Can ChatGPT Be A Doctor?

Axios has the sensational headline: ChatGPT plays doctor with 72% success.

Driving the news: A new study from Mass General Brigham researchers testing ChatGPT’s performance on textbook-drawn case studies found the AI bot achieved 72% accuracy in overall clinical decision making, ranging from identifying possible diagnoses to making final diagnoses and care decisions.

Let’s break this down a little.

Textbook Case Studies

ChatGPT depends on its training the basically read the internet and an unknown number of books. This means that it likely had access to these case studies, or something similar. In other words, it already knew the answer to the test question. This is not the same thing as a real diagnosis.

Accuracy Changes

ChatGPT’s models are incredibly opaque — even by AI standards.

First, accuracy in ChatGPT has already been observed as changing. It isn’t just ChatGPT, it is an issue with AI models more broady:

AI drift occurs when an AI system’s performance and behavior change over time, often due to the evolving nature of the data it interacts with and learns from. This can result in the Artificial intelligence system making predictions or decisions that deviate from its original design and intended purpose. In essence, AI model drift is a form of algorithmic bias that can lead to unintended consequences and potentially harmful outcomes.

Analytics Insight

Second, OpenAI puts out new version of its models every few months. You don’t notice this as an end-user, but it can make a big difference in output, and in the ability to truly test in accuracy.

To the right is a partial list of OpenAI models and the date they will be shutdown: no more access to them at all.

This means that any study done today on one of these models can’t be replicated in January. Every few months the models need to be re-tested for accuracy.

A lead AI researcher says:

“Any results on closed-source models are not reproducible and not verifiable, and therefore, from a scientific perspective, we are comparing raccoons and squirrels,” [Sasha Luccioni of Hugging Face] told Ars.

Ars Technica

Partial ChatGPT Deprecation Schedule

SHUTDOWN DATEMODELPRICERECOMMENDED REPLACEMENT
2024-01-04text-ada-001$0.0004 / 1K tokensgpt-3.5-turbo-instruct
2024-01-04text-babbage-001$0.0005 / 1K tokensgpt-3.5-turbo-instruct
2024-01-04text-curie-001$0.0020 / 1K tokensgpt-3.5-turbo-instruct
2024-01-04text-davinci-001$0.0200 / 1K tokensgpt-3.5-turbo-instruct
2024-01-04text-davinci-002$0.0200 / 1K tokensgpt-3.5-turbo-instruct
2024-01-04text-davinci-003$0.0200 / 1K tokensgpt-3.5-turbo-instruct

It is an open question if LLM models will be able to perform at this kind of level in the future, but we can’t count on them today.

This Distracts from Helpful Machine Learning

ML (AI in a more specific context) is already proven in other areas. For example, Mayo Clinic uses ML in radiology.

“Radiology has had the lead, partly because AI is driven by data, and radiology has a lot of digital data already ready to be used by AI.”

Radiology has a narrow context, and an understandable learning concept. We can define what radiological images look like and if they show areas of concern — or not. This is different from an LLM like ChatGPT where the learning scope is so broad we don’t understand it: it really is a black box. [1]

Look Beyond The Hype

You need to look beyond the hype to understand where AI is making gains today. You’ll usually find that information in less-mainstream publications, and in headlines that are non-sensational.

[1] You could argue that this is a matter of scale, and that radiology is much smaller black box. You’d be right, but the number of variables is so vastly different that it’s more than Apples and Oranges. In addition, testing radiology outcomes is relatively straightforward, unlike broader medical diagnoses.

[2] You know where LLMs work well? Summary: the SEO summary for this post was created by ChatGPT:

ChatGPT achieves 72% accuracy in clinical textbook case studies, but concerns arise over drift, model opaqueness, and frequent updates. Don’t go to Dr. ChatGPT

ChatGPT, Model GPT-4. August 3 version

How the Other 1% Commutes

Every once in awhile I flip open FlightRadar and look at downtown Manhattan, looking for helicopters, usually in the middle of south Manhattan.

Screenshot from flighradar24 that show’s information on helicopter N227MH.

You have to make some inferences for sure, but looking the owner, takeoff and destination (if any) are enough to give you a guess if it is a tourist, commute, police, news, or something else.

Screenshot from flighradar24 that shows flight data path of helicopter N227MH.

This trip was to an airport not far away. May have saved a couple of hours in NYC traffic.

Screenshot from Meridian Helicopter's website, it says:

Helicopter Leasing
With high-end VIP-style Bell 206L3 & Bell 206L4 or utility helicopters available for lease, we provide executives with the option of travelling in style. Custom packages are available to suit your mission.
Registered owner of N227MH, Meridian Helicopters. According to their website, they provide helicopters for lease so executives can travel in style.

To be clear, I don’t begrudge anyone because they have access to a helicopter. It’s interesting to see.

Screenshot from FlightRadar24 that shows a helicopter trip from JFK to downtown Manhattan.
Trip from JFK to downtown Manhattan. I can honestly save I’ve never been picked up from the airport by an aircraft.

