Health discourse in social media videos often contains densely entangled claims spanning multiple thematic aspects, stances, evidential frames, and rhetorical functions within short conversational spans. Existing approaches largely rely on coarse topic-level, sentiment-based, or stance-oriented representations that do not adequately capture this structure. Our analysis identifies an average of 13.22 atomic claims per minute, motivating richer claim-level discourse representations. We introduce a structured framework for claim-level discourse analysis in dense health narratives. Our framework models discourse through tuples linking atomic claims with thematic aspects, stance, and multidimensional pragmatic discourse attributes. To support this setting, we construct a benchmark spanning four health domains with 1,191 manually annotated claims from 60 videos. Using this framework, we evaluate automated structured discourse analysis under different discourse context settings. Results show that current LLMs achieve strong performance on thematic categorization and stance prediction, but struggle with high-dimensional pragmatic profiling. We also find that different discourse tasks benefit from different forms of contextual reasoning, suggesting that future systems may require task decomposition and specialized inference strategies.
How people narrate their experiences offers a window into how the mind organizes them. Computational approaches to therapeutic writing have evolved from lexical counting to neural methods, yet remain fragmented: dictionary tools miss discourse structure, while embeddings conflate local coherence with global organization. No existing framework maps these techniques onto the hierarchical processes through which narratives are constructed. Here we introduce a three-level framework - micro-level lexical features, meso-level semantic embeddings, and macro-level LLM narrative evaluation - and show, across 830 Chinese therapeutic texts spanning depression, anxiety, and trauma, that macro-level evaluation substantially outperforms lexical and embedding features for mental health prediction. This challenges the field's emphasis on word-counting: formal structural features (Labov's story grammar, RST coherence, propositional composition) demonstrate that narrative organization per se carries predictive signal, while clinically-grounded narrative dimensions capture how psychological states are expressed through discourse. Semantic embeddings add minimal independent value but yield incremental gains in multi-level classification. By grounding computational levels in discourse processing theory, this framework identifies macro-structural organization as the primary locus of clinical signal and generates testable hypotheses for intervention design and longitudinal research.
Large language models (LLMs) are increasingly being used to generate health text from structured records such as wearable time series, biomarkers, vitals, and care-management logs. For recurring health outputs, fluency is not enough: systems must remain faithful to source data, ground explanatory claims in available evidence, follow stated policies, emit machine-readable outputs, and run cheaply enough for repeated use. We ask which responsibilities in structured health generation should be deterministic computation rather than runtime LLM prompting. We introduce Think Fast, Talk Smart, a sleep-health insight pipeline in which deterministic code performs recurring analysis before one bounded LLM writer call. Across 280 user-nights and six models, achieves lower numeric error, lower instruction-compliance error, and lower end-to-end cost than structured zero-shot and few-shot one-call baselines. Layer replacement reveals contract-specific failures: LLM comparison raises numeric error, LLM ranking degrades policy selection, LLM attribution increases unsupported causal language, and an LLM-generated writer interface reintroduces errors even after upstream facts are deterministic. The results support a broader design rule: let code own recurring analysis, and let LLMs express verified facts within bounded interfaces.
Large Language Models such as GPT-4o and GPT-5 achieve strong zero-shot performance on biomedical claim verification, but cost and opacity limit scalable use. We fine-tune three small LLMs: Phi-3-mini (3.8B), Qwen2.5-3B, and Mistral-7B, via QLoRA on SciFact and HealthVer, providing the first study of QLoRA models against GPT-4o and fine-tuned BioLinkBERT encoders. Mistral-7B QLoRA surpasses both GPT-4o and GPT-5 (up to 12% F1 gain) at a fractional cost using just 1,008 training examples. We conduct extensive in-domain and cross-domain evaluation: models trained on SciFact tested on HealthVer and vice versa, at matched sizes to isolate dataset structure from data quantity. We identify a previously unreported structural artifact in SciFact that inflates in-domain scores, and show through bidirectional out-of-domain evaluation that training on structurally sound data enables robust cross-domain transfer. We plan to release all code and adapter checkpoints.