tests are processed in (e.g. which X-Rays the radiologist looks at first). But once the report is written the author has a responsibility to ensure any urgent result is escalated. As a requester (I order tests), if I result needs urgent action within days or less, I expect a phone call to myself or another doctor in the practice.
I know there are a lot of conversations going on about the dangerous elements of LLMs, but it’s nice to read a story like this alongside them — it’s a reminder of the remarkable potential of this new technology.
Could you have found out somehow else about the severity of the problem? Maybe, sure! But the fact that you had this LLM to ask, and it so easily understood whatever info you gave it, asked clarifying follow-up questions, and gave you info/directions in the way you needed to hear them — it’s such a new way of interacting with computers, almost like an API but made for humans to use, and cases like this is where that value shines most clearly IMO.
This being said, a problem with blood tests is that a layperson won't know right off the bat if a value outside of the normal range is ok or a life-threatening issue. I understand it might introduce a lot of complexity for labs and that there's some level of "big picture analysis" involved that will require some human intervention, but even just a color-coded line for WBC/RBC, hemoglobin and platelets could already go a long way, as OP's case demonstrates.
This should become standard. When blood works or whatever exam results are available they should go through some kind of automated system that can flag critical situations like this, without waiting for a doctor.
While this might not be standard everywhere in the world, and probably isn't, if one was concerned about their health and had access to their results themselves, wouldn't you look at them?
This reminds me of the redditors who post questions about mundane government services where it would be quicker to simply call the agency in question and ask.
Depends on the service / agency. Some have long wait times.
Heck ChatGPT might be quicker than both reddit and the agency at this point, and I'm not an "AI bro" by any means... But I gotta accept when its usefulness actually works.
Wow oh wow does this depend on the agency, and depend on the question, and assumes you even know how to ask the question the right way. And I think considering that, the analogy operates quite well. People often don't know how to ask about medical things, they just describe symptoms ("platelet count" probably isn't a highly googled term for self-diagnosis). People do similar things when they have a problem with government and don't know where to turn, may not know which agency to contact, or how navigate that agency's phone trees, etc.
And funny enough, most of the responses are "Did you call <agency_name>?".
Usually it's the DOL which around here is quick to get a hold of via phone.
Are you saying that the doctor failed to take action on something that was at a concerning level on her labs? Or that she should have scanned her labs for anything that was on the edges of those normal ranges?
I generally agree that more data is a good thing, but simple blood work can be kind of a large amount of data now that's not immediately recognizable to the average person. However, this is exactly the case where I want more assistance with AI... there's simply too much data for me to reliably tell what's meaningful and what's not anymore. AI can process a bunch of data and tell me what I need to know in about a second or two.
I have a rare disease which causes an obscure blood marker to basically jump two orders of magnitude.
If you google this jump marker, basically all the links you find are about a deadly leukemia that you will be dead of in six months.
My appointment with my doctor was two weeks away. Those were very very dark two weeks.
I definitely think you should go over the results with your doctor, but Google or even ChatGPT is not a doctor
From the post that her doctor hadn't yet reviewed the labs and the turn around time for the doctor was 2 - 3 days. I'm naturally curious about my own results so I do look at them and search the WWW for the meaning of the results if the lab tech doesn't provide any contextual clues. If WebMD says I have Lupis and I'm going to die tomorrow, then I'll reach out to my doctor in some form or fashion.
> simple blood work can be kind of a large amount of data now that's not immediately recognizable to the average person.
You'll find every [common] blood test has descriptors on the Intertubes from a variety of sources. Insurance, in the US anyway, isn't going to allow niche complex tests without going through weeks of denials. And even when doing standard blood workup, you're not going to need to know the items in the green, just the one or two out of range.
You're of course free to allow AI to invade your medical records as you see fit if that is the way you want to go about it. My point above was that "AI" wasn't necessary nor revolutionary in respect to identifying the author's medical issue.
Sometimes what’s “normal” is highly dependant on other factors. In that case you might get a table or other comparative information provided.
That said, some results are still concerning if they’re “high-normal” or “low-normal”, and some results are not that worrying even if they’re slightly abnormal.
> When blood works or whatever exam results are available they should go through some kind of automated system that can flag critical situations like this, without waiting for a doctor.
We already have this. Based on either individual results or how results relate to each other.
Labs will detect critical results and then a range of things happen:
- a scientist may repeat or check the result if the value is extreme, to ensure it isn’t an error
- a scientist may alert a pathologist to the result immediately
- a scientist or pathologist may contact the referring doctor/hospital by phone to provide the result immediately
- in some cases, the lab will contact the patient directly (if they need to go directly to hospital for example)
This also gets done with radiology.
This then gets followed by the official report in hours to days depending on how much confirmation is required.
