Iterative LLM-based improvement for French Clinical Interview Transcription and Speaker Diarization

In this paper, we introduce DiarizationLM, a framework to leverage large language models (LLM) to post-process the outputs from a speaker diarization system. Various goals can be achieved with the proposed framework, such as improving the readability of the diarized transcript, or reducing the word diarization error rate (WDER). In this framework, the outputs of the automatic speech recognition (ASR) and speaker diarization systems are represented as a compact textual format, which is included in the prompt to an optionally finetuned LLM. The outputs of the LLM can be used as the refined diarization results with the desired enhancement. As a post-processing step, this framework can be easily applied to any off-the-shelf ASR and speaker diarization systems without retraining existing components. Our experiments show that a finetuned PaLM 2-S model can reduce the WDER by rel. 55.5% on the Fisher telephone conversation dataset, and rel. 44.9% on the Callhome English dataset.

Clinical documentation is a critical factor for patient safety, diagnosis, and continuity of care. The administrative burden of EHRs is a significant factor in physician burnout. This is a critical issue for low-resource languages, including Finnish. This study aims to investigate the effectiveness of a domain-aligned natural language processing (NLP); large language model for medical transcription in Finnish by fine-tuning LLaMA 3.1-8B on a small validated corpus of simulated clinical conversations by students at Metropolia University of Applied Sciences. The fine-tuning process for medical transcription used a controlled preprocessing and optimization approach. The fine-tuning effectiveness was evaluated by sevenfold cross-validation. The evaluation metrics for fine-tuned LLaMA 3.1-8B were BLEU = 0.1214, ROUGE-L = 0.4982, and BERTScore F1 = 0.8230. The results showed a low n-gram overlap but a strong semantic similarity with reference transcripts. This study indicate that fine-tuning can be an effective approach for translation of medical discourse in spoken Finnish and support the feasibility of fine-tuning a privacy-oriented domain-specific large language model for clinical documentation in Finnish. Beside that provide directions for future work.

This paper describes TalTech's submissions to the Beyond Transcription Challenge (BeTraC), which requires generating SOAP notes directly from long doctor-patient conversation recordings, without intermediate transcription. After screening open-weight speech LLMs for long-audio robustness, we adapted Voxtral Mini (lightweight track) and Voxtral Small (heavyweight track) with LoRA supervised fine-tuning followed by DAPO reinforcement learning that uses the challenge metric, Open Medical Concept F1, as its reward. Our systems ranked first in both tracks, and an independent LLM-as-a-judge evaluation showed the lowest hallucination rate among all submissions, indicating that reinforcement learning against a concept-matching metric need not compromise factual reliability. We also find that fine-tuning on text transcripts transfers well to speech input and appears to improve robustness on out-of-domain real recordings.