I'm not sure what your point is. Are you saying that medicine is inherently fallible and therefore AI is more likely to make a good diagnosis - particularly a cluster of specialist AIs?
Yeah I think the OP is muddling the point by conflating "physician's version of the diagnosis" with "The Diagnosis".
There is absolutely one "The Diagnosis". Human body is a machine, albeit a very complex one, and all measurement sources have noise. But they are all measuring one reality, and if there is a problem, there should be one explanation that all measurements align with. They can be noisy but can never be conflicting (instrument error notwithstanding).
Physicians' ability to arrive at "The Diagnosis" would vary, but it does not mean one does not exist. I am not sure if characterizing human body as derministic or not is relevant here.
I think „the diagnosis” is over simplification and lots of professionals would disagree that there’s always a single one. As a patient your goal is to eliminate the symptoms of whatever is going on in your system. Often times there could be many reasons for it and only curing one can help you already. The diagnosis is a help tool to choose the roght curation method.
Thus, chasing the „right” diagnosis (whatever that is?) is pointless, as it only the outcome (reducing symptoms, stopping the damage) can tell you if the diagnosis was right, but not the only one right.
> I think „the diagnosis” is over simplification and lots of professionals would disagree that there’s always a single one.
"The Diagnosis" does not mean "one root cause".
Situation: my car has some unexplained vibrations.
1. Mechanic A says that it is the engine mounts
2. Mechanic B says that it is some weirdness in how the exhaust assembly is hanging to the underbody
3. Mechanic C says that it is just my wife farting
I replace engine mounts and 40% of the problem is reduced. I then drive without my wife and the remaining 60% is solved.
"The Diagnosis" was: 40% mounts, 60% wife, 0% exhaust.
This is a kind of thinking a lot of programmers fall prey to. The real world, outside of code, is a very fuzzy and inherently analog place. There is very rarely one in any complex system having a complex problem needing a complex solution. At some point even the definition of diagnosis gets fuzzy.
The best demonstration of this in medicine is probably the DSM-5. What, really, is the difference between Narcissistic Personality Disorder and Borderline Personality Disorder and Generalized Anxiety Disorder? Can they overlap? (Yes.) How do you treat them? (It's not easy.) What about depression: how do you tell if someone has Major Depressive Disorder or Bipolar Depression? (Again: not easy.) In some circumstances the only way to tell the difference between the two is what drugs work: if antidepressants help, it's Major Depression; if mood stabilizers help, it's Bipolar Depression. It's kind of odd to define a One True Diagnosis by "well we fixed it this way, so it must have been that", with no other way to do it, isn't it? (What if both work? What if one works for a while, then the other works? What if treatment with antidepressants induces bipolar (hypo)mania? All of those happen!)
Pyschiatry gets complicated because the failures are not mechanical. Even if you could image every single neuron in a person's head we do not have a very good way to define an algorithm for these issues. I do not have a good answer for psychiatry.
> This is a kind of thinking a lot of programmers fall prey to. The real world, outside of code, is a very fuzzy and inherently analog place.
Having said that, I would vehemently reject and push back against this, and without doubting your sincerity, characterize it as an ad hominem.
The vast majority of issues with the human body are mechanical in nature. Restricted blood flow, unwanted tissue, a broken bone, a bad valve etc. These are causal descriptions of "disease". Where causal descriptions exist, the "One True Diagnosis" principle holds. Psychiatry just happens to be unique in that it is a fuzzy science where we rely on checklists and ultimately all diagnosis is probabilistic.
EDIT:
> This is a kind of thinking a lot of programmers fall prey to. The real world, outside of code, is a very fuzzy and inherently analog place. There is very rarely one in any complex system having a complex problem needing a complex solution. At some point even the definition of diagnosis gets fuzzy.
I would also push back against this mindset in general. This is not a falsifiable claim, it is incoherence as an argument, and I do not need to be a programmer to hold this position.
That the real world is analog is irrelevant to its amenability to causal explanations. Or "fuzzy": "fuzzy" in this context just does not mean anything.
I am not trying to sound exasperated or win internet points, just impress this point on you and anyone reading this. We can write math to predict weather, make it tractable to solve using approximations, tolerate IEEE 754 weirdness, and finally tell what the clouds will do a week from now. This is nature telling us that there is a pattern to how it behaves, and it is the only weapon we have as scientists.
To say that nature is not amenable to explanations is a very defeatist thing to say: neither Newton nor Einstein nor any of the million-odd people that have built modern society would exist if nature did not have causal explanations. I urge you to reject this defeatist thinking.
There's quite a few diseases and conditions that don't have definitive tests. For example, alzheimer's and parkinsons are diagnosed based on medical history and symptoms. With alzheimer's an autopsy can tell for sure but that's not much help for a patient. I'm sure there's other things out there with similar situations. Hard to come up with "the one true" diagnosis with an definitive way to determine it.
Not GP, but I'd argue that over-rationalism and underestimating both the complexity of the real world and the theory-ladenness of one's perspective is just as dangerous. The point is not to be paralysed by complexity, but to acknowledge it and acknowledge the reality of unknowable unknowns in our decision-making. I don't consider that defeatist in the least. Epistemic humility is the rational response to a complex world; courage is to act anyway.
> We can write math to predict weather, make it tractable to solve using approximations, tolerate IEEE 754 weirdness, and finally tell what the clouds will do a week from now.
Even so, we’re operating on approximate datasets and sometimes our predictions are wrong. I think a lot of the medical field is like that - people are doing the best they can with what they have.
It’s entirely possible that DSM-5 will be viewed as flawed and inaccurate in a century, but it’s better than nothing.
Similarly, for every possible medical affliction there could be “The Diagnosis” that would describe how to treat it, we’re just unable to be that accurate and thorough. The fuzziness just means that you’d need 10’000 data points about the state of the body instead of 10-100 and also be able to reason about them.
Most disorders in the DSM-5 are defined by polythetic criteria, i.e. meeting X out of Y symptoms from a list for a given duration of time, or by conjunction of polythetic criteria. These definitions are socially constructed and statistically validated for pragmatic use, but very rarely have definite underlying biological markers. Especially as concerns personality disorders, these disorders can also simply be an inheritance of cultural or political baggage and prior psychoanalytic theory.
> In some circumstances the only way to tell the difference between the two is what drugs work: if antidepressants help, it's Major Depression; if mood stabilizers help, it's Bipolar Depression.
This is ridiculous. There is zero mention in the DSM-5 or ICD-11 of "if these drugs work, it's this, otherwise it's this." I would question a psychiatrist dispositively making a diagnosis on such grounds.
There is absolutely one "The Diagnosis". Human body is a machine, albeit a very complex one, and all measurement sources have noise. But they are all measuring one reality, and if there is a problem, there should be one explanation that all measurements align with. They can be noisy but can never be conflicting (instrument error notwithstanding).
Physicians' ability to arrive at "The Diagnosis" would vary, but it does not mean one does not exist. I am not sure if characterizing human body as derministic or not is relevant here.