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A year or so ago, I fed my wife's blood work results into chatgpt and it came back with a terrifying diagnosis. Even after a lot of back and forth it stuck to its guns. We went to a specialist who performed some additional tests and explained that the condition cannot be diagnosed with just the original blood work and said that she did not have the condition. The whole thing was a borderline traumatic ordeal that I'm still pretty pissed about.


On the flip side, i had some pain in my chest... RUQ (right upper quadrant for those medical folk).

On the way to the hospital, ChatGPT was pretty confident it was a issue with my gallbladder due to me having a fatty meal for lunch (but it was delicious).

After an extended wait time to be seen, they didnt ask about anything like that, and at the end they were like anything else to add, added it in about ChatGPT / Gallbladder... discharged 5 minutes later with suspicion of Gallbladder as they couldnt do anything that night.

Over the next few weeks, got test after test after test, to try and figure out whats going on. MRI. CT. Ultrasound etc.etc. they all came back negative for the gallbladder.

ChatGPT was persistant. It said to get a HIDA scan, a more specialised scan. My GP was a bit reluctant but agreed. Got it, and was diagnosed with a hyperkinetic gallbladder. It is still unrecognised as an issue, but mostly accepted. So much so my surgeon initally said that it wasnt a thing (then after doing research about it, says it is a thing)... and a gastroentologist also said it wasnt a thing.

Had it taken out a few weeks ago, and it was chroically inflammed. Which means the removal was the correct path to go down.

It just sucks that your wife was on the other end of things.


This reminds me of another recent comment in some other post, about doctors not diagnosing "hard to diagnose" things.

There are probably ("good") reasons for this. But your own persistence, and today the help of AI, can potentially help you. The problem with it is the same problem as previously: "charlatans". Just that today the charlatan and the savior are both one and the same: The AI.

I do recognize that most people probably can't tell one from the other. In both cases ;)

You'll find this in my post history a few times now but essentially: I was lethargic all the time, got migraine type headaches "randomly" a lot. Having the feeling I'd need to puke. One time I had to stop driving as it just got so bad. I suddenly was no longer able to tolerate alcohol either.

I went to multiple doctors, was sent to specialists, who all told me that they could maaaaaybe do test XYX but essentially: It wasn't a thing, I was crazy.

Through a lot of online research I "figured out" (and that's an over-statement) that it was something about the gut microbiome. Something to do with histamine. I tried a bunch of things, like I suspected it might be DAO (Di-Amino-Oxidase) insufficiency. I tried a bunch of probiotics, both the "heals all your stuff" and "you need to take a single strain or it won't work" type stuff. Including "just take Actimel". Actimel gave me headaches! Turns out one of the (prominent) strains in there makes histamine. Guess what, Alcohol, especially some, has histamines and your "hangover" is also essentially histamines (made worse by the dehydration). And guess what else, some foods, especially some I love, contain or break down into histamines.

So I figured that somehow it's all about histamines and how my current gut microbiome does not deal well with excess histamines (through whichever source). None of the doctors I went to believed this to be a "thing" nor did they want to do anything about it. Then I found a pro-biotic that actually helped. If you really want to check what I am taking, check the history. I'm not a marketing machine. What I do believe is that one particular bacterium helped, because it's the one thing that wasn't in any of the other ones I took: Bacillus subtilis.

A soil based bacterium, which in the olden times, you'd have gotten from slightly not well enough cleaned cabbage or whatever vegetable du jour you were eating. Essentially: if your toddler stuffs his face with a handful of dirt, that's one thing they'd be getting and it's for the better! I'm saying this, because the rest of the formulation was essentially the same as the others I tried.

I took three pills per day, breakfast, lunch and dinner. I felt like shit for two weeks, even getting headaches again. I stuck with it. After about two weeks I started feeling better. I think that's when my gut microbiome got "turned around". I was no longer lethargic and I could eat blue cheese and lasagna three days in a row with two glasses of red wine and not get a headache any longer! Those are all foods that contain or make lots of histamine. I still take one per day and I have no more issues.

But you gotta get to this, somehow, through all of the bullshit people that try to sell you their "miracle cure" stuff. And it's just as hard as trying to suss out where the AI is bullshitting you.

