搜索结果：Clinical linguistics & phonetics

The competency of any intelligent agent is bounded by its formal account of the world in which it operates. Clinical AI lacks such an account. Existing frameworks address evaluation, regulation, or system design in isolation, without a shared model of the clinical world to connect them. We introduce the Clinical World Model, a framework that formalizes care as a tripartite interaction among Patient, Provider, and Ecosystem. To formalize how any agent, whether human or artificial, transforms information into clinical action, we develop parallel decision-making architectures for providers, patients, and AI agents, grounded in validated principles of clinical cognition. The Clinical AI Skill-Mix operationalizes competency through eight dimensions. Five define the clinical competency space (condition, phase, care setting, provider role, and task) and three specify how AI engages human reasoning (assigned authority, agent facing, and anchoring layer). The combinatorial product of these dimensions yields a space of billions of distinct competency coordinates. A central structural implication is that validation within one coordinate provides minimal evidence for performance in another, re

Clinical NLP increasingly relies on electronic health record (EHR) data to detect suicidal behaviors, treating clinical documentation as more reliable ground truth than social media. We argue that this framing obscures how EHR-based suicidality datasets encode a particular operationalization of suicidality, shaped by who authors the data, how episodes are bounded, and how ambiguity is resolved. We ground this argument in a case study of the ScAN dataset, built over MIMIC-III clinical notes. We show how governance constraints, ICD-based cohort selection, single-annotator labeling, and hospital-stay-level aggregation produce labels that reflect clinician-documented judgments, treat suicidality as a bounded episode, and assume that intent can be reliably inferred from documentation. A linguistic analysis demonstrates that identical labels subsume heterogeneous clinical framings differing in temporality, negation, and uncertainty. We argue that clinical NLP should examine the assumptions embedded in suicidality datasets before interpreting their labels as ground truth.

Empiric antibiotic prescribing in high-risk clinical contexts often requires decision making under conditions of incomplete information, where inappropriate coverage or unjustified escalation may compromise safety and antimicrobial stewardship. While clinical decision-support systems have been proposed to assist in this process, many approaches lack explicit governance and evaluation mechanisms defining scope, abstention conditions, recommendation permissibility, and expected system behavior. This work specifies a governance and evaluation framework for deterministic clinical decision-support systems operating under explicitly constrained scope. Deterministic behavior is adopted to ensure that identical inputs yield identical outputs, supporting transparency, auditability, and conservative decision support in high-risk prescribing contexts. The framework treats governance as a first-class design component, separating clinical decision logic from rule-based mechanisms that determine whether a recommendation may be issued. Explicit abstention, deterministic stewardship constraints, and exclusion rules are formalized as core constructs. The framework defines an evaluation methodology

Introduction: Semantic search, which retrieves documents based on conceptual similarity rather than keywords, offers advantages for retrieval of clinical information. However, deploying semantic search across health systems, comprising hundreds of millions of clinical notes, presents formidable engineering, cost, and governance challenges that have prevented institutional adoption. Methods: We deployed a semantic search system at a large children's hospital indexing 166 million clinical notes (484 million embedding vectors) from 1.68 million patients. The system uses instruction-tuned qwen3-embedding-0.6B embeddings, stores vectors with storage-optimized indexing, maintains full-text metadata in a low-latency key-value store, and operates within a HIPAA-compliant governance framework. We evaluated the system by optimizing the model and chunking strategy using a physician-authored benchmark, characterizing full-scale performance (cost, latency, retrieval quality), and assessing clinical utility via chart abstraction efficiency and comparison to ICD-10 cohort generation. Results: The system delivers sub-second query latency with monthly operational costs of ~USD 4,000. Qwen3 embeddin

We introduce SoftTiger, a clinical large language model (CLaM) designed as a foundation model for healthcare workflows. The narrative and unstructured nature of clinical notes is a major obstacle for healthcare intelligentization. We address a critical problem of structuring clinical notes into clinical data, according to international interoperability standards. We collect and annotate data for three subtasks, namely, international patient summary, clinical impression and medical encounter. We then supervised fine-tuned a state-of-the-art LLM using public and credentialed clinical data. The training is orchestrated in a way that the target model can first support basic clinical tasks such as abbreviation expansion and temporal information extraction, and then learn to perform more complex downstream clinical tasks. Moreover, we address several modeling challenges in the healthcare context, e.g., extra long context window. Our blind pairwise evaluation shows that SoftTiger outperforms other popular open-source models and GPT-3.5, comparable to Gemini-pro, with a mild gap from GPT-4. We believe that LLMs may become a step-stone towards healthcare digitalization and democratization.

