Peut-on utiliser Chat GPT pour diagnostiquer les patients ?
Dans cette vidéo, un médecin explore les capacités d’une intelligence artificielle appelée Chat GPT pour diagnostiquer un patient souffrant de diarrhée acide biliaire. Il fournit à Chat GPT des informations limitées sur le patient et l’invite à poser des questions pour approfondir sa compréhension. Finalement, Chat GPT parvient à proposer le bon diagnostic de diarrhée acide biliaire. Néanmoins, le médecin souligne que l’IA ne peut pas remplacer entièrement les médecins, car il existe souvent des nuances et des zones grises dans le domaine médical. Cependant, l’IA peut être un outil précieux pour assister les médecins dans leur raisonnement et leur formation médicale. A la fin de la vidéo, les spectateurs sont encouragés à proposer d’autres maladies à tester avec Chat GPT.
Source : Doc Schmidt | Date : 2023-06-12 23:00:24 | Durée : 00:05:04
I’m curious if it would catch my proper diagnosis or come to the same erroneous conclusion as my prior hepatologist.
I was diagnosed with NASH based on bloodwork and imaging (MRI and FibroScan) as well as being significantly obese. I had elevated liver enzymes and abdominal tenderness. They were very surprised to find out that I had “cirrhosis” according to my scans, with low grade esophageal varices and portal hypertension. By the followup visit, my liver enzymes had returned to normal levels, and I lost a good 20lbs after starting Buspar. I had the lowest possible MELD score. No biopsy was taken. The usual diet and exercise lifestyle changes were recommended.
5-6 years later, I was finally diagnosed with hEDS, POTS, and most importantly, MCAS and chronic idiopathic urticaria. I also had some puzzling followup imaging that said I only had fibrosis.
I cross referenced my diagnoses to see if NASH was a common comorbidity as well. It wasn’t. I did a little more searching in medical journals and ran a specific search on mast cells and NASH. I found a paper cautioning other doctors that mast cell infiltration of the liver could give a false positive. At my next GI appt, I asked about this. I was now on multiple medications for my MCAS. The blood tests and FibroScan showed only mild fibrosis this time, and the supposed irreversible damage had absolutely vanished. My doctor thinks that this was indeed what happened to me. It’s been a life changing experience.
I think chat GPT should be 1st line or as patient advocate to make sure they go to the right next place. Right now, there are so many hoops a promary care doc needs fill out on EMS, its not really seeing a doctor that is happpening anyways.
Just out of curiosity, are you using gpt4 or gpt3.5? I'm just wondering since it seems like you're maybe using gpt3.5 (based on the way it kind of tapers off into becoming more and more general as the messages get longer), and you should maybe consider paying the extra 20usd they charge for access to gpt4 in order to truly get a real view of what AI can do these days… Gpt4 is RIDICULOUSLY more competent.
ChatGPT is better then several doctors I met over the years.
Can it replace doctors? Hell no. Can it function as an amazing tool for doctors to use in order to help come up with weird "unicorn" illnesses when you have no idea after a slew of tests? Absolutely.
I have been a physician for over 25 years. This is a tool that can help physicians, not replace them. My worry is when people without a medical background start to use this to self diagnosis ( I’m looking at you, GOOGLE) that it will lead to a lot of angst and people with incorrect information.
When you said “Bile Acid Diarrhea”, I thought “oh, like what I get because I had my gallbladder removed last summer?”
Do I get an honorary doctorate now? 😂
Dx rosacea va lupus rash.
It would be interesting if you can get access to IBM Watson (the AI that won Jeopardy), which is actually designed for medical diagnosis (with different training data to the Jeopardy version!), to compare.
The SeHCAT test gets payed by insurance in some countries. You just have to find a doctor that knows it
You should test chatgpt on diagnosing things with vague symptoms. The stuff that doctors often misdiagnose. Like chronic fatigue syndrome, fybromyalgia, ehler-danlos syndrome, or even endometriosis. Let's see if ChatGPT is better at believing women.
Another point: try explain symptoms like a patient would rather than a doctor.
Now AI has already trained 😅😅😅😅
any doctor who pushed the mRNA injections deserves to be replaced.
See if It can guess POTS, Gastroparesis and or intusseception
It will get even better very fast, but I think the big thing it'll be is a interview tool for doctors. If you have it listening in the background of an interview it could prompt you with questions, differentials that you may not have considered, what investigations have the best evidence, and so on, and then automatically write up medical notes. It will never do the human thing of showing a patient you care and filling them with confidence and trust, but it can supplement all of the knowledge based skills for a doctor.