There was exactly a single doctor in my life, who I would consider good in that regard. I had already figured the above one out by that time but I was doing keto and it got all of my blood markers, except for cholesterol into normal again. She literally "googled" with me about keto a few times, did a blood test to confirm that I was in ketosis and in general was just awesome about this. She was notoriously difficult to book and later than any doctor for schedules appointments, but she took her time and even that would not really ever have been enough to suss out the stuff that I figured out through research myself if you ask me. While doctors are the "half gods in white", I think there's just way too much stuff and way too little time for them. It's like: All the bugs at your place of work. Now imagine you had exactly one doctor across a multitude of companies. Of course they only figure out the "common" ones ...


One challenge that may sound obvious.. is that super rare stuff gets seen super rarely, even by specalists.

In practice it means you often have to escalate from GP to local specialist to even more narrow specialist all the way to one of the regional big city specialist that almost exclusively get the weird cases.

This is because every hop is an increasingly narrow area of speciality.

Instead of just “cancer doctor” its the “GI cancer doctor” then its “GI cancer doctor of this particular organ” then its “an entire department of cancer doctors who work exclusively on this organ who will review the case together”, etc.


It's horses not zebras until it's actually a zebra and your life depends on it. I think those sorts of guidelines are useful in the general case. But many medical issues quickly move beyond the general case and need closer examination. Not sure how you do that effectively without wasting tons of money on folks with indigestion.


Interesting to read, thank you very much. Are you still eating ketogenic? The bacillus subtilis seems to metabolize glucose, so are yours still alive? And did you try other probiotica beforehand? I am having HIT and eating a mostly carnivore diet with mostly fresh/unfermented meat.


I no longer do keto no. I also started keto after I had gotten better already from the probiotics but not much. I'm not sure where you read about that subtilis can only live off of glucose. I'm having a hard time finding primary sources that actually talk about this but handily Google's "AI mode" also "answered" my search query and it does state it primarily thrives on glucose and sugars but can also break down and live off of proteins and fats.

FWIW, as I understand it, many probiotics aren't going to colonize on their own and "stick around" for a prolonged period of time when you stop taking them, even under good circumstances but you can't quote me on that so to speak. And in the past we would've gotten many of them through one way or another through our diet as well, just not through a probiotic but naturally.

I tried multiple probiotics. Both blends of multiple types as well as things like "Saccharomyces Boulardii"-only preparation. I don't recall all the exact ones I tried though.


after reading your comment, my perception is mixed


If it was inflamed would your GGT level be high?


> I fed my wife's blood work results into chatgpt and it came back with a terrifying diagnosis

I don't get it... a doctor ordered the blood work, right? And surely they did not have this opinion or you would have been sent to a specialist right away. In this case, the GP who ordered the blood work was the gatekeeper. Shouldn't they have been the person to deal with this inquiry in the first place?

I would be a lot more negative about "the medical establishment" if they had been the ones who put you through the trauma. It sounds like this story is putting yourself through trauma by believing "Dr. GPT" instead of consulting a real doctor.

I will take it as a cautionary tale, and remember it next time I feed all of my test results into an LLM.


At least in Poland, I can almost always see my results before my doctor does - I get a notification that the labwork is ready and I can view results online.

Also, the regular bloodwork is around $50-$100 (for noninsured or without a prescription), so many people just do this out of pocket once in a while and only bring to doctor if anything looks suspicious.

Finally, there is EU regulation about data that applies to medical field as well - you always have the right to view all the data that any company has stored about you. Gatekeeping is forbidden by law.


You don't need a doctor to order bloodwork. I get a full panel done yearly, just to establish a baseline and trend. I try not to overanalyze it, and just keep it around for a professional in case some real issue arises in the future.


In some countries you do. The Netherlands for example


> it stuck to its guns

It gave you a probabilistic output. There were no guns and nothing to stick to. If you had disrupted the context with enough countervailing opinion it would have "relented" simply because the conversational probabilities changed.


I was amused but not impressed when I was able to convince Claude Code that it was useless and absolutely not a service worth paying for. It literally apologized and recommended I ask for a refund. I mean, I still get lots of value from CC. Just that it's easy to push them into whatever corner you want.


It's amazing this still needs to be said, especially here


Here, sure.

For the general public, these tools have been advertised this way.

So if a good subset of HN still gets fooled, the layperson is screwed.


Hmm or the layperson wouldn’t be “smart” enough to think that ChatGPT could give useful answers to complex health questions.


