I can't help but feel that the turkeys here are the patients rather than the doctors. Why are pwMS sceptical about AI? Allow me to speculate:
1. After more than a decade of cufs and underfunding, pwMS sense that AI appointments are being used to replace actual human contact and appointments. You appear to be suggesting this.
2. Who is introducing AI and why? We only need to glance at recent events in the US for an example of the malicious political goals of tech oligarchs, who are using small change (by their standards) to buy elections with the goal of taking an axe to the state.
3. As social scientist Michel Foucault convincingly explains, science is not objective and reflects the prejudices and priorities of the people who created it. You also refer to this in your piece when you show how medicine was originally - and still is, to a certain extent - misogynist. Various studies have been conducted on how LLMs mimic and imitate the racism and sexism of their host societies.
4. All of this is not to say I'm techphobic and that i don't see a role for AI in medicine. I also broadly agree with your diagnosis of contemporary medicine and it matches my experience as a pwMS. However, the point of AI should be to improve our lives, not to save time. I can see how AI could detect lesions on an MRI scan that might be missed by the human eye, but there it is acting as an aid to the human doctor not as their replacement. My ideas on this are influenced by thinkers such as Evgeny Morosov.
I am particularly wary of how an LLM will change its answer if you are giving gendered symptoms. I can see a future where women are gaslight even more because "oh the LLM said it doesn't matter" without the doctor even putting in the little bit of work they would have done to gaslight you before
I don't use AI at the moment because I have access to all the top journals: Nature, Science, Cell, Lancet, Brain, Annals of Neurology etc. BUT I just made a recent accidental discovery. There is this new AI platform GregoryAI which someone created to bring all the best MS research from all these top journals together where you can see the latest research and search for anything specific you want. I tried using chat-gpt a few times but it gave me some silly answers so I stopped using it. But I agree with you, these AI technologies are already getting so good that one can see getting information from AI is going to give more depth, breadth, and detailed, valuable information to the patient than a single human HCP could manage. And having this AI in your pocket and accessible anytime you want at no cost is going to be revolutionary. I think all this is likely to assist and enhance medical care and as you say free up space for more detailed research by HCP's. I don't think its going to replace human doctors, but the whole system of education and practice as you say I think will change. I mean this is really going to happen in so many industries that in 10-20 years so many professions will be learning and practicing in new and different ways.
With AI , perhaps patients won’t need actual drs? Just communicate with the computer and the AI program will spit out a uniform treatment. What a horrifying idea. I need my beloved neurologist, who knows MS and also knows me.
1. So many conditions have a vast canon of similar symptoms. How is AI going to pick the right horse without assessing the physical and mental health of the patient?
2. What you describe isn’t really AI IMHO but rather scraping of existing information from curated or (if you open it up) wild west sources. So more of a knowledge-base than AI?
On the other hand I have a condition that went undiagnosed for a decade and has had a devastating on my health. All the symptoms were in my MR but never correlated. What doctor has time to manually do that? Therefore I see AI as having potential in this area (with of the course the caveats in item one above).
Probably at some point, and soon. If I can jailbreak them to get prescriptions it might even helpful.
Right now, I still have my doubts (then again I do have those with doctors too) . Assuming ChatGPT o1 would be less prone to hallucinating, I asked it to do a literature review on ALA a week ago. I am aware it has no access to the web in the public version but a knowledge cutoff in 2023 seemed alright. While the outcome was sensible enough, it still invented studies and even entire DOI (some valid, just pointing to completely different studies).
Gemini (currently no paid subscription to it so no trial of deep research yet and my overall view of Gemini Flash is not that positive) and Claude (in general my favorite LLM) did not do any better.
Generally, would not self manage anything without reviewing the references. No refernces, then its useless for serious inquiry and equivalent to Facebook, just a "bit" of information that you see which must exist independently in many other places.
The good thing about the output of a curated NotebookLM answer is that every statement is referenced. This is why it is a game-changer, and it does not appear to hallucinate. If something sounds odd, you can check out the reference.
Sounds great then for important things, but you still gotta check them references! A large chunk of the "new world" is operating on what they heard only. That's fine for cooking a meal, fixing a car. Going "high tech" (if that fits) is not what the average MSr is prepared or capable of doing. I will put it off to the last minute. I'll read your blog instead!
I can't help but feel that the turkeys here are the patients rather than the doctors. Why are pwMS sceptical about AI? Allow me to speculate:
1. After more than a decade of cufs and underfunding, pwMS sense that AI appointments are being used to replace actual human contact and appointments. You appear to be suggesting this.
