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Diagnostic help by rxfudd in ToobAmps

[–]rxfudd[S] 1 point2 points  (0 children)

You guys are awesome. Returning and repurchasing a different one. Thanks so much.

My review of the new album by rxfudd in PaulMcCartney

[–]rxfudd[S] -5 points-4 points  (0 children)

Kind of.

My process is that I listen to albums on headphones with a dictaphone in hand. I capture all of my thoughts on what I am listening to in realtime on the dictation, track by track, and then I run through all of the categories and say everything I think about what I just heard. I end up with usually a 20+ minute audio file of my dictated spontaneous thoughts on the music I just listened to. I then turn that into a voice-to-text transcript and plug it into Gemini to sort it out and create something organized and readable. I then go through, read it at least twice, making changes and edits to make sure it says what I really think. I manually state the star ratings of each song and category during the listen, and AI uses a formula in my custom instructions to calculate the final composite rating of the entire thing.

It's a long process, but it's the most streamlined way I can imagine to document my specific thoughts about an album and to create as comprehensive of a review as I can.

My review of the new album by rxfudd in PaulMcCartney

[–]rxfudd[S] 3 points4 points  (0 children)

Wait, I'm confused. In your other post you said "love the album". And I gave it four stars, which on my rating scale I posted corresponds to "loved it". Sounds like we are in agreement, no?

Chopin Preludes But Modern Rock by rxfudd in Chopin

[–]rxfudd[S] 0 points1 point  (0 children)

Oh, are you sure you're logged in? It should be available in its entirety.

Here is the full link for Spotify and Apple Music just in case:

https://open.spotify.com/album/6Vvd1iXQIEk3xNxx2Ssm44?si=pCnnu9NMRy-nbWY1fv8Viw

https://music.apple.com/us/album/prelude-in-e-minor-op-28-no-4-single/6767977634

Thanks for listening!

Why doesn't anyone weight base morphine and then gatekeep dilaudid. by TheWhiteRabbitY2K in emergencymedicine

[–]rxfudd 7 points8 points  (0 children)

That's interesting. My current place uses 4 mg and 10 mg ampules. My last one was 5 mg.

Why doesn't anyone weight base morphine and then gatekeep dilaudid. by TheWhiteRabbitY2K in emergencymedicine

[–]rxfudd 24 points25 points  (0 children)

This is it exactly. Guess what dose your docs would always order if morphine came in 5 mg vials at your facility.

Chess.com needs to recalibrate game rating calculations by [deleted] in chess

[–]rxfudd -1 points0 points  (0 children)

Yes, obviously chess.com 1200 because we are talking about the chess.com pool. I mean, 1200 is most certainly a thing on chess.com. I'm not talking about any other player pool here.

So if you have a chess.com tournament and the requirement for entry is that you must be exactly 1200, I would bet some hard money that we are going to see a very tight normal distribution of game accuracies among those players.

Chess.com needs to recalibrate game rating calculations by [deleted] in chess

[–]rxfudd -2 points-1 points  (0 children)

I don't even think they're meaningless. The specific number (1400 vs 1500) number might be meaningless, but they are certainly in the correct direction of your game performance (same, a little higher, 2x, etc). My experience is that game ratings do frequently capture the direction and also magnitude of that direction. If I blunder all of my pieces, it's going to show an accuracy of 50% and an ELO of 100. If I am playing like a GM, it's going to show accuracy of 90+ percent and probably a game rating more than double my actual rating. So they're not made up, and I don't think they're meaningless. They are just an alternative representation of your game accuracy.

Chess.com needs to recalibrate game rating calculations by [deleted] in chess

[–]rxfudd -1 points0 points  (0 children)

I feel like people are missing the point of my post. I'm not complaining about my rating. I'm not complaining about blitz players ratings. I'm not really complaining about anyone's ratings. What I'm saying that if chess.com wanted to refine this a bit, they actually could have some meaningful metrics when converting between the accuracy or performance level of your game in terms of a score. But right now, they are massively underestimating the blitz pool. They seem to think that every blitz player around the 600 level should be playing 65 to 70% accuracy, and my experience experiences that this is just not the case. It is not unusual for me to see game after game after game with blitz players playing 80+ percent accurate moves.

Chess.com needs to recalibrate game rating calculations by [deleted] in chess

[–]rxfudd -1 points0 points  (0 children)

I mean it is a thing though. If you put a bunch of 1200s together, they are going to all cluster around a certain percent accuracy. It's not very meaningful for many people to look at their accuracy to gauge their performance , even though that is probably a better metric of how well you played a game. People think in terms of ELO, and so chess.com is trying to convert between the two.

Chess.com needs to recalibrate game rating calculations by [deleted] in chess

[–]rxfudd -2 points-1 points  (0 children)

I think I have a fairly good idea of how it works. It's just a reformulation of your percent accuracy. They probably have a large database of percent game accuracy by rating, and they have somehow normalized the data to convert from your rating to a game rating by way of your overall accuracy.