I asked a doctor friend why it seems common for healthcare workers to keep the results sheets to themself and just give you a good/bad summary. He told me that the average person can't properly understand the data and will freak themselves out over nothing.


I'm in the US and have never experienced anyone keeping results to themselves.

In fact, I can now easily access even my doctor's appointment notes. I have my entire chart unless my doctor specifically writes private notes.


I think it's your problem you got stressed from a probabilistic machine answering with what you want to hear.


I fed about 4ish years of blood tests into an AI and after some back and forth it identified a possible issue that might signal recovery. I sheepishly brought it up with my doc, who actually said it might be worth looking into. Nothing earth shattering, just another opinion.


I am sorry I have to say so, but the value of LLM is their ability to reason based on their context. Don't use them as smart wikipedia (without context). To your use case, provide them with different textbook and practice handbook and with the medical history of the person. Then ask your question in a neutral way. Then ask it to verify their claim in another session and provide references.

It is so unfortunate that a general chatbot designed to answer anything was the first use case pushed. I get it when people are pissed.


> it stuck to its guns

Everyone that encounters this needs to do a clean/fresh prompt with memory disabled to really know if the LLM is going to consistently come to the same conclusion or not.


> A year or so ago, I fed my wife's blood work results into chatgpt

Why would you consult a known bullshit generator for anything this important?


Stories like yours are why I'm skeptical of these "health insight" products as currently shipped. Visualization, explanation, question-generation - great. Acting like an interpreter of incomplete medical data without a strong refusal mode is genuinely dangerous


>The whole thing was a borderline traumatic ordeal that I'm still pretty pissed about.

Why did you do the thing people calmly explained you should not do? Why are you pissed about experiencing the obvious and known outcome?

In medicine, even a test with "Worrying" results is rarely an actual condition requiring treatment. One reason doctors are so bad at long tail conditions is that they have been trained, both by education and literal direct experience, that chasing down test results without any symptoms is a reliable way to waste money, time, and emotions.

It's a classic statistics 101 topic to look at screening tests and notice that the majority of "positive" outcomes are false positives.


Please keep telling your story. This is the kind of shit that medical science has been dealing with for at least a century. When evaluating testing procedures false positives can have serious consequences. A test that's positive every time will catch every single true positive, but it's also worthless. These LLMs don't have a goddamn clue about it. There should be consequences for these garbage fires giving medical advice.


Part of the issue is taking it's output as conclusion rather than as a signal / lead.

I would never let an LLM make an amputate or not decision, but it could convince me to go talk with an expert who sees me in person and takes a holistic view.


Isn't it two sides to the same coin?

You should be happy about it that it's not the thing specifically when the signs pointed towards it being "the thing"?


You are _absolutely_ going to die in the next 30 minutes.

When it doesn't happen will you still be happy?


Depends if I'm now broke from blowing it all on crack and hookers.


How is this apples-apples at all?

But to answer directly... yes? yes, I am.

[edit]

A bit it more real. My blood pressure monitor says my bp is 200/160. Chat says you're dead get yourself to a hospital.

Get to the hospital and says oh your bp monitor is wrong.

I'm happy? I would say that I am. Sure I'm annoyed at my machine, but way happier it's wrong than right.


This is another example of why its frustrating still.

"Yes I'm happy I'm not dying" ignores that "go to the hospital [and waste a day, maybe some financial cost]" because a machine was wrong. This is still pretty inconvenient because a machine wasn't accurate/calibrated/engineered weak. Not dying is good, but the emotions and fear for a period of time is still bad.


Yeah I guess I just don't see eye-to-eye on this.

I 100% understand those frustrations. That the "detectors" should've been more accurate, or the fears, battery of tests, and costs associated of time and money. But, if you have the means to find out something that could have been extremely concerning is actually "nothing wrong" - isn't that worth it?

My friend is 45, had bloody stool -> colonoscopy -> polyps removed -> benign. Isn't that way better than colon cancer?

Maybe it's a glass half-empty-full thing.


It's interesting because presumably you were too ashamed to tell the doctor "we pasted stuff into chatgpt and it said it means she is sick", because if you had said that he would have looked at the bloodwork and you could have avoided going to a specialist.

It's an interesting cognitive dissonance that you both trusted it enough to go to a specialist but not enough to admit using it.


