Dr. Jose Francisco Abad (Courtesy of UPMC)
The use of artificial intelligence is becoming ubiquitous, but when it comes to health care, determining when and where organic intelligence should drive action could be a lifesaving distinction
Dr. Jose FranciscoAbad, a family medicine physician and certified clinical informatics specialist guiding AI implementation at UPMC, recently parsed the complex and evolving question of AI’s
Q: How can self-diagnosis
A: I used to say this before AI, but Google was ‘three clicks to death.’ You put in a symptom like a cough and then you look at cough and it says bloody cough. And then, next thing you know, you have lung cancer
AI is probably going to be an accelerated form of three clicks to death, where it’s going to help you make assumptions about something that you may or may not have without context — which I think has a tremendous amount of psychological harm
When you order a test or when you give advice to a patient, you’re kind of assuming that that information is going to [provide] space to process the emotion or feeling. So if I order a test and I say, ‘Hey, I’m going to order a test that will let me know if you have X disease.’ Then you prep the patient in understanding what’s possible from the result of that test. You give them reassurance that you’re going to follow up with them depending on the outcome
The information in and of itself, without that human intervention or without that compassion or empathy, can be very detrimental because you could spiral into obsessive thoughts about something that may or may not come to pass
Q: What are some ways to determine if an online health
A: When the AI is saying ‘This is where I’m getting the information’ and it’s from a website that doesn’t have any kind of national recognition or notoriety, you should be really careful about believing what it says
Whereas if it says something like the CDC, World Health Organization, American Academy of Family Physicians or American Academy of Pediatrics, these are trusted organizations that you know are invested in providing accurate and good care for patients
A lot of the times when I’ve second-guessed an AI answer, it’s usually because the
Q: How can human input affect AI’s ability to make a diagnosis?
A:AIs can really only make recommendations or give advice based off the information that they’re provided. AI tools like Grok and ChatGPT and Gemini will just answer a question at face value
There’s an adage that I was taught in high school: “Garbage in, garbage out.” So a calculator, if you say 5 times 5 is 25, but you only have five groups of four apples, the calculator isn’t going to know that the information that you put in was incorrect and is going to give you an answer based on the assumption that it was correct
Q: How is a doctor better at direct diagnosis?
A:Physicians have context and breadth. Over years of experience and seeing patients and being in different care settings, I can tell the difference between somebody who says my pain is 2 out of 10 and they’re writhing in pain and they can’t stop shaking and they can’t complete a sentence versus somebody who’s calm, serene and looks at you dead in the eye and says I’m in 10 out of 10 pain
So there’s a lot of nonverbal (information). There’s a lot of experience-based context that changes how information is processed. That context and breadth of experience let you determine other factors that would help you make a decision. It’s completely excluded in a one-person-to-AI-based inquiry
Q: Why should a health care professional’s words always take prededence over AI?
A:A doctor has spent countless hours and years to be able to give that advice. They’ve passed through college, they’ve passed through medical school, they completed a residency, they got board certified and so they got their medical license after residency. And they have to do continuing medical education, which means their knowledge is tested and their assumptions are kept up to date
Whereas in AI, there’s nothing. Nobody is testing an AI on its medical knowledge
Q: How can AI’s functionality affect my results?
A: AI is kind of lazy. It’s going to spend the least amount of energy and the least amount of work to try to get you an adequate answer. And so if you have limited information and you don’t give it much direction and you’re using a fast answer, you’re going to get the quickest thing that takes the least amount of time and expends the least amount of energy
Q: Is it ever OK to take medical advice from an AI answer? Why or why not?
A:Myinitialreactionisyoucannevertrustit,because that’s on the assumption that what you’re telling the AI is accurate. So I think you [should] always have a little bit of mistrust. But at the same time, sometimes AIs can be really helpful for people who are worrying about something and don’t need to
If your question is simple, then I think the AI can be a little bit more trusted. But if your question is complex or you’re not giving enough information, I think you have to take it with a grain of salt and use it to help you make your next decision
For example, I think it could be used for reassurance if you have a straightforward question like ‘Can I take Tylenol during pregnancy?’ That should be something that the AI would pretty much give you a straight answer that’s commonly regarded to be safe in this scenario
It can also prompt you to think of things that you weren’t thinking of. If [someone is] asking for help about a medical issue, then it can give a list of things to consider that helps to build a conversation with a doctor who does evaluate them. But it shouldn’t act as a solend then you need experience and a human to interpret all of that information
The thing that I would recommend is just to push assumptions with the AI, or write a prompt that is as much detail as possible
Q: How are some doctors using AI?
A: I use an AI to listen to the conversation [with a patient]. It writes my notes
But an AI can also think about, ‘What could I be missing? And so it will prompt me and it’ll say, ‘Hey, your patient mentioned that they’re fatigued and they snore loudly when they were talking to you about their cough. Did you want to consider doing a sleep study because these are signs of sleep apnea?’
It’s really helpful because sometimes I get lost in the breadth of all the symptoms that somebody’s giving me. It helps to organize these thoughts and to consider something
But I don’t go ‘Oh, my patient has sleep apnea’ and just diagnose it. I still have to do a test and ask other questions. It furthers the discussion and the evaluation and the analysis. It cannot be the final evaluation, analysis or definitive source
Q: Is AI’s application in health care improving?
A: I think as AI continues to learn, it’s going to continue to get smarter and better. The one truth that we always talk about is the computer is not greater than brain and brain is not greater than computer, but brain and computer together are better. Keeping a human in the loop is always going to be important
About the Writer
Josh Ewers is a TribLive staff writer
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