2. Who is introducing AI and why? We only need to glance at recent events in the US for an example of the malicious political goals of tech oligarchs, who are using small change (by their standards) to buy elections with the goal of taking an axe to the state.
3. As social scientist Michel Foucault convincingly explains, science is not objective and reflects the prejudices and priorities of the people who created it. You also refer to this in your piece when you show how medicine was originally - and still is, to a certain extent - misogynist. Various studies have been conducted on how LLMs mimic and imitate the racism and sexism of their host societies.
4. All of this is not to say I'm techphobic and that i don't see a role for AI in medicine. I also broadly agree with your diagnosis of contemporary medicine and it matches my experience as a pwMS. However, the point of AI should be to improve our lives, not to save time. I can see how AI could detect lesions on an MRI scan that might be missed by the human eye, but there it is acting as an aid to the human doctor not as their replacement. My ideas on this are influenced by thinkers such as Evgeny Morosov.
I am particularly wary of how an LLM will change its answer if you are giving gendered symptoms. I can see a future where women are gaslight even more because "oh the LLM said it doesn't matter" without the doctor even putting in the little bit of work they would have done to gaslight you before
I don't use AI at the moment because I have access to all the top journals: Nature, Science, Cell, Lancet, Brain, Annals of Neurology etc. BUT I just made a recent accidental discovery. There is this new AI platform GregoryAI which someone created to bring all the best MS research from all these top journals together where you can see the latest research and search for anything specific you want. I tried using chat-gpt a few times but it gave me some silly answers so I stopped using it. But I agree with you, these AI technologies are already getting so good that one can see getting information from AI is going to give more depth, breadth, and detailed, valuable information to the patient than a single human HCP could manage. And having this AI in your pocket and accessible anytime you want at no cost is going to be revolutionary. I think all this is likely to assist and enhance medical care and as you say free up space for more detailed research by HCP's. I don't think its going to replace human doctors, but the whole system of education and practice as you say I think will change. I mean this is really going to happen in so many industries that in 10-20 years so many professions will be learning and practicing in new and different ways.
Had a brief look at GregoryAI looks very interesting- thank you for sharing!
https://gregory-ms.com
With AI , perhaps patients won’t need actual drs? Just communicate with the computer and the AI program will spit out a uniform treatment. What a horrifying idea. I need my beloved neurologist, who knows MS and also knows me.
I’m pro AI but
1. So many conditions have a vast canon of similar symptoms. How is AI going to pick the right horse without assessing the physical and mental health of the patient?
2. What you describe isn’t really AI IMHO but rather scraping of existing information from curated or (if you open it up) wild west sources. So more of a knowledge-base than AI?
On the other hand I have a condition that went undiagnosed for a decade and has had a devastating on my health. All the symptoms were in my MR but never correlated. What doctor has time to manually do that? Therefore I see AI as having potential in this area (with of the course the caveats in item one above).
Probably at some point, and soon. If I can jailbreak them to get prescriptions it might even helpful.
Right now, I still have my doubts (then again I do have those with doctors too) . Assuming ChatGPT o1 would be less prone to hallucinating, I asked it to do a literature review on ALA a week ago. I am aware it has no access to the web in the public version but a knowledge cutoff in 2023 seemed alright. While the outcome was sensible enough, it still invented studies and even entire DOI (some valid, just pointing to completely different studies).
Gemini (currently no paid subscription to it so no trial of deep research yet and my overall view of Gemini Flash is not that positive) and Claude (in general my favorite LLM) did not do any better.
I am not referring to ChatGPT or open-source Gemini but NotebookLM, a curated LLM.
"You do not have access to view this notebook"
Not sure what to do. I have shared it with anyone with access to Google. It must be a Google software bug.
Generally, would not self manage anything without reviewing the references. No refernces, then its useless for serious inquiry and equivalent to Facebook, just a "bit" of information that you see which must exist independently in many other places.
The good thing about the output of a curated NotebookLM answer is that every statement is referenced. This is why it is a game-changer, and it does not appear to hallucinate. If something sounds odd, you can check out the reference.
Sounds great then for important things, but you still gotta check them references! A large chunk of the "new world" is operating on what they heard only. That's fine for cooking a meal, fixing a car. Going "high tech" (if that fits) is not what the average MSr is prepared or capable of doing. I will put it off to the last minute. I'll read your blog instead!