Clinical named entity recognition in the Portuguese language: a benchmark of modern BERT models and LLMs

Large Language Models are transforming the support for clinical decision and their application in real scenarios. Yet, most benchmarks are conducted in English, and cross-lingual evaluation is needed to tackle the language gaps in global access. We introduce ClinicalBr, the first bilingual benchmark for clinical decision built from real Brazilian case reports. The corpus contains 2,892 cases drawn from 28 SciELO medical journals, spanning 18 specialties, and is structured as parallel Portuguese-English pairs. Each case supports four evaluation tasks: diagnosis retrieval, differential diagnosis, exam recommendation, and treatment planning. We evaluate four models: MedGemma-27B, Sabiá-4, DeepSeek-R1, and o3-mini, across both languages. The central finding is that the Portuguese-English performance gap is task-dependent, not general. In diagnosis retrieval, English yields a consistent advantage across all models, with +7.5-12.1 accuracy points. This advantage disappears in differential diagnosis, exam recommendation, and treatment planning, where confidence intervals cross zero for most models and Portuguese completeness scores are marginally higher. Brazilian-endemic conditions proved easier than the full corpus, not harder, indicating that tropical presentations are adequately represented in current pre-training. Exam recommendation was the hardest task across all models and both languages, with F1 scores below 0.10, well below the differential diagnosis ceiling of 0.20-0.27.

ClinicalEncoder26AM is a multilingual Diagnosable ColBERT for clinical and biomedical texts, which aligns at multiple levels its token-level semantic with ClinicalMap25, a clinical latent space inspired by BioLORD-2023 and enriched with synthetic and annotated supervision. The post-training recipe builds upon BGE-M3, and combines synthetic clinical notes, patient--doctor conversations, and annotated resources such as MedMentions, while considering both named-entity-level and sentence-level representations in a multi-adapter distillation, along with a ColBERT-style retrieval objective. In this system demonstration paper, we evaluate the model in the MultiClinNER shared task by finetuning it as a BIO tagger for patient symptoms, disorders, and procedure spans, using a lightweight two-layer CNN head to improve local boundary detection. The resulting system remains simple, processes most documents in a single 8192-token window, and achieves state-of-the-art multilingual entity recall, while achieving Top 5 overall across all entity types and languages in Character-weighted F1 scores. Training curves further show that ClinicalEncoder26AM is markedly more data-efficient than the base M3 model, supporting the usefulness of its clinical post-training for downstream information extraction. The model can be downloaded on https://huggingface.co/Parallia/ClinicalEncoder26AM-Diagnosable-Colbert-L2-for-multilingual-medical-texts

High-quality corpora are essential for advancing Natural Language Processing (NLP) in Portuguese. Building on previous encoder-only models such as BERTimbau and Albertina PT-BR, we introduce NorBERTo, a modern encoder based on the ModernBERT architecture, featuring long-context support and efficient attention mechanisms. NorBERTo is trained on Aurora-PT, a newly curated Brazilian Portuguese corpus comprising 331 billion GPT-2 tokens collected from diverse web sources and existing multilingual datasets. We systematically benchmark NorBERTo against Strong baselines on semantic similarity, textual entailment and classification tasks using standardized datasets such as ASSIN 2 and PLUE. On PLUE, NorBERTo-large achieves the best results among the encoder models we evaluated, notably reaching 0.9191 F1 on MRPC and 0.7689 accuracy on RTE. On ASSIN 2, NorBERTo-large attains the highest entailment F1 (~0.904) among all encoders considered, although Albertina-900M and BERTimbau-large still hold an advantage. To the best of our knowledge, Aurora-PT is currently the largest openly available monolingual Portuguese corpus, surpassing previous resources. NorBERTo provides a modern, mid-sized encoder designed for realistic deployment scenarios: it is straight-forward to fine-tune, efficient to serve, and well suited as a backbone for retrieval-augmented generation and other downstream Portuguese NLP systems.