This position paper investigates the potential of integrating insights from language impairment research and its clinical treatment to develop human-inspired learning strategies and evaluation frameworks for language models (LMs). We inspect the theoretical underpinnings underlying some influential linguistically motivated training approaches derived from neurolinguistics and, particularly, aphasiology, aimed at enhancing the recovery and generalization of linguistic skills in aphasia treatment, with a primary focus on those targeting the syntactic domain. We highlight how these insights can inform the design of rigorous assessments for LMs, specifically in their handling of complex syntactic phenomena, as well as their implications for developing human-like learning strategies, aligning with efforts to create more sustainable and cognitively plausible natural language processing (NLP) models.

We introduce Clinical ModernBERT, a transformer based encoder pretrained on large scale biomedical literature, clinical notes, and medical ontologies, incorporating PubMed abstracts, MIMIC IV clinical data, and medical codes with their textual descriptions. Building on ModernBERT the current state of the art natural language text encoder featuring architectural upgrades such as rotary positional embeddings (RoPE), Flash Attention, and extended context length up to 8,192 tokens our model adapts these innovations specifically for biomedical and clinical domains. Clinical ModernBERT excels at producing semantically rich representations tailored for long context tasks. We validate this both by analyzing its pretrained weights and through empirical evaluation on a comprehensive suite of clinical NLP benchmarks.

Developing AI models that are useful in clinical practice, requires efficient collaboration between clinicians and AI developers. This poses a practical challenge: clinicians must repeatedly communicate and refine their requirements with AI developers before those requirements can be translated into executable model development. This iterative process is time-consuming, and even after repeated discussion, misalignment may still exist because the two sides do not fully share each other's expertise. Coding agents may help close this gap. They can write and refine code on their own, and they carry working knowledge of both medicine and AI to understand commands formulated by both medical experts and developers. We present a prototype that lets clinicians drive AI development directly. A clinician describes the task in plain language, and the system turns the description into a working pipeline, refines it through repeated experiments together with the clinician, and returns a model that meets the stated clinical objective. Across five clinical tasks, the system reliably produces models that matched the clinician's request and reached competitive performance. Most notably, on chest rad

Phonetics is the scientific field concerned with the study of how speech is produced, heard and perceived. It abounds with data, such as acoustic speech recordings, neuroimaging data, or articulatory data. In this paper, we provide an introduction to different areas of phonetics (acoustic phonetics, sociophonetics, speech perception, articulatory phonetics, speech inversion, sound change, and speech technology), an overview of the statistical methods for analyzing their data, and an introduction to the signal processing methods commonly applied to speech recordings. A major transition in the statistical modeling of phonetic data has been the shift from fixed effects to random effects regression models, the modeling of curve data (for instance via GAMMs or FDA methods), and the use of Bayesian methods. This shift has been driven in part by the increased focus on large speech corpora in phonetics, which has been driven by machine learning methods such as forced alignment. We conclude by identifying opportunities for future research.