Should We Really Change the Name of the Tallest Peak in The Great Smoky Mountains?

2 minutes to read

Unedited photo of view from Clingmans Dome at sunset. Nov 1, 2021, Jonathan Addington

Clingman’s Dome (6,643′) is the highest mountain in the Great Smoky Mountains, and the third highest East of the Mississippi, its current name comes from United States Senator and General Thomas L. Clingman [1].

So why is Cambell County in Tennessee — a red county if there ever was one [2] — voting to change the name to “Kuwohi?”

Cherokee inhabited the Smoky Mountains and their surroundings until their forced removal in the 1800s. Today, of course, they own nearly none of it.

“It’s not like we just occupied the land, we lived on the land,” Hill told NPR. “Our own government, towns, language, our own newspaper; we were thriving communities. Then, due to forced removal, we were forced out of our homelands.”

NPR Interview
Clingmans Dome seen from Mount LeConte, Oct 5, 2020. Jonathan Addington

You’d think that the names of mountains, rivers and valleys in the park would have several Cherokee names, but only Abrams Falls is named after any Cherokee (his Christian name). There is scant history in the form of placards or other markings of the Cherokee at all in the park.

Clingmans Dome is ‘Kuwohi’ in Cherokee — it’s original name — and it was in the middle of the Cherokee territory before their forced removal.

So, what’s the issue with General Clingman? He was a Confederate general. And he is hardly central to Clingmans Dome.

Of course, Clingman was more than a confederate general, he was a land surveyor and explored the Smokies.

So why did he get the honorific? Not because he was the first on the mountain, or the first white person to explore it, not because he discovered it.

It was named because the man who found it’s altitude — Arnold Guyot — wanted to give tribute to the man who paid for Guyot’s expedition: Clingman [3].

It’s hard to argue for anything else other than a return the Cherokee name. It was a peak central to the land taken from them, then renamed for a man who most noteworthy legacy was a rebellion against the United States.

Cambell County was not the first to suggest the un-renaming of the mountain, the Cherokee themselves passed a resolution in 2022 for the same purpose. Buncombe County, NC passed a resolution for the restoration of the name in 2022, Knox County approved of the name change in June of 2023,

Mount LeConte seen from Clingmans Dome. There is a classic cloud inversion, where the clouds are below the mountain peaks. Nov 1, 2021, Jonathan Addington

What can you do?

Ultimately this is a federal decision, not a state decision. Here are two things you can do:

  1. Share this article on social media, let your people know that it matters, and why it matters.
  2. Write your congressional representatives. This is a pretty easy PR win for any of them, so long as they believe it has something behind it.

Here is some suggested language [4]:

Dear [Rep], in 1858 the name of the mountain now known as Clingmans Dome was renamed from its Cherokee name of Kuwohi. Today, the Cherokee believe that we should restore its original name. I support this, along with communities surrounding the park, including Knox County, Campbell County and Buncombe County.

We aren’t trying to erase history: it’s the opposite, a return to history. The history of the Smoky Mountains is rich and incredible, and the Cherokee were the first settlers in and around the mountains. What is a better way to pay homage to our past and support our friends at the same time?

As someone who loves American history, the Great Smoky Mountains and our treasured national parks I urge you to suppose legislation to restore the mountain to its original name: Kuwohi.

Sincerely — your name

It is enough to just drop that message on the Contact page of their website.

Diana Harshbarger (TN), Tim Burchett (TN), Chuck Fleischmann (TN), Scott Desjarlais (TN), Andy Ogles (TN), John Rose (TN), Dr. Mark Green (TN), David Kustoff (TN), Steve Cohen, (TN), Senator Bill Hagerty (TN), Senator Marsha Blackburn (TN), Donald Davis (NC), Deborah Ross (NC), Greg Murphy (NC), Valerie Foushee (NC), Virginia Foxx (NC), Kathy Manning (NC), David Rouzer (NC), Dan Bishop (NC), Richard Hudson (NC), Pat McHenry (NC), Chuck Edwards (NC), Alma Adams (NC), Wiley Nickel (NC), Jeff Jackson (NC), Senator Richard Burr (NC), Senator Thom Tillis (NC)

Panorama of Clingmans Dome as seen from Mount LeConte, Oct 5 2020, Jonathan Addington

[1] The origin of certain place names in the United States, page 85. See it online here.

[2] In 2020 Cambell County went for Trump, 83%. “Since the founding of the Republican Party, only three Democratic Presidents, all Southerners, have carried the county.”

[3]  Tennessee Historical Society, https://tennesseeencyclopedia.net/entries/clingmans-dome/

[4] This is nearly verbatim from Cambell county Commission Tyler King, who said it eloquently.

Q3 Kaseya Product Updates, IT Glue, Network Glue, ConnectBooster and Compliance Manager

I watched the webinar, so you don’t have to 🙂

Kudos to the Kaseya team for flying through this — so much better than when vendors take 10x as long as needed. BUT, I’m sure I missed a few things here.