> "A year or so ago"

What model?

Care to share the conversation? Or try again and see how the latest model does?


Never ceases to surpise me why people taking word salad output so seriously.

And probably the same people laugh at ancient folks carefully listening to shamans.


Why not just ask WebMD?


You used a predictive/statistical proximity chatbot on a single point-in-time snapshot of her blood, and you’re pissed that the result wasn’t useful? I think any decent GP would push back, want to see trends in the data, or at least look at the broader context.

I mean, at some point we have to admit that LLMs aren’t designed for correctness but utility.


Do you have a custom prompt/personality set? What is it?


Yea, if only he had said "make sure you are always honest" first!


It's not that you need to ask it to be honest, it's that the defaults are kind of stupid and obnoxiously sycophantic. ChatGPT is also prone to getting stuck on particular ideas. If you're using the vanilla personalities without a custom prompt, not aware of and working against its issues, and not starting new chats occasionally you won't get good results. You'll get good-sounding garbage.

Part of my custom prompt is ```When using factual information beyond what I provide, verify it when possible. When researching factual questions—especially by relying on papers and studies—actively look for null findings, negative results, and contradictory evidence, not just positive or confirmatory findings.```

To me, the most interesting result of that part of my prompt is that in thinking mode, it ends up re-checking it's assumptions and sources fairly often. It's not about honesty, but correctness.

A custom prompt isn't the be-all end-all either. The right kind of questioning is important, and you also need to get a fresh context when you ask new questions or if you want to double check something.


Gotta love the replies to this. At least more of the botheads are now acting like they're trying to ask helpful questions instead of just flat out saying "you're using it wrong."


You’re pissed about your own stupidity? In asking for deep knowledge and medical advice from a Markov chain?


Does anyone else find the AI writing excruciating? It's not that hard to prompt the AI to not write in AI-ese. And it's a million times better if a human writes it. It's low effort just to paste the slop....

The tells:

"EquipmentShare’s founders grew up in a commune where rules were strict, and self-reliance wasn’t a slogan — it was a necessity."

"The EquipmentShare founders didn’t start by trying to “disrupt” an industry. They started by solving their own problem."

"Over time, they didn’t just build a marketplace. They built an operating system for the jobsite."


First one is definitely AI-ese, but the rest, I cannot tell if they are just business platitudes or AI. Sigh.


This is not the point of this post, but is anyone else getting tired of this front end style that Claude creates? I see it on web apps everywhere and (just like with AI writing and images) I get that funny "is this slop?" feeling


Yes, though it might be GPT-5 UI.


In studies like this I always wonder if they have the causation reversed. Is the exercise staving off the dementia or are people who are healthy enough (mental and physical health) to exercise in the first place less likely to get dementia?


Fascinating. I have a prompt running on GPT4 turbo that takes an input text and outputs a report in a tabular format that includes some summary and analysis, and on about 1 in 50 runs, after the table headers it'll output a few hundred newlines and then spit out some Korean or Thai text, which, if I put it in Google translate can be pretty weird (i.e. it has nothing to do with the input text).

This reminds me of that.


Fair or not, a week per year is an extremely common formula for calculating severance at a large company


This varies a lot between cultures and jurisdictions obviously. But not even half of Dells emplyees are in the US, so presumably a large chunk of these layoffs will be elsewhere.


Dealerships should not exist and only exist due to terrible laws making it illegal for most automakers to sell direct. And there is a reason the dealer lobby has fought Tesla's direct selling model tooth and nail.

My rule when buying a car from a dealer is refuse everything they try to sell you. They will basically hold you hostage up to and including telling you that you are being foolish and irresponsible for refusing warranties and gap insurance and whatever else. (I even have had them take my wife aside to tell her how irresponsible I was being). But you have to ride it out.


> Dealerships should not exist and only exist due to terrible laws making it illegal for most automakers to sell direct.

Dealerships exist because the automakers wanted them, and those laws exist due to the automakers' foul play.

Automakers want to make cars. They don't want to manage stores, deal with thousands of different municipalities' rules for selling and registering vehicles, repair vehicles they've already sold, or store millions of cars in inventory until they're sold. They let someone else do all that, and it lets them run their factories at a nice even pace with essentially guaranteed buyers for their output.