We evaluate the impact of large language model-based clinical decision support in live care. In partnership with Penda Health, a network of primary care clinics in Nairobi, Kenya, we studied AI Consult, a tool that serves as a safety net for clinicians by identifying potential documentation and clinical decision-making errors. AI Consult integrates into clinician workflows, activating only when needed and preserving clinician autonomy. We conducted a quality improvement study, comparing outcomes for 39,849 patient visits performed by clinicians with or without access to AI Consult across 15 clinics. Visits were rated by independent physicians to identify clinical errors. Clinicians with access to AI Consult made relatively fewer errors: 16% fewer diagnostic errors and 13% fewer treatment errors. In absolute terms, the introduction of AI Consult would avert diagnostic errors in 22,000 visits and treatment errors in 29,000 visits annually at Penda alone. In a survey of clinicians with AI Consult, all clinicians said that AI Consult improved the quality of care they delivered, with 75% saying the effect was "substantial". These results required a clinical workflow-aligned AI Consult i

This paper is dedicated to the design and evaluation of the first AMR parser tailored for clinical notes. Our objective was to facilitate the precise transformation of the clinical notes into structured AMR expressions, thereby enhancing the interpretability and usability of clinical text data at scale. Leveraging the colon cancer dataset from the Temporal Histories of Your Medical Events (THYME) corpus, we adapted a state-of-the-art AMR parser utilizing continuous training. Our approach incorporates data augmentation techniques to enhance the accuracy of AMR structure predictions. Notably, through this learning strategy, our parser achieved an impressive F1 score of 88% on the THYME corpus's colon cancer dataset. Moreover, our research delved into the efficacy of data required for domain adaptation within the realm of clinical notes, presenting domain adaptation data requirements for AMR parsing. This exploration not only underscores the parser's robust performance but also highlights its potential in facilitating a deeper understanding of clinical narratives through structured semantic representations.

Digital Twins hold great potential to personalize clinical patient care, provided the concept is translated to meet specific requirements emerging from established clinical workflows. We present a general and unspecialized Digital Twin design combining knowledge graphs and ensemble learning to reflect the entire patient's clinical journey and assist clinicians in their decision-making. Such a design is predictive, modular, evolving, informed, interpretable and explainable, thus opening broad clinical applications.

Background: LLM judges increasingly score whether clinical language models give overconfident answers under incomplete evidence, yet whether a measured "safety gain" reflects real behavior change or the judge's calibration is unresolved. Using a structured evidence-sufficiency prompt as a test case, we asked whether it reduces unsafe overconfident answers, how far that effect depends on the scoring judge, and what it costs in helpfulness. Methods: In a retrospective public-data benchmark (Real-POCQi, HealthBench, MedRBench), four models (GPT-5.5, Claude Opus 4.8, Gemini 3.5 Flash, Grok 4.3) answered a fully paired common panel (1,200 cells) with a standard prompt and the wrapper. The pre-specified endpoint was the paired reduction in unsafe overconfidence scored by the primary judge (GPT-5.4-nano); secondary analyses added a different-family judge (Claude Sonnet 5), a correctness judge, matched scaffold controls, and a blinded three-clinician review. Results: Unsafe overconfidence fell from 49.3% to 24.7%, a paired reduction of 24.7 points (95% CI 21.8-27.7; p<0.001), robust in direction across models and paraphrases. Magnitude was judge-dependent: Sonnet agreed on direction but

Chesi's (forthcoming) target paper depicts a generative linguistics in crisis, foreboded by Piantadosi's (2023) declaration that "modern language models refute Chomsky's approach to language." In order to survive, Chesi warns, generativists must hold themselves to higher standards of formal and empirical rigor. This response argues that the crisis described by Chesi and Piantadosi actually has little to do with rigor, but is rather a reflection of generativists' limited social ambitions. Chesi ties the fate of generative linguistics to its intellectual merits, but the current success of language model research is social in nature as much as it is intellectual. In order to thrive, then, generativists must do more than heed Chesi's call for rigor; they must also expand their ambitions by giving outsiders a stake in their future success.