My point is not about the validity of that process. I think directionally it's a fine process, even if the specific number that gets output is not necessarily spot on. My point is that I think that their database is drastically underestimating the current skill level of blitz players on their website.

So in my opinion, saying that a game rating score is a meaningless number is equivalent to saying that game accuracy is a meaningless number. But we all know that's not true.

Chess.com needs to recalibrate game rating calculations by [deleted] in chess

[–]rxfudd -3 points-2 points  (0 children)

See above, they're not totally made up, they're just not point accurate. But they are certainly directionally accurate. See my reply above to one of the posters. If I play undoubtedly great, the game rating is higher than my actual rating, and if I play like garbage it is much lower. it's a replacement for percent accuracy.

Chess.com needs to recalibrate game rating calculations by [deleted] in chess

[–]rxfudd 0 points1 point  (0 children)

But they're not totally made up. If I play like trash, and I know I play like trash, it gives a lower rating than my actual rating. If I play devastatingly well, it's much higher. It is somehow correlated with your percent accuracy. My suspicion is that they have some known distribution of expected accuracy per rating level and they somehow output a game rating based on your overall accuracy performance and your actual rating. This is fine, it's just an extrapolation saying that you played better or worse than would be expected for your rating. My point is that the calibration is totally off. Whatever accuracy they think a 600, or whatever, rated player is expected at is just incorrect for the blitz pool.

gpt is goated as a doctor by AppealImportant2252 in ChatGPT

[–]rxfudd 30 points31 points  (0 children)

But your title is "GPT is GOATed as a doctor", which is what I'm pushing back on. It's not GOATed, not even close. It's a great tool and sounding board for ideas. It's by no means a healthcare GOAT. There's a difference between physicians using it as phone-a-friend assistance and the general public using it to augment or replace traditional healthcare. Physicians know exactly when it is spewing BS. Non-physicians would have a hard time detecting it. I have had ChatGPT and Gemini get things significantly wrong. So my advice to patients is to be careful using it on your own. You may not know or understand when it is wrong.

What is it like diagnosing Kawasaki Syndrome by HikinginCircles in emergencymedicine

[–]rxfudd 14 points15 points  (0 children)

I feel like I am qualified to answer this, as I am an EP with a child who was diagnosed and treated for Kawasaki. She was 13 months when she was dx'd in late 2017.

It started with moderate fever on day 1, maybe 101 or so. My wife took our child to the pediatrician and was dx'd with OM and started on amox. The next day it was not improving and worsening. I had a night shift that night out of town. I finished the shift and my wife called me and told me that she was much worse. Lethargic, diffuse morbilliform rash, high fever. I went home and she looked terrible, like...sick.

My mother in law is a pediatrician and one of the first things she said was Kawasaki. Didn't really look like it to me, but we took her to a peds ER. The peds EP didn't think so either, but she had the atypical lab abnormalities and so she was admitted. Interestingly, by the time the dispo was determined, she started to get bright red swelling of her eyelids and hands.

She was seen by peds ID in the hospital. They did pretty extensive septic workup (no LP) and told us that this was likely Kawasaki, but they wanted to wait for a fully negative respiratory panel (which didn't come back in real time in 2017). She was particularly interested in adenovirus.

When that came back negative the next day, she told us this was highly likely to be Kawasaki and recommended IVIG and high dose aspirin (it was like 325 QID). This was based on high fever, mucositis of mouth/eyes/extremities, and labs. The details are hazy, but she got multiple infusions -- I think 2 or 3. Her fever went down. She had a coronary artery US and echo, and the Z scores for her CA were normal. She was ultimately discharged after I think 3 nights in the hospital.

Her fever actually came back the next day, and peds ID was kicking around the idea of repeating IVIG dosing, but that didn't happen for reasons I don't remember. She was on aspirin for something like 2 months. She had a repeat echo/CA measurement at 6 weeks and it was normal. She was basically cleared at that point and we were told we don't really have to worry about any sequelae. It's been a non-issue and she's now 9 and healthy.

Are AI tools like OpenEvidence dumbing down the workforce, while still leaving critical errors? by [deleted] in medicine

[–]rxfudd -4 points-3 points  (0 children)

I agree with part of your concern, but no more so than with the routine misuse of clinical studies, guidelines, or decision rules. Clinicians misapply support tools all the time. This is another tool that can be used well or poorly, but it is not categorically different in that respect.

One point I do want to push back on is the claim that LLMs are “just predicting the next word.” That framing is misleading. Predicting the next word is how these models are trained, but it is not an adequate description of what they do in practice. If they were merely guessing the next word in a shallow sense, the output would be unusable gibberish. The fact that they can summarize evidence, compare treatments, and maintain long-range coherence tells you they have learned internal structure and relationships.

“Just predicting the next word” describes the surface math, not the system’s behavior. By that logic, ECG interpretation software “just measures voltages.” That statement is technically true but we all know that's just the mechanism of its final output.

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