Anyway, this comment reads wildly similar to the dropbox comment.
Dropbox?
https://news.ycombinator.com/item?id=9224
Basically, something along the lines of (paraphrasing) 'this can be done today by using existing tooling'
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...oh by the way, you should probably go to the ER.
I think that should then be enough to know to Google "Low platelet count". The person may not know the significance of that immediately, true.
Btw I agree AI can help, my issue is with greedy people salivating for money while attempting to do "AI doctor", "AI teacher" "AI physiatrist" , this important AIs should be build by non profits and correctly checked by competent people for safety. Because of $$ reasons this AIs will be marketed with more abilities then they have and the downsides will be hidden, again because of $$
I agree with you about the Dropbox comment though. This whole thing is about having a polished user experience rather than bouncing between Google searches, Google Lens, and various other websites.
I would. You would.
> Anyway, this comment reads wildly similar to the dropbox comment.
My point was that this isn't revolutionary/interesting. AI w/ camera can detect apples that have bruises, but AI's cousin Vision/ML has been doing this since at least the early 2000s.
Further to my point was that while yes, using all of the ways the author went about identifying the issue (picture etc) AI makes for a nicer UX, it wasn't required, nor was the invasion of privacy into the author's medical history required.
The author torched a forest to figure out their issue when burning the paper mill would have done the trick.
I would've had no idea prior to reading this article.
There seems to be real value in the LLM being able to probe with relevant diagnostic questions, then picking out "Your platelet count is alarmingly low. You should go to the ER urgently." from the three lab work panels uploaded. Even if I had properly gone through those results myself at that point (not a given, by the timing), the level of danger seems very easy to miss.
> My point was that this isn't revolutionary/interesting [...] it wasn't required [...] The author torched a forest to figure out their issue when burning the paper mill would have done the trick.
And you can do anything a computer can with sticks and sand.
If an LLM is the best tool available (that isn't a given, but it does seem to have done well here) I don't see what makes it the equivalent to torching a forest. Its size? Energy usage? More capable than strictly necessary? Maybe factors I'd consider if designing, say, object detection for a low-powered doorbell camera - but not really things I'd worry about in what's potentially a medical emergency.
[Edit: Callout: https://www.reddit.com/r/ChatGPT/comments/1glttmh/i_asked_ch... Original Post: https://old.reddit.com/r/ChatGPT/comments/1glqv2o/chatgpt_sa... ]
https://hardmodefirst.xyz/chatgpt-saved-my-life-no,-seriousl...
I took that pic at 11:02 ET today
1. Get your DNA fully sequenced for $200 from Nebula.
2. Download your .cram file. 50gb+
2a. Or if you have a 23andme profile, just request to download your raw data. Use that output file.
3. Use WGS Extract to generate a datafile from the cram file of the SNPs and genotypes.
4. Zip that output file. Upload to a ChatGPT session.
5. This enables you to ask questions about your specific genetic profile.
Bring your findings to your doctor. Discuss their plausibility. It may surface a solution that they hadn’t thought of.
With an LLM, we’re trying to efficiently search the entire space using as many granular, personal attributes as possible.
We’re trying to find plausible hypotheses. Especially those that haven’t been considered.
The final determination and action is still a partnership between you and your doctor.
I am smart. I am capable of understanding deeply technical subjects.
I have a team of smart doctors to present my findings to.
I’m looking for plausibility. Not the full diagnosis.
LLMs aren't an oracle of truth, science and medicine can't solve everything. It's OK to be sick and not have answers, if you've "done everything" and the experts don't have an answer chat gpt won't automagically summon an answer from its statistical soup. It sucks but it's a fact of life, we're not gods, and neither are llms.
7. Receive email in 5 years disclosing how your chat data may have been part of a security breach.
I'm not sure the value of the discussion around those comments outweighs risk of spreading/normalizing that idea.
That it worked for you, doesn't mean it's a wise general recommendation.
Any diagnosis and action set of steps found, you’ll have to work with your doctor to implement.
Do not rely “solely”..
I had high blood pressure for 30 years. ER visits. Multiple cardiologists in SF.
I had a nodule on my left adrenal gland. Hyperaldosteronism.
I diagnosed this. Not the doctors.
The doctors missed this for decades.
Have you done this? Any interesting results?
https://dnacomplete.com/tier-selection/
Nebula offered specials for full genome sequencing.
They’re now owned by DNA complete.
DNA Complete prices it at 495. I paid half that for 30x.
“By analyzing your DNA multiple times, we can significantly increase accuracy. 30x Whole Genome Sequencing means that 100% of your DNA is sequenced an average of 30 times, thus providing even higher accuracy. Typical DNA Ancestry tests sequence less than 1% of your DNA.”