Research in speech technologies and comparative linguistics depends on access to diverse and accessible speech data. The UCLA Phonetics Lab Archive is one of the earliest multilingual speech corpora, with long-form audio recordings and phonetic transcriptions for 314 languages (Ladefoged et al., 2009). Recently, 95 of these languages were time-aligned with word-level phonetic transcriptions (Li et al., 2021). Here we present VoxAngeles, a corpus of audited phonetic transcriptions and phone-level alignments of the UCLA Phonetics Lab Archive, which uses the 95-language CMU re-release as our starting point. VoxAngeles also includes word- and phone-level segmentations from the original UCLA corpus, as well as phonetic measurements of word and phone durations, vowel formants, and vowel f0. This corpus enhances the usability of the original data, particularly for quantitative phonetic typology, as demonstrated through a case study of vowel intrinsic f0. We also discuss the utility of the VoxAngeles corpus for general research and pedagogy in crosslinguistic phonetics, as well as for low-resource and multilingual speech technologies. VoxAngeles is free to download and use under a CC-BY-NC

Specialised pre-trained language models are becoming more frequent in NLP since they can potentially outperform models trained on generic texts. BioBERT and BioClinicalBERT are two examples of such models that have shown promise in medical NLP tasks. Many of these models are overparametrised and resource-intensive, but thanks to techniques like Knowledge Distillation (KD), it is possible to create smaller versions that perform almost as well as their larger counterparts. In this work, we specifically focus on development of compact language models for processing clinical texts (i.e. progress notes, discharge summaries etc). We developed a number of efficient lightweight clinical transformers using knowledge distillation and continual learning, with the number of parameters ranging from 15 million to 65 million. These models performed comparably to larger models such as BioBERT and ClinicalBioBERT and significantly outperformed other compact models trained on general or biomedical data. Our extensive evaluation was done across several standard datasets and covered a wide range of clinical text-mining tasks, including Natural Language Inference, Relation Extraction, Named Entity Reco

Large Language Models (LLMs) have become capable of generating highly fluent text in certain languages, without modules specially designed to capture grammar or semantic coherence. What does this mean for the future of linguistic expertise in NLP? We highlight several aspects in which NLP (still) relies on linguistics, or where linguistic thinking can illuminate new directions. We argue our case around the acronym RELIES that encapsulates six major facets where linguistics contributes to NLP: Resources, Evaluation, Low-resource settings, Interpretability, Explanation, and the Study of language. This list is not exhaustive, nor is linguistics the main point of reference for every effort under these themes; but at a macro level, these facets highlight the enduring importance of studying machine systems vis-à-vis systems of human language.

A significant debate has emerged in response to a paper written by Steven Piantadosi (Piantadosi, 2023) and uploaded to the LingBuzz platform, the open archive for generative linguistics. Piantadosi's dismissal of Chomsky's approach is ruthless, but generative linguists deserve it. In this paper, I will adopt three idealized perspectives -- computational, theoretical, and experimental -- to focus on two fundamental issues that lend partial support to Piantadosi's critique: (a) the evidence challenging the Poverty of Stimulus (PoS) hypothesis and (b) the notion of simplicity as conceived within mainstream Minimalism. In conclusion, I argue that, to reclaim a central role in language studies, generative linguistics -- representing a prototypical theoretical perspective on language -- needs a serious update leading to (i) more precise, consistent, and complete formalizations of foundational intuitions and (ii) the establishment and utilization of a standardized dataset of crucial empirical evidence to evaluate the theory's adequacy. On the other hand, ignoring the formal perspective leads to major drawbacks in both computational and experimental approaches. Neither descriptive nor exp

Objective: Integrating EHR data with other resources is essential in rare disease research due to low disease prevalence. Such integration is dependent on the alignment of ontologies used for data annotation. The International Classification of Diseases (ICD) is used to annotate clinical diagnoses; the Human Phenotype Ontology (HPO) to annotate phenotypes. Although these ontologies overlap in biomedical entities described, the extent to which they are interoperable is unknown. We investigate how well aligned these ontologies are and whether such alignments facilitate EHR data integration. Materials and Methods: We conducted an empirical analysis of the coverage of mappings between ICD and HPO. We interpret this mapping coverage as a proxy for how easily clinical data can be integrated with research ontologies such as HPO. We quantify how exhaustively ICD codes are mapped to HPO by analyzing mappings in the UMLS Metathesaurus. We analyze the proportion of ICD codes mapped to HPO within a real-world EHR dataset. Results and Discussion: Our analysis revealed that only 2.2% of ICD codes have direct mappings to HPO in UMLS. Within our EHR dataset, less than 50% of ICD codes have mapping