Abstract
Background: To determine whether cross-lingual clinical annotation projection can be formulated as a text-preserving, document-level generative task that produces verifiable character-level annotations for multilingual clinical corpus construction, and to characterize its robustness and computational trade-offs relative to candidate-based projection pipelines. Methods: We developed a constrained LLM projection workflow that inserts entity tags directly into immutable target-language text, followed by deterministic validation and character-offset reconstruction. We evaluated it alongside supervised candidate-span projection and hybrid ML-LLM refinement for transferring Spanish Disease, Symptom, and Procedure annotations into six languages. Evaluation used MultiClinAI gold standard with strict span matching and character-overlap F1 Results: Direct LLM projection achieved the strongest and most consistent performance. GLM 5.2 obtained a mean Strict F1 of 0.9201 across 18 language-entity combinations, while locally deployable Gemma4:31B achieved 0.9133. The best LLM configuration improved Strict F1 over the previous state of the art in all 18 settings, by 0.0564-0.1512, yielding 55,416 grounded mentions with reconstructed offsets. Conclusions: Direct LLM-based projection enables high-quality multilingual clinical annotation transfer and provides a practical approach for extending clinical NLP resources to languages with fewer annotated datasets and language-specific tools. Combined with local inference and deterministic validation, it can substantially reduce expert time and cost for multilingual clinical corpus construction.
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Jun 7, 2026cs.CL
Word-level cross-lingual alignment is central to annotation projection, translation auditing, and cross-lingual faithfulness estimation, yet existing neural aligners are rarely adapted to specialized domains. In this paper, we introduce ClinicalAligner26AM, a large-context multilingual aligner model for biomedical and clinical text initialized from ClinicalEncoder26AM. Our training recipe is inspired by AWESoME Align. We build our soft alignment target by sharpening with Sinkhorn-Knop optimal transport a cost matrix established for parallel clinical texts and conversations through the fusion of sentence-level, phrase-level, and token-level signals. We distill this sharpened alignment matrix directly into our student aligner, by encouraging its naive cosine-based token similarity scores to match this target. At inference time, we project source-span scores through the learned token alignment matrix and decode the longest valid high-scoring span in the target text, optionally supported by MultiClinNER predictions summarized in Appendix B. We evaluate CA26AM on the MultiClinCorpus shared task, which projects Spanish clinical entity annotations into six target languages. Our two submitted systems ranked respectively first and second across all languages and entity types, with character-weighted F1 scores above 0.95 in nearly all settings.
François Remy
Aug 4, 2026cs.CL
Multilingual large language models (LLMs) have been shown to perform better on non-English classification tasks when the representations of the given language are more aligned to English within the model. Several cross-lingual alignment (CLA) scores have been proposed for use with LLMs, along with multiple approaches for extracting embeddings from the models. We provide a comparative analysis of 27 CLA score variants, examining how they differ and how well each predicts downstream performance across three tasks. Crucially, while LLMs are widely used for generative tasks such as machine translation, prior work has focused almost exclusively on classification. We therefore investigate whether CLA scores are similarly predictive of translation performance. To enable computing correlations across target languages, we propose a PMI-based translation metric, which is less dependent on the target language and correlates strongly with chrF. We find that CLA with English predicts translation quality comparably to or better than source-target CLA, providing new evidence that LLMs use English as an internal pivot language.
Adnan Al Ali, Kathy Hämmerl, Jindřich Libovický +1
May 17, 2026cs.CL
Linguistic annotation of transcribed speech is essential for research in language acquisition, language disorders, and sociolinguistics, yet remains labor-intensive and time-consuming. While Large Language Models (LLMs) have shown promise in automating annotation tasks, their ability to handle complex discourse-level annotation in non-English languages remains understudied. This study evaluates whether LLMs can reliably annotate narrative macrostructure-the hierarchical organization of story grammar elements-in spoken Mandarin, using the Multilingual Assessment Instrument for Narratives (MAIN) as a testbed. We compared four LLMs against trained human annotators on narratives produced by children, young adults, and older adults. The best-performing model achieved agreement with human raters (k=.794) approaching human-human reliability levels (k=.872) while reducing annotation time by 65%, whereas the locally deployable lightweight model performed substantially worse. Annotation difficulty varied systematically by macrostructure element type, with categories requiring subtle semantic differentiation posing persistent challenges. Furthermore, model reliability decreased on young adult narratives, which exhibited greater lexical variation, semantic ambiguity, and multi-element integration within single utterances. These findings suggest that LLMs can effectively support discourse-level annotation in non-English spoken corpora, while highlighting the continued need for human oversight in semantically complex tasks. Our prompt templates are open sourced for future use.
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