Automakers did, in the 1990s, start to get jealous of the money their dealerships were making on the back of their products. Ford and GM both opened factory stores competing directly with their own dealers. They knew just where to open those stores and what to sell at them, because they had full knowledge of where their successful dealers were, and what they were best at selling at those dealerships. The franchisees were taking all the risk in selecting sites and financing inventory just for their franchisor to swoop in and undercut their business with their own store next door.

That unfairness is what led the dealers to lobby for those state laws banning the automaker from competing with its own franchisees.


Unfairness? It is completely fair.

If the dealerships don't like it, they should learn advanced engineering and industrial manufacturing, and make their own cars. If they can't, then they should have been let to fail since they couldn't adapt.


I don't understand how you can say that. If McDonalds opened a new restaurant next door to each of their highest grossing existing restaurants, and charged lower prices there, do you think that would be completely fair to the franchisees that spent millions of dollars building and operating those restaurants for McDonalds? Why would it ever be fair for a franchisor to act like that?


Unless the franchise has a contract with the franchisor that states non-compete, then it is not only fair but completely legal.

A franchise had the capital to make their own restaurant but chose to be subservient to a franchisor instead. That's on them. Owning a business has great rewards, but is supposed to have great risk too.

It is time we brought the risk back. Policy the is cut throat to business is good policy. Businesses should be ravenously competing, failing, and going bankrupt. There should be no bailouts. There should be no patents. It should be survival of the fittest -- as it is for the poorest of society.


The last time I bought a car I wanted to pay cash, and the sales person gave me this wet puppy look. So I negotiated a 5 year finance rate where I calculated it would be net-zero in difference to me, literally; let's say it was 50K in cash, so I would pay $25K now, and finance $25K over the next 5 years, and they would get ~2% more, which in the grand scheme of inflation, meant a net-zero loss on my purchasing power.

I considered it a win-win situation, since it left me with more money in the bank, the sale person got their kick backs from the finance company (they proceeded to give me the free replacement car mats and other freebies associated with the finance deal), and I got positive credit ratings.

But yes, what a pain.


Isn’t the pain of even thinking about the existence of a monthly payment a true cost? I’d so much rather just pay upfront and never think about it again.


I've never had an auto loan, is there a reason they couldn't just take the financing to get the incentives and then just pay it in full the next month?


They can come with early payoff penalties. It seems weird, but a loan is a thing that can be and often is packaged up and sold. If you pay it off, they have nothing to sell. Resale value of your loan is a factor in how much it costs.

Asset-backed securities are a strange world of value based on value that can either lead to market collapse (because someone misvalued them, see 2007-2008) or market efficiency (because more people can afford debt for stuff).


With today's technology, if you can afford to buy it outright, you can setup the right autopay so you don't have to think about it.


I only sort of agree. Yes you can setup autopay but it's still there, and you still see charges on your account. Perhaps this is minor, but I still prefer to have no additional things out there floating around that require any thought.


When I bought my current car, the financing deal was probably at least neutral to me. But I just didn't want to deal with it.


> I considered it a win-win situation

> the sale person got their kick backs

I don't understand why this is your concern, to the point where you were willing to take on debt to satisfy this stranger's arbitrary incentive.

Please don't take this the wrong way but I think you might want to revaluate if it really was a win-win, or rather if you caved to their pressure tactics and now you're lying to yourself about it.


Dealerships should exist, their exclusive right to sell cars should not.

Customers should have the option to buy from a factory and to buy from a dealership.

Maybe I need a car now or want a curated selection instead of infinite choice, but I also want to buy from the factory and get my dream car or work truck in the exact specification I need without the dealer markup.

By allowing the choice they would be forced to compete and that should be good for the customer!


Don't go to dealerships that play these games. Seek out dealers that focus on business sales where the direct to consumer is not the bulk of their business. A lot of countryside dealers (deep country) have the same attitude. They let you drive the vehicle, if you want it they will find financing if you need them to. Sign the papers and leave. They will probably pitch some accessories and a warrantee extension. Zero drama. At those dealerships if they try that shit (sneaking in charges or playing any games) they could lose generations of business from a person. City dealerships are a pressure cooker because they have so much competition. If someone leaves they are never coming back. There is no philosophy of repeat business from a particular customer. If that happens it's just gravy.


My wife has a negotiation technique that has worked well for her:

“I’m a lawyer. I have a pre-approved loan. Give me your best and final offer.”

