Helping patients to use AI wisely

education
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Here’s what I have so far, related to your advice:

Common Mistakes We Make when Using AI

Doctors report uses of AI that can create anxiety in patients that actually make our consults more difficult.

  1. When we ask valid questions the wrong way

    • Examples:
      “Can symptom X be caused by disease Y?” OR
      “Can disease Y cause symptom X?”:

    • *Why this type of question is not helpful:
      It leads to replies favoring what worries you or your expectation.

      Doctors don’t begin investigating with a specific diagnosis in mind and then seek confirmation for something they already believe to be true. Instead, they begin a process called differential diagnosis that works something like this:

      Right now, your symptoms are clues in a medical mystery, and we have a shortlist of a few different possibilities that could be causing them. We are going to use targeted tests to systematically cross those options off the list until we find the exact answer and the right treatment.*

  2. Insufficient background provided for a reliable diagnosis:

    • Why is this a problem?
      Our health conditions depend on many individual details within our medical files—such as age, weight, fitness, diet, current medications, and treatment history. Only your doctor has access to this complete history, and a reliable diagnosis can only be made through direct physical examinations and medical tests..

Greetings, Given the concerns raised by doctors on this forum regarding how patient use of AI is making the practice of medicine more challenging, I have drafted (with the help of AI) a set of guidelines for patients.

I hope this post is appropriate for this forum. If you find these guidelines helpful, please feel free to adapt them as a handout for your patients or post them on your patient portals.

How ai Can Help Patients

The Good: How AI Can Help You
The Risks: What AI Cannot Do

How to Ask AI Good Questions
How to Check AI Replies: Levels of Evidence

Strong Evidence | Weak Evidence – not real evidence at all

Widely-Believed Myths
About the Author

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This is great, Karl. Thanks for putting it together. One possible suggestion is to caution patients against asking AI to confirm their pre-existing theories or to substantiate their deepest fears. My interactions with certain patients suggest that their questions to AI have taken the following form: “Can symptom X be caused by disease Y?” OR “Can disease Y cause symptom X?”

This approach is the exact opposite of the approach that doctors use for differential diagnosis. Patients’ approach invariably culminates in AI “confirming” their deepest-seated fears or personal theories regarding the cause of their symptoms.

Physicians take a detailed history (informed by deep knowledge of each patient’s personal context) before arriving at a differential diagnosis. They don’t start a clinical encounter with a specific diagnosis in mind and then seek confirmation for something they already believe to be true. In other words, many patients seem to use AI as a data-dredging device (analogous to dredging an administrative database to identify “causal” relationships between a drug exposure and a clinical event).

If patients ask the AI agent very specific questions, seeking support for their preconceived ideas, and, if they sense even a whiff of support from AI (often because they aren’t familiar with ways to get AI to provide only “high quality” evidence), the subsequent clinical encounter can become extremely challenging.

So the lines “AI is not a doctor” and “AI can not diagnose you” are true, but need some elaboration.

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Revisions are likely, but I put together a PDF version that can be printed and distributed.

I see that the bookmarks did not translate correctly. I’ll fix shortly but the link to the PDF will remain unchanged.

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