Comment by amluto | Hacker News Reader

Comment by amluto | Hacker News Reader

I find the whole field of radiology to be utterly baffling. There are doctors who specialize in, and hopefully understand, specific diseases and/or parts of the body. But we have radiologists who are supposed to be able to look at images, taken by quite a variety of technologies and parameters, of any part of the body, and are expected to accurately interpret the findings, possibly without any relevant context.

In my personal experience interacting with the medical system, it’s, unsurprisingly, quite common for an actual specialist to look at the same images a radiologist looked at, and see something quite different. And it’s nearly always the case that a specialist or a reasonable careful non-specialist who is willing to read a bit of the literature or even ask a chatbot [0], will figure out that at least half of what the radiologist says is utterly irrelevant.

So I think that the degree to which ML can perform as well as a radiologist is not necessarily a great measurement for ML’s ability to assist with medical care.

[0] Carefully. Mindlessly asking a chatbot will give complete nonsense.

Irrelevant to them. A radiologist is on the hook for missing a tiny possible tumor in a scan for a blood clot.

They like to show off occasionally. We had a rectal foreign body that was described as a Phillips-head screwdriver. I was hoping to catch them out by noticing it was Pozidriv, but it was in fact a Phillips.

I'd take it further/slightly parallel direction. Medicine is at the same time a science and a weird "feel and experience" area.

On the one hand it's a science: controlled experiments, calculated dosages, all based on an understanding of low level biology, fancy imaging methods, measuring currents in people's bodies and so on.

On the other hand, there seems to be plenty of "he seems fine to me", "tests came back fine but something seems off to me so let's try another test", "doesn't seem to be responding to this drug, let's try the other one", "in my experience this drug works better than that one". It seems like a pretty big chunk of subjectivity is actually a part of the field.

> On the one hand it's a science: controlled experiments

Those experiments are so hilariously expensive these days, and the results are often not actually fully published, so good data is often unavailable.

> calculated dosages

Often calculated based, in large part, on researchers’ vibes and their vibes when designing experiments.

> all based on an understanding of low level biology

There are many, many drugs with partially or even almost fully unknown mechanisms.

Radiologists work best in consultation with the physicians ordering the studies. Sadly, this is less and less common as workloads increase in medicine. When I started 20 years ago there were whole teams that came through the radiology department every morning to review all of the cases on their patients. Now I go weeks without seeing another physician.

Reply on news.ycombinator.com