Show HN: I'm a dermatologist and I vibe coded a skin cancer learning app

Thanks for your kind words with regards to the app and well done for getting such a high score!. I agree that BCC is often subtle. My practice is also largely focused on skin cancer. I would say that the majority of melanomas (and SCCs) that I diagnose would be obvious to a patient that underwent a short period of focused training and checked their skin regularly. A possible explanation for the difference in our experience is that the incidence of skin cancer (and also atypical but benign moles) a lot higher in Australia than in the UK.

You wrote:

"This is awesome. Great use of AI to realize an idea. Subject matter experts making educational tools is one of the most hopeful things to come out of AI.

It’s just a bummer that it’s far more frequently used to pump wealth to tech investors from the entire class of people that have been creating things on the internet for the past couple of decades, and that projects like this fuel the “why do you oppose fighting cancer” sort of counter arguments against that."

Let's take that bit by bit then if you find it hard to correlate.

> This is awesome.

Agreed, it is a very neat demonstration of what you can do with domain knowledge married to powerful technology.

> Great use of AI to realize an idea.

This idea, while a good one, is not at all novel and does not require vibe coding or LLMs in any way, but it does rely on a lot of progress in image classification in the last decade or so if you want to take it to the next level. Just training people on a limited set of images is not going to do much of anything other than to inject noise into the system.

> Subject matter experts making educational tools is one of the most hopeful things to come out of AI.

Well.. yes and no. It is a hopeful thing but it doesn't really help when releasing it bypasses the whole review system that we have in place for classifying medical devices. And make no mistake: this is a medical diagnostic device and it will be used by people as such even if it wasn't intended as such. There is a fair chance that the program - vibe coded, remember? - has not been reviewed and tested to the degree that a medical device normally would be and that there has been no extensive testing in the field to determine what the effect on patient outcomes of such an education program is. This is a difficult and tricky topic which ultimately boils down to a long - and possibly expensive - path on the road to being able to release such a thing responsibly.

> It’s just a bummer that it’s far more frequently used to pump wealth to tech investors from the entire class of people that have been creating things on the internet for the past couple of decades

As I wrote, I'm familiar with quite a few startups in this domain. Education and image classification + medical domain knowledge is - and was - investable and has been for a long time. But it is not a simple proposition.

> and that projects like this fuel the “why do you oppose fighting cancer” sort of counter arguments against that.

Hardly anybody that I'm aware of - besides the Trump administration - currently opposes fighting cancer, there are veritable armies of scientists in academia and outside of it doing just that. This particular kind of cancer is low hanging fruit because (1) it is externally visible and (2) there is a fair amount of training data available already. But even with those advantages the hard problems, statistics, and ultimately the net balance in patient outcomes if you start using the tool at scale are where the harsh reality sets in: solving this problem for the 80% of easy to classify cases is easy by definition. The remaining 20% are hard, even for experts, more so for a piece of software or a person trained by a piece of software. Even a percentage point or two shift in the confusion matrix can turn a potentially useful tool into a useless one or vice versa.

That's the problem that people are trying to solve, not the image classification basics and/or patient education, no matter how useful these are when used in conjunction with proper medical processes.

But props to the author for building it and releasing it, I'm pretty curious about what the long term effect of this is, I will definitely be following the effort.

Better like that?

IMO it is better to keep the barriers to entry as low as possible for prototyping. Letting domain experts build what they have in mind themselves, on a shoestring, is a powerful ability.

Most such prototypes get tossed because of a flaw in the idea, not because they lacked professional software help. If something clicks the prototype can get rebuilt properly. Raising the barriers to entry means significantly fewer things get tried. My 2c.

Well I mean more low-brow stuff like "Pint?", a social media app to find other people to go for a pint with :)

Same here, that's why I only ever code in assembly and recommend everyone else to do the same.

brother, no one cares. if LLMs made something exist that did not exist previously, they worked. it doesnt matter if you could have done it faster by hand if doing so would have resulted in the program not existing.

My Resume has plenty of padding already and it's not about learning, it's about "maybe this random idea might actually work" and proving out that concept

No additional coding.

You can take the code from a dog/cat classifier and use it for anything.

You only need to change the training data.

Apple has always been pretty good at this. AppleScript, Automator, Shortcuts. I did all kinds of cool stuff in OSX 10.4 back before I wrote any traditional code.

This has often been tried. SQL, for instance, was specifically designed to feel like natural language and be useable by people with minimal technical background. But it always runs into the same problem. As you start to expand the capabilities of these scripting languages and you get into the nitty gritty reality of what programming genuinely involves, they always end up being just really verbose and awkward to use languages that are, otherwise, like any other programming language.

Even worse is the tendency for scripting languages tend to try to be robust against errors, so you end up with programs that are filled with extremely subtle nuance in things like their syntax parsing which, in many ways, makes them substantially more complex than languages with extremely strict syntactic enforcement.

Workers are over specialized. And our business domain models are rigid. We want to streamline and standardize which often means that code is written in few places.

It would be nice if we could have the cake and eat it here. With LLM:s there's certainly opportunities if we can find ways to allow both custom scripting and large scale domain constrained logic.

I still wish a better name had been coined/had stuck.

It’s hard to take the name “vibe coding” seriously, and maybe that was the whole point, but I feel like AI coding is a bit more serious than the name “vibe coding” implies.

Anyone that disagrees that it should be taken more seriously can surely at least agree that it’s likely it will cross that threshold in the not too distant future, yet we’re still going to be stuck with the silly name.

People have the grandest ideas about the quality of the average piece of software existing in the real world.

What is the end goal of software? The vast majority of engineers seem to believe the goal is for the software to be perfect, when actually it's to do things like catch cancer early or make money. Do you think a person who’s life was saved by software with footguns cares?

Lose the tunnel vision.

Why don’t they deserve to see the light of day? Maybe the market gets to decide what “sucks” or doesn’t. More ideas in the marketplace gives users more choice.

Different people have different ideas about what counts as benefit.

The only kind of productivity is progress toward somebody's arbitrary goals. There's nothing "true" about it.

There's a big difference between a "prototype" (or a POC, or a spike, or whatever your company calls it), and an "MVP" (minimum viable product). An insecure product is not viable. A product which cannot be extended or maintained without being almost competitively rewritten is not viable.

MVP means just enough engineered code to solve a problem, rough around the edges and lacking features sure, but not built by someone who has literally no idea what they were doing.

Prototypes of physical products are never put into production and sold to consumers. Unfortunately software prototypes "run", and are sold at that point. Then they begin to scale, and the inherent flaws in their design are amplified. The same thing used to happen with MS Access apps; the same thing still happens with "low code" solutions.

The engineers cost just as much after the prototype phase, but if you don't hire them to build your MVP then you never have one.

Thanks for this - and thanks for maintaining this incredibly useful resource. What would be the best way to contact you?

The issue is that your criticism is misguided and not very helpful. In your parent comment you totally miss the forest for the trees. Or, the reason why this app has been made in the first place.

Further, your suggestions are inactionable, and again, miss the point. It’s a low effort - “Lol, why don’t you just…”. No, the point is not to find skin cancer. The point is to show a bunch of pictures to people who are interested, and let them see if they can identify worrying skin lesions.

> It was a low effort attempt to make something interesting and it wasn’t.

Maybe to you, but others in this thread found it interesting.

> Lowers the bar for what good software really is.

Software is a means to some end, not the end in itself. I can make the best coded software that does nothing [0], there is no point to that other than to practice one's skills, but again, those skills are to achieve something in the end.

[0] https://github.com/EnterpriseQualityCoding/FizzBuzzEnterpris...