Symphony for Speech-to-Text: Supporting Real-Time Medical Voice Interfaces
Authors: Arne Nix, Robert James, Lasse Borgholt, Anna B. Ekner, Lana Krumm, Julius Severin, Dan Engel, Lars Maaløe, +1 more
Abstract
After decades of use in dictation and, more recently, ambient documentation, speech is emerging as a primary modality for interacting with technology and AI in healthcare. Yet medical speech recognition remains difficult: systems must capture specialized terminology, resolve contextual ambiguity, and render measurements, abbreviations, and clinical shorthand precisely. Existing solutions are typically optimized either for general-purpose transcription or narrow dictation workflows, limiting their reliability in safety-critical settings and their usefulness for broader clinical workflows. We introduce Symphony for Speech-to-Text, a medical-grade speech recognition system for real-time streaming and batch file-based clinical use. Symphony decomposes the transcription process into specialized components for recognition, formatting, and contextual correction to optimize medical term recall while producing clinically structured text in real time and adapting across use cases. Evaluations on public benchmark and medical speech datasets show that Symphony substantially outperforms state-of-the-art systems in clinical settings while matching or exceeding them in general-domain settings, suggesting robust generalization rather than overfitting. We release a clinical benchmark dataset to support reliable validation and further progress in medical speech recognition. Symphony is available through a production-grade API for live dictation, conversational transcription, and batch audio file processing.
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.
Speech offers a uniquely informative window into health by simultaneously engaging neurological, motor, respiratory, and vocal systems. Current clinical speech AI methods have largely progressed through isolated condition-specific studies, making results difficult to compare and generalization difficult to assess. We introduce SpeechDx, a large-scale benchmark for clinical speech AI spanning 12 datasets and 27 tasks across diverse health conditions. To enable evaluation across shared clinical mechanisms, SpeechDx structures tasks by the stage of speech production they disrupt: conceptualization, formulation, and articulation. The benchmark tests generalization by including tasks with limited labeled data and evaluating the same health condition across multiple datasets, distinguishing clinically meaningful patterns from dataset artefacts. We systematically evaluate 12 state-of-the-art audio encoders across all tasks and under zero-shot cross-condition transfer. Results show that large-scale speech models represent the strongest overall baselines, domain-specific models improve performance only on closely matched tasks, and no current representation generalizes reliably across the clinical speech landscape. SpeechDx establishes a shared evaluation framework for tracking progress toward general-purpose clinical speech representations
Although Whisper models benefit from large-scale multilingual pre-training, their performance on Burmese medical speech remains limited. This work presents a Burmese medical speech recognition framework built on a high-quality 28-hour corpus recorded and validated by native speakers. We fine-tune Whisper models using full fine-tuning (FFT) and parameter-efficient fine-tuning (PEFT) with LoRA. To evaluate robustness, we apply waveform- and spectrogram-level data augmentation under controlled noise and simulated room acoustics. While augmentation reduces performance on clean speech, it significantly improves robustness in noisy and reverberant environments across FFT and PEFT settings. Our best-performing system, fully fine-tuned myMediWhisper-Medium without augmentation, achieves a state-of-the-art Word Error Rate (WER) of 23.44%, outperforming much larger general-domain fine-tuned models. Dataset and other resources can be found at the Huggingface repository: https://huggingface.co/datasets/LULab/mediTalk-mm-rdy.