Good god that install script. This is it, this is the tool that AppImage was created for.
By cursory, I mean an evaluation that does not take into account a very thorough assessment of all the evidence. P(condition | evidence) is not very accurate when the evidence is vague and sounds like many other conditions. It is a rare doctor who spends more than a few minutes asking about all possible symptoms, even those that may not occur to the patient that they have. Such doctors certainly exist, and I’ve had a few, but for the most part I have to do my own research and present it to a doctor for it to even be considered as a possibility.
As anecdata of one, I’ve been having all sorts of weird rashes that come and go. Could be eczema, lupus, psoriasis, who knows. Googling makes you think it could be anything. So I took my entire medical history, all medications, all symptoms, their frequency, etc. and threw everything into ChatGPT with the prompt “Give me a list of possible diagnoses ranked by likelihood based on the evidence”. At the top of the list “Mononucleosis (EBV induced)”.
Ah, but I forgot to mention that I had mono 12 years ago. I can’t catch that twice. So I told ChatGPT that I had it previously. “Still mono. Possibly recurrent due to some problem of the immune system.” So I went and got an EBV antibody panel. Positive for all three, including the EBNA test which is positive if you ever had mono previously.
It blew my mind that a LLM sussed this out, because mono wasn’t even on my radar.
Please people, for the love of life and health, don’t trust your medical issues to LLMs.
You’re lucky it was just mono.
Maybe find a better doctor if you feel you’re not getting good enough care…
People can't know when they should/can trust an llm over a doctor. People will also misuse LLMs in the context of medical diagnosis where asking the right questions and examining the right places (and properly) can be critical.
People have biases, people can have psychosomatic symptoms, people can be easily influenced, etc.
Yes, exactly.
Doubly so when one has no medical expertise.
Unlikely, probably. ChatGPT aims to please.
There's also the risk that it recommends something that is in appropriate, but within your ability (like over-the-counter meds that shouldn't be used in your condition).
But - all this stuff happens all the time anyway. Most people don't involve a doctor until they encounter something really wrong that they don't recognize. They're more likely to mention it to someone else offhand and may take whatever recommendation they get.
Fair point. I could see a lot of people doing that.
It goes both ways. Replace "you give the AI" with "you give the doctor" and the issue "nothing is wrong" does not magically disappear. As a matter of fact, many doctors I have spoken with couldn't diagnose a thing and I wouldn't trust them.
One of them googled about the potential symptoms of the disease in front of me because he had no familiarity with it. And that's fine I guess since humans cannot know everything? But this only reinforces the point that LLMs can definitely have their place in assisting people, and their doctors, with diagnosing their health conditions.
Imagine you have a doctor who has read through literally all the medical books, documentation, research topics, experiments ... whatnot. Human of that kind does not and simply cannot exist. I think not many people understand the value and potential of LLMs, no matter how much this particular topic would be seen as sensitive or controversial.
You might not, but others would.
I mean people take random advice from the internet all the time. IIRC There was a whole craze about ingesting or injecting bleach to “cure autism” or something.
Random advice from an LLM is no better.
Even worse, maybe, since there’s not going to be a bunch of negative replies to whatever the LLM outputs.
But the article and the comment both describe situations where they talked to a physician first, went to ChatGPT to refine their understanding, and then went back to a physician. Seems like a good use of LLMs.
> Unpopular take: ChatGPT is better at diagnosing medical problems than a doctor who does a cursory evaluation.
Which is dangerous and harmful advice.
No reason to muddy the waters.
Due to my partner's work, I live in a town of about 100,000. There is a doctor shortage - New patient intake can be months. The system hangs on with physicians' assistants. Going to a specialist often means months of waiting or hours of travel.
We are living in a degraded health system between the lack of doctors, burnout of doctors and nurses, and a private equity system buying up everything in sight and sucking out every last dollar it can.
Maybe it's better in large cities.
I’d bet that, if you live in the US, there are options for doctors within a 1-2 hour drive from you.
I drive an hour and a half to see an independent dentist I trust.
I’m lucky enough to have a decent doctor only 20 mins away.
Either way, I’d never trust my health to an automated system. Especially one which can’t be held accountable in any way.
At least LLM advice is normally quite sensible compared with a lot of the junk advice out on the internet.
I can't see any mention at all of bruises being a symptom in the article, did I miss that bit? Also if you're going to fill an article with ai-generated images, can't you at least photoshop in some correct text instead of getting an AI to try and writing the text for you? "Honestly? chatgpt convunced me." isn't awful, but "Ancôoidions, your instructions." is completely incomprehensible to me
Far more reliable, no risk of hallucination.
