MedWER: A Reproducible, Model-Free Evaluation Protocol for Medical Speech Recognition

Medical automatic speech recognition (MedASR) requires adaptation to specialised terminology, limited annotated clinical data, and multilingual use cases. Although large-scale pretrained ASR models such as Whisper achieve strong generalisation, their behaviour after medical and multilingual adaptation remains insufficiently understood beyond word error rate (WER). This paper investigates how multilingual medical adaptation reshapes the internal representations of Whisper models through layer-wise encoder analysis. We compare zero-shot decoding, English-only fine-tuning, German-only diagnostic fine-tuning, two-stage EN->EN+DE continuation, and direct EN+DE fine-tuning across Whisper model sizes. Fine-tuning substantially improves MedASR performance, but the best model depends on the adaptation setting: Whisper-Medium gives the lowest English WER (7.72%) and the lowest combined EN+DE WER under direct EN+DE training (26.30%); German-only Whisper-Large-v3 gives the lowest German WER (44.96%), but as a within-corpus diagnostic on 86 single-speaker training utterances rather than robust generalisation. Layer-wise analysis of the two-stage Whisper-Small trajectory shows that English medical fine-tuning produces the dominant encoder shift, whereas multilingual continuation largely preserves the adapted representation space. Domain and language information remain highly recoverable across layers, while linearly recoverable error-predictive cues weaken as WER improves.

Advances in deep learning and end-to-end Automatic Speech Recognition (ASR) have enabled robust multilingual models, but evaluation metrics remain limited in assessing accuracy. Efforts to improve or replace the common metric Word Error Rate (WER) often focus on English, leaving evaluations for low-resource languages under-explored and hindering fair cross-lingual comparisons. We present OpenWER, an open-source implementation that improves WER robustness through language-specific normalisation and compound word detection. A token-based Levenshtein alignment preserves complementary metrics and allows metadata embedding for granular accuracy scores. Our analysis of 52 languages shows absolute WER reductions of up to 25% compared to common libraries. OpenWER contributes to fairness in ASR research by increasing the reliability of WER across diverse languages and enabling more comprehensive accuracy evaluations.

This article concerns comparative studies on the Automatic Speech Recognition (ASR) model incorporated with the Large Language Model (LLM) used for medical interviews. The proposed solution is tested on polish language benchmarks and dataset with medical interviews. The latest ASR technologies are based on convolutional neural networks (CNNs), recurrent neural networks (RNNs) and Transformers. Most of them work as end-to-end solutions. The presented approach in the case of the Whisper model shows a two-stage solution with End-To-End ASR and LLM working together in a pipeline. The ASR output is an input for LLM. The LLM is a component by which the output from ASR is corrected and improved. Comparative studies for automatic recognition of the Polish language between modern End-To-End deep learning architectures and the ASR hybrid model were performed. The medical interview tests were performed with two state-of-the-art ASR models: OpenAI Whisper incorporated with LLM and Scribe ElevenLabs. Additionally, the results were compared with five more end-to-end models (QuartzNet, FastConformer, Wav2Vec 2.0 XLSR and ESPnet Model Zoo) on Mozilla Common Voice and VoxPopuli databases. Tests were conducted for clean audio signal, signal with bandwidth limitation, and degraded. The tested models were evaluated on the basis of Word Error Rate (WER) and Character Error Rate (CER). The results show that the Whisper model performs by far the best among the open-source models. ElevenLabs Scribe model, on the other hand, performs best for Polish on both general benchmark and medical data.