[rscho]

> if you are under 40 you will never encounter a physician who believes you are at risk of heart attack or stroke

This is absolutely not true. Only someone knowing nothing about healthcare could come to such a conclusion.

> guidelines that act like programs, and your local doctor is the interpreter.

Such reframing is irrational. You are reframing scientific facts into an almost completely empirical context. It doesn't work like that at all.

[yieldcrv]

Then the entire medical industry is failing at communicating that

The relatability of OP’s shared experience has us wanting to replace most medical professionals with genAI language models as soon as the regulations allow

[rscho]

> replace most medical professionals with genAI language models as soon as the regulations allow

Understandable, I guess. But not feasible now, nor in the foreseeable future. The problem is not even "AI" performance. The real problem is that the useful data isn't available to machines, because it's mostly acquired through meeting patients in person. It's gonna take lots of money to make machines that can compensate for that.

[yieldcrv]

Multimodal language models have already been good at accepting imaging input and noticing things that professionals overlook

I don't see how a meeting patient in person requirement is an issue. They can listen to the patient, have a context window large enough to analyze their medical history and environmental factors, look at charts, and diagnostics of tissues

and still have a much greater EQ, ability to affirm, and have empathy more than the dismissive high IQ doctor ever will

humans are going to chose that because smart humans don't have those attributes

[rscho]

It is said that "90% of diagnosis is made on patient history". That's the whole problem for machines. We'll need machines able to converse and integrate patient appearance, behaviour etc. as well as humans, and reliably derive the appropriate conclusions from that before we get efficient medical AI. We'll see how fast progress can be made, but from what I see from chatGPT and the like, I seriously doubt the current AI wave will achieve acceptable results in real, everyday medicine. IMO, procedural medicine where lots of multimodal info is always available and the environment relatively fixed, such as (simple) surgery, is a better candidate for (reliable) automation in the near term. Something like prosthetic orthopedics, maybe ?

[mquander]

Isn't it dramatically easier to provide more useful history to machines?

If I'm providing history to a doctor I am pretty much trying to jam the history into a two minute explanation, and they are trying to remember our previous interactions based on short summarized notes that they made without my help.

If I'm providing history to a machine I can take my time to tell the machine as much as I want every time. I can send it whole spreadsheets of symptom logging and tell it my whole life story.

[rscho]

Maybe for you, but not for most people. Because most people do not behave the way you are describing. Most people express themselves in vague, sometimes incomprehensible ways linked to their cultural and personal background. Their priorities might not be aligned with their best interests at all. Some will even think it clever to hide info from the doc, because they are prejudiced against docs or fear being reported, etc. That's why a skilled clinician is first of all a skilled interrogator, and second an accurate observer. The way you look, behave, walk and talk is very often of more value than lab tests. That's what a good GP is actually: someone good at extracting information from people. An unfortunate consequence of that is that every doc you'll meet will want to hear your story again, which gets old fast for patients.

[JumpCrisscross]

> We'll need machines able to converse and integrate patient appearance, behaviour etc. as well as humans, and reliably derive the appropriate conclusions from that before we get efficient medical AI

This presupposes the problem of medical records having been solved.

[rscho]

No, this presupposes that the machine won't interact solely with the medical record, but mostly directly with the patient. At least, that's my understanding. In this view, medical records won't be just text records anymore, but records of the whole system 'sensorium' for lack of a better term.

[yieldcrv]

relevant today

https://www.nytimes.com/2024/11/17/health/chatgpt-ai-doctors...

[mannykannot]

> Then the entire medical industry is failing at communicating that.

Rebutting hypobolic extrapolations from literally one datum is still not something that the entire medical industry - or just my PCP and cardiologist, for that matter - should be prioritizing (unless they have a patient doing just that), even if the prevalence of such claims has increased over the last decade or so.

The afforementioned professionals had no reticence in taking my pre-40 symptoms of heart disease seriously, even though I did not present any of the correlates frequently associated with it.

[yieldcrv]

many demographics have well studied issues of being validated at all

It’s not hyperbolic, it’s a relatable shared experience, which are the words I used for a reason. as its not a single datum, while also avoids any attempt to quantify it at all

[mannykannot]

Ipnon's claim was explicitly stated to follow from just one datum, thus:

>The main calculator used in the US to calculate 10-year risk of cardiovascular incident literally cannot compute scores for people under 40. There are two consequences to this....

And the first claim:

> If you are under 40 you will never encounter a physician who believes you are at risk of heart attack or stroke.

If that's not hyperbolic, where's your evidence that it even just close to being the case?

[yieldcrv]

yes, the word “never” is hyperbolic, while the words “relatable shared experience” are not

moving on

[mannykannot]

In this case, it would still be incorrect and uninformed if one were to substitute "frequently" or "routinely" for "always". The problem is not just a careless choice of qualifier.

I specifically directed my reply to you to where you had said, in response to Rscho's criticism of Ipon's hyperbolic claim, "then the entire medical industry is failing at communicating that", where "that" is what Rscho said in response to Ipon's hyperbole. I stand by my position that it can hardly be faulted for not preemptively responding to such nonsense, regardless of whatever you see/imagine as being relatable shared experiences.