And that worked! We were in and done in less than five minutes.

Sadly, not everyone can use that technique.


No, dealerships exist so that the manufacturer doesn’t have a monopoly on the sales, and especially post-sale warranty service, of your car. Witness Tesla’s service deception and customer abuse along the Rivian shit show as plain evidence that monopolies are bad.


It’s certainly the case that the Tesla service centers suck, and perhaps they would be better if they were independent and competed with each other. But I’m not sure what this has to do with new car sales. I think my personal preference would be to buy a car from the manufacturer (the actual thing I want to buy, i.e. the car, is identical no matter what route it takes from a manufacturer to me), but perhaps service should be a competitive market. After all, a Tesla owner is not buying corporate Tesla service — they’re buying service from a specific customer service operation and a specific set of technicians.

I’m not familiar with the “Rivian shit show”.


I think automakers should be allowed to sell direct but most prefer to sell through franchised dealers. Building out a nationwide dealer network and holding inventory takes an enormous amount of capital.


The dealership service centre's are only good for oil changes that cost a premium. They don’t the time to care about anything other than routine servicing at a huge markup. Got an oddball issue? Your average self run mechanic is a much better option.


Too bad the independent car mechanics are as good as scamming repair customers as the car dealerships are at scamming car buyers.


> Dealerships should not exist

Don't fret too much, they won't survive much longer.


I've been hearing this for like a decade now on hn.


We have it on good authority that global climate change is going to destroy civilization soon enough


I wouldn't put the blame entirely on the dealerships. The automakers are complicit in this whole thing too. Without the dealers there is no service model.


It's mostly on the car manufacturers. Most of them seem to want the dealership model nowadays.

There's no such laws in place requiring independent dealerships in Canada. Aside from the usual direct sales car companies, Genesis dealerships in Canada are all owned by Genesis Canada and I can order a car direct from Genesis. Yet most of the big names in cars operate with independent dealerships, as well as practically every motorcycle manufacturer as far as I know. In fact, Mercedes-Benz Canada just sold off all their Toronto dealerships to a AWIN/Zanchin [1] and AFAIK it wasn't because they were forced to.

I don't have any real insight into why this is the case. Most I can say is that if direct sales was so lucrative for car makers, one has to wonder why they didn't take advantage of it here. That being said, FortNine released a video on why motorcycle dealerships work this way; I suspect a lot of it applies to cars as well: https://www.youtube.com/watch?v=meHYBhcpdvQ

[1]https://media.mercedes-benz.ca/releases/release-048f50ed0ac9...


If manufacturers sold direct they would have to book all inventory until it sold. Right now, dealerships work with the banks to finance inventory until it sells. Part of the reason they are so aggressive...they are paying interest on each vehicle daily.

The manufacturer gets cold hard cash for the vehicles, now. They are off the books except for the warrantee.


What do the millions of independent mechanics do all day?


This is cool but definitely can see where you're running into some of the same AI tendencies that I've run into in my own (much less fun) projects.

There's some variety in here but AI in general really struggles to vary in tone within a single output. I'll be interested to see if the project can overcome that tendency.

The scoring - AI HATES to give things low scores. It's too nice. In my experience it does better if you have named outcomes e.g. negative, neutral, positive and then convert those to numbers. A more interesting solution might involve logprobs where you ask "do you like this person yes/no" and then use the logprobs value on yes/no to measure the AI's "uncertainty" about the match.


yep, a lot of interesting challenges! Will keep you posted. I think cracking the "tone variety" challenge would be a big unlock.


Just before sleep is pretty good, but the shower is where I've had all my best ideas.


I've had some good ones loading the dishwasher too.

I think it is just that you're off doing something mindless.


Shower here too, and walking the dog


Maybe AI is "losing steam" but this is an opinion column masquerading as news, with one or two quotes (from e.g. noted AI skeptic Gary Marcus) or anecdotes supporting each section.

It would be equally possible to collect a series of similar but opposite data points to assert that AI is in fact gaining steam.


Of course it's an opinion column. But how is it masquerading as news? All opinion columns have a central thesis that is supported by facts. This is a thesis about the current state and future of AI. Like any opinion piece, the author chooses facts that support the thesis.