Overall, the changes are incremental. Nothing will rock your world. If you are an Autotask and/or Datto RMM user those incremental changes will translate to greater efficiency for your techs. (In minutes per day, not hours).

I’m hardly shilling for Kaseya here, but the updates are targeted at MSPs, it looks like more than Kaseya selling more of everyhing (or upselling, or cross selling).

IT Glue

SSO now allows for specific users to bypass SSO, in case the SSO provider goes down.

Exports can now be scheduled in the UI, or pulled in via the API.

OTP secrets are exported in the run book as well.

Offline Passwords

The ITG Browser password extension allows for offline mode for passwords — in beta. Also, it only works on Windows/Chrome. Other options are “on the roadmap” to “look into.” Comes out of beta in Q4.

Admin controls will be available. Existing permissions will carry over to offline mode, MFA and SSO still supported if ITG is offline (how does this work?)

Datto SaaS Protection Integration

They really ran through this at a fast clip. It looks like you can view all the relevant information from the ITG interface.

Spanning for Google Workspace

Similar to above, it didn’t look quite as complete.

Datto BCDR DR Runbook

Soon (December?) you can run Datto BCDR run books inside ITG. ITG says that this will help with clients who need DR runbooks on hand for compliance.

Network Glue

Automatic password rotation (September)

Password rotation is an existing feature, it now allows scheduling. ON-PREM AD ONLY. Nothing for Azure AD. (“On the roadmap”)

SNMPv3 Discovery (December)

No details given other than the headline. SNMP data can be pulled in as well, I don’t know if this is an existing feature.

Datto Networking Integration

Existing feature, it looks a lot like the Datto Network dashboard data, but inside ITG and I’d argue more readable. But, nothing here is mind-blowing.

Wifi Credentials Auto-documentation (Q4)

Save the WPA password automatically from the Datto Networking to ITG.

This is a great idea, but not exactly business changing.

Datto RMM & Autotask Integrations

Surface Documentation to Autotask Tickets

Create ticket rules to pull documentation into the ticket. At a glance, this looks like it will help junior techs, that don’t know what to search for. I can imagine — kind of — where this would be more help than time investment. In the meantime, it looks like writing a lot of rules.

Launch Datto RMM Web Remote from ITG.

ITG Checklists in Autotask

Ok, so this one I am a little excited about. You can create checklists in ITG and show them in Autotask PSA tickets.

RMM Integrations

Device passwords and documentation from ITG available in Datto RMM. If this works like they showed it, it will be great. Let techs get to documentation and passwords without jumping over to ITG.

MyGlue, myITProcess and Compliance Manager

TruMethods veteran Jeff LeClair goes over MyGlue, myITProcess and Compliance Manager. I don’t use any of these three products so take this with a grain of salt. But I didn’t see anything new in MyGlue or myITProcess. Compliance Manager will pull in data from across the Kaseya ecosystem. “No more copy and paste.”

ConnectBooster

Andy Nordin

Dashboard customizations

Move widgets around partner (your) dashboard, turn them on and off, “not quite snap to grid yet.” In the future “more widgets,” with “advanced metrics.”

“In the coming months” MSPs can turn on and off dashboard items for specific users at their clients.

Invoices Generation

Can choose HTML or PDF, based on customer. Looks like maybe (?) it can ingest PDFs from their party accounting solutions.

Notifications & Service Boards?

Andy went over something here but I completely missed it.

Is the cybersecurity job market losing steam?

The Wall Street Journal reports today (2023-08-21): More Cyber Companies Announce Layoffs. It’s not a clickbait headline, there really are companies laying off cybersecurity workers but it’s important to realize it isn’t indicative of the larger job market.

The companies listed (Rapid7, Secureworks [owned by Dell], HackerOne, Dragos) only do cybersecurity: there are not other workers to lay off.

A cybersecurity recruiting firm in the article is quoted:

The uptick in cy­ber­se­cu­rity job seek­ers gained steam late last year and is con­tin­u­ing, said Mark Sas­son, man­ag­ing part­ner at Pin­point Search Group, a re­cruit-ing firm in cy­ber­se­cu­rity.

Headlines from last year announce that cybersecurity has a 0% unemployment rate. Overall, there is clearly more demand for workers than people available to fill the roles.

In addition, the landscape still favors the bad guys. From my POV, things are marginally better for Windows based environments today than they were five years ago but by no means where the must be. The number of types of attacks to defend against mean that those of us in the industry increasingly need to use new tools to protect against cyberattacks — man power isn’t enough.

Businesses large and small will continue to rely on outsourcing major portions of security because it isn’t possible to maintain enough skill in house, only companies that offer security to many organizations can achieve the economies of scale needed at the macro level to come close to filling the cyber gap.

Finally, government regulation is finally stepping up after decades of ignoring risk. This is happening on the state level, and in multiple laws and regulations at the federal level. Some of the specifics are onerous but on the whole this regulation is needed — it essentially outlaws gross negligence on the cyber side of business.

Don’t read the article and think that the need for cybersecurity is abating— there is no end in sight.