Love your channel, Doc Schmidt. I was diagnosed with Celiac disease about 5 years ago and was still having “bathroom emergencies”, even though I know very well the dietary restrictions (my dad has had Celiac for decades!). I had a cholecystectomy 15 years ago and just was never quite right since. I did my research and landed on possible BAM. Called my GI, asked for a Chlorestyramine trial and…problem solved.
PS. I mix it with milk and it’s quite palatable that way.
@Doc_Schmidt Is this using the free gpt-3.5 model or the subscription gpt-4 model in ChatGPT?
Please make this a whole series it’s fascinating!
There is such a long wait to get a colonoscopy I’m surprised you wouldn’t order it right away. Luckily my doc ordered early while I was doing the other tests…I still had to wait months to get in.
Watched with interest. Remember, this is only the very beginning of AI. But in terms of its utility in clinical medicine, the art of medicine is in obtaining the pt's. history. It might be informative to ask a pt. to provide responses to the program's questions. I doubt it could then provide as precise a diagnosis as it did in the case you chose. As an aid to the physician who must have a complete differential for a constellation of symptoms, signs and historical data, it should be very useful.
I mean, after cholecystectomy isn't that the most likely cause? Would love to see you give it rare diseases you've encountered.
Please. The patient has to fill out forms that ask surgical history, so with symptoms starting back when gall bladder was removed, and symptoms triggered by food? My own first guess is straight from my nursing school med surg textbook that I havent looked at for thirty years – diarrhea due to bile acid. Too easy. Problem would be that a textbook explanation can still be incorrect.
This is a great video, thank you for sharing!
Try Stauffer syndrome
So did the patient get the bile acid diarrhea after having her gall bladder out?
Irritable bowel, leaky gut syndrome , histamine intolerance,DAO deficiency, and histamine intolerance please. Thank you, Dr Schmidt. Love your videos ❤
I would be curious if ChatGPT can get close if the patient history is more narrative, the way a doctor would typically hear it from a patient. Part of medical training is deciphering meaningful symptoms from long anecdotes.
Fyi, it looks like you're using gpt 3.5. GPT 4 has been shown in studies to be a much better medical reasoner. It's generally far superior to 3.5 in all area of performance except for speed of text generation.
Very interesting. My AI caveat is that after 13 years of being a doctor the one thing I have learned is that half the battle is knowing how to ask the question and knowing how to tease information from anwers that are not ckear. I don't think AI would cope well with that
Make it diagnose an autoimmune condition, please. That would be interesting to see.
Some lawyers recently used ChatGPT in their case research and it made up cases which they used and got in trouble for. I wouldn’t rely on it anymore than I rely on Dr. Google.
One time, I gave it a simple biology, where the patient had hepatitis and was CMV+ and was vaccinated to hepB
It told me the patient has a hepB hepatitis lol
It would be interesting to see how it responds if the information wasn't neatly presented to it…
Great vid!
At least use GPT-4. It's the difference between a elementary school students and an undergrad.
Am I the only one who would love to shunt my job over to a bot and go live in some warm country for the rest of my life XD
Dissociative identity disorder would be an interesting one
Its not gonna replace, its gonna help you! You are gonna be able to treat more patients and faster and save more lifes
It would be great another video like that but with direct answers from a patient although probably that's almost impossible. I'm not a medical professional but I don't think the average patient communicates that well medical history.
I would rather speak with a real human.
I don't know if you follow any of the LawTubers but the fact that ChatGPT just made up 6 legal precedents when asked to help write a motion is frightening! More frightening was the fact that the lawyers doubled down and said that of course the cases were real – ChatGPT assured them they were – when the court and opposing lawyers questioned their veracity! Personally, the concept of AI diagnosing me is frightening! It can only be as good as the programmer. – who may not be a doctor… I'll see a human being, thanks!!
Are there actual medications that can help with the diarrhea after losing your gallbladder?
AI will be a very specialised and helpful tool….but we also need a human factor in medicine..it cant be all robotic.
Cavernous Malformation and possibly more specific CCM2 with spinal and brain cavernous. How’s that for rare? This is what I have and it’s Cavernous Malformation awareness month.
You should Ask it of it can diagnose Iktyosis. My brother have that
I have indolent systemic mastocytosis. It took 2 months, many thousands of dollars worth of tests and doctors from every specialty trying to figure out my symptoms before I got a diagnosis. I would love to see how AI does at guessing my diagnosis.
Do remember that the leading edge of this technology which we have at this present moment is the worst it will ever be going forward through time.
Not a med student, but a hopeful pre-med. My first thought when you said she had her gallbladder removed was something to do with the inability to break down/absorb fats or other nutrients – kind of close, I suppose!
You should DEFINITELY make this into a series, although you could go more in depth into the reason for your answers to its questions.