Sure. I just think one should interrogate and really understand the data points being used to support this claim. Let's see how they look when presented as bullet points:

- Nvidia's Revenue and AI Spending: Sequoia says "the industry spent $50 billion on chips from Nvidia to train AI in 2023, but brought in only $3 billion in revenue." - This comes from some Sequoia presentation which it appears was originally cited in an earlier WSJ article and then has been repeated everywhere. It would be nice to see that presentation and the context of this data in that presentation. And yes, this nascent industry in essentially its first year of commercialization brought in less than was invested in anticipation of future growth

- Synthetic Data for Training: "To train next generation AIs, engineers are turning to 'synthetic data,' which is data generated by other AIs. That approach didn’t work to create better self-driving technology for vehicles, and there is plenty of evidence it will be no better for large language models," says Gary Marcus, a cognitive scientist. aka Gary Marcus a noted AI skeptic

- Incremental Gains in AI Models: "AIs like ChatGPT rapidly got better in their early days, but what we’ve seen in the past 14-and-a-half months are only incremental gains," says Marcus. "The truth is, the core capabilities of these systems have either reached a plateau, or at least have slowed down in their improvement." aka Gary Marcus a noted AI skeptic

- Convergence in AI Model Performance: "Further evidence of the slowdown in improvement of AIs can be found in research showing that the gaps between the performance of various AI models are closing. All of the best proprietary AI models are converging on about the same scores on tests of their abilities, and even free, open-source models, like those from Meta and Mistral, are catching up." No citation provided for this "research".

- Commoditization: "A mature technology is one where everyone knows how to build it. Absent profound breakthroughs—which become exceedingly rare—no one has an edge in performance." A broad generalization.

- AI Startups Facing Turmoil: "Some AI startups have already run into turmoil, including Inflection AI—its co-founder and other employees decamped for Microsoft in March. The CEO of Stability AI, which built the popular image-generation AI tool Stable Diffusion, left abruptly in March. Many other AI startups, even well-funded ones, are apparently in talks to sell themselves." People at a couple of start-ups are moving around. Unsourced general claim that unnamed AI startups are looking to sell themselves (is this actually bad news?)

- High Operational Costs: "The bottom line is that for a popular service that relies on generative AI, the costs of running it far exceed the already eye-watering cost of training it... analysts believe delivering AI answers on those searches will eat into the company’s margins." Unsourced "analysts". Would be interesting to see the context of this discussion but also it is not unusual for investment in a new wave of growth to eat into margins initially

- Survey Data on AI Use: "A recent survey conducted by Microsoft and LinkedIn found that three in four white-collar workers now use AI at work. Another survey, from corporate expense-management and tracking company Ramp, shows about a third of companies pay for at least one AI tool, up from 21% a year ago.

This suggests there is a massive gulf between the number of workers who are just playing with AI, and the subset who rely on it and pay for it." Two cherry-picked surveys conducted for marketing purposes jammed together to make an unrelated claim.

- Limited Revenue Growth: "OpenAI doesn’t disclose its annual revenue, but the Financial Times reported in December that it was at least $2 billion, and that the company thought it could double that amount by 2025.

That is still a far cry from the revenue needed to justify OpenAI’s now nearly $90 billion valuation." It is completely normal for the leading edge company showing massive growth in a nascent field to have a huge valuation. It doesn't always work out well for that company but this is expected whether the company is ultimately a success or not and the ability to tap that valuation improves the likelihood of success

- Productivity and Job Replacement: "Evidence suggests AI isn’t nearly the productivity booster it has been touted as, says Peter Cappelli, a professor of management at the University of Pennsylvania’s Wharton School. While these systems can help some people do their jobs, they can’t actually replace them." Non-specific "evidence" is cited here.

- Challenges in AI Usage: "AIs still make up fake information, which means they require someone knowledgeable to use them. Also, getting the most out of open-ended chatbots isn’t intuitive, and workers will need significant training and time to adjust." Author assertion

- Historical Patterns in Technology Adoption: "Changing people’s mindsets and habits will be among the biggest barriers to swift adoption of AI. That is a remarkably consistent pattern across the rollout of all new technologies." Author assertion


It is an opinion piece and yet you're continually surprised it contains opinions.

And even when they reference sources / experts you dismiss them simply because you disagree with them.


Gary Marcus is not an expert, he is a pundit. This is mostly a rehashing of his opinion, with his opinion being cited as evidence of facts.


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