Only as reliable as the information contained in the system. The whole point of an LLM is to agglomerate as much information as possible with little manual intervention which causes them to both be a) far more intelligent and knowledgeable than any old-school symbolic expert system, and b) also more prone to biases and hallucinations.
is fairly basic medical knowledge. Even a cursory Google search would be enough to get that answer.
What then?
The pathology company I send my samples to contacts my clinic to ensure we received urgent results. This it's important because there's no guarantee the message ever arrived in the doctor's inbox. If you work in tech you should know this to be the case.
The only way to ensure timeliness is for the pathology company to contact the patient directly if they can't verbally hand over to the requesting doctor.
My guess is that the end result is that companies are going to tune their models to default to telling people to go to the ER.
Based on the confident manner with which all LLMs present their answers and based on the fact that people are clearly using LLMs for their medical expertise, I think it would be pretty easy to go after one for giving medical advice that caused actual damages.
* with at the same time having this data nicely collected for OpenAI to boost further training
This is the point at which you call your doctor.
AI is also helpful to parse the story about how AI is helpful.
IMO, saving one life justifies every cent invested into OpenAI. How many thousands (or many, many more) will we never know about?
This is a huge differentiator from Google, where doctors sigh and act aggressively skeptical when you do your own research.
That doesn't seem to be the case.
Tax the rich.
What if every cent spent on OpenAI, spent elsewhere, had saved two lives?
That's a really inefficient health care system.
"Globally in 2023, there were an estimated 263 million malaria cases and 597 000 malaria deaths in 83 countries." [2]
" In the 20th century alone, malaria claimed between 150 million and 300 million lives, accounting for 2 to 5 percent of all deaths" [3]
There's a widely claimed factoid that Malaria has killed half of all people ever born, and while that might be true, there's plenty of debate you can find about how accurate that claim is. In any case, Malaria is one of, if not the, most deadly infectious disease in human history.
We could have wide-spread elimination of malaria transmission now. We could eradicate malaria with further developments. [4]
> IMO, saving one life justifies every cent invested into OpenAI.
Common reporting says openAI spent $5b last year. That's 1.25b vaccines. The population of Africa is 1.5b, and Africa has the most malaria cases of any continent. So you could make a really, really big impact in that 263m cases/597k deaths per year just by investing in something that already exists.
[1] https://www.unicef.org/supply/media/19346/file/Malaria-vacci... [2] https://www.who.int/news-room/fact-sheets/detail/malaria [3] https://www.ncbi.nlm.nih.gov/books/NBK215638/ [4] https://www.who.int/news-room/fact-sheets/detail/malaria
https://www.who.int/news-room/fact-sheets/detail/malaria
> Current malaria vaccines reduce uncomplicated malaria by ~40%, severe malaria by ~30%, and all-cause mortality by 13%.
https://www.cdc.gov/malaria/php/public-health-strategy/malar...
The vaccine doesn't work that well. As your article [4] says
>The highest impact will be achieved, however, when the vaccines are introduced alongside a mix of other WHO-recommended malaria interventions such as bed nets and chemoprophylaxis.
It does not say that.
And in any case, as we should all very well know by now, vaccines don't have to be 100% effective at disease prevention to be effective at disease spread reduction, especially at scale.
But, lets grant the point: Fine. Use some of that $5b annual spend to fund other preventatives.
"Dr Google saved my life"
It's a very rudimentary chain of medical reasoning and doesn't really need an LLM to conclude that low platelets and petechiae is bad news
at the time i was anchoring on digestive issues and hadn't thought too much about the bloodwork results
i.e. he shouldn't had to have to consult ChatGPT in this case
through then given how good people can be to convince themself that they shouldn't call help even if they really need it (or the opposite) ChatGPT might really help there
As someone currently experiencing multiple unexplained systems and getting shuffled around to experts who continue to push appointments further and further back, I can't agree more. I've been using AI a lot lately, and some of these specialists I have actually met with are often surprised at how much knowledge I came in with (granted, I've always been this way, even before AI, it's just now even easier).
But yeah, I had a similar but much less extreme case where I had tests come back, and my primary didn't even look at it for four days. Luckily, I was able to supplement and resolve the (minor) issue myself after talking it over with AI.
If I can provide one advice is to always question your doctors. Get multiple opinions on serious issues, and educate yourself like this person did. Come prepared to doctor visits and don't be afraid to challenge them if they tell you something that contradicts what you learned.
Today on "that totally happened."
Today, on "that totally happened."
"When my site is under load, I should:"
- Fall back to a degraded text mode representation that is still readable
- Redirect to an error display
- Load the site correctly, then a few seconds later redirect to the error display anyways, forcing users to quickly ctrl-A ctrl-C so they can read the article
Hint to the designer: it's not the third one.
edit: Snagged a pastebin https://pastebin.com/awpVkJB7