Multi-stage explainability framework translates transformer speech models into clinical cognitive impairment narratives
A new arXiv preprint proposes a framework for making transformer-based speech cognitive impairment detection clinically interpretable by combining SHAP token attribution, linguistic feature analysis, and a four-stage LLM reasoning pipeline using LLaMA-3.1-70B-Instruct. The system is built on the SpeechCARE-Adaptive Gating Network multimodal model (F1=72.11% on NIA PREPARE) and maps outputs to four cognitive-linguistic dimensions. Physician evaluation on 70 samples showed strong alignment with clinical profiles and a System Usability Scale score of 82/100, suggesting practical clinical workflow integration potential.
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LEAF-X: Entropy-guided explainability framework for transformer-based ASR models
Researchers introduce LEAF-X (Listening with Entropy-guided Attention for Faithful explainability), a model-intrinsic XAI framework for transformer-based automatic speech recognition systems like Whisper. The method combines entropy-guided attention weighting, multi-layer attention rollout, and optional causal ablations to produce sparse token-to-frame attributions. Evaluations show 32% improved faithfulness and 35-39% stronger locality/sparsity compared to perturbation-based explainers and raw attention maps, enabling more auditable ASR.
LLM-augmented XAI framework with mutual feature interactions for network operations
A new arXiv paper proposes a framework combining LLMs with SHAP-based explainability, augmented by mutual feature interaction data, to generate natural language explanations for AI/ML models used in network operations. The approach is validated on an optical quality-of-transmission estimation task with human evaluators, showing 12.2% and 6.2% improvements in explanation usefulness and scope over a SHAP-only baseline, with 97.5% correctness. The work targets the gap between technical XAI outputs and actionable insights for non-specialist network operators.
Explainability pipeline reveals divergent cues used by deepfake speech detectors
Researchers propose an audio-native explainability pipeline using Integrated Gradients on time-aligned self-supervised representations to localize decision evidence in deepfake speech detectors. Applied to three WavLM-based detectors (AASIST, CA-MHFA, SLS) on the ASVspoof 5 benchmark, the method reveals that despite similar performance, each detector relies on fundamentally different cues: environmental noise, phoneme artifacts, and word boundaries respectively. Findings are validated via causal masking experiments that confirm performance degrades when primary cues are removed. The work advances interpretability of audio deepfake detection, relevant to AI safety and media authenticity.
Language-based digital twins using LLMs proposed for elderly cognitive health monitoring
Researchers propose a framework that uses large language models to construct digital twins of elderly individuals by mimicking their conversational patterns and stylometric cues, enabling continuous, non-invasive monitoring for Mild Cognitive Impairment. A multi-head conditional variational autoencoder (cVAE) is introduced to evaluate fidelity and predict cognitive scores (MoCA). Experiments on the I-CONECT dataset show the approach preserves individual identity characteristics and outperforms baseline GPT-generated responses on reconstruction and cognitive score prediction. The work positions language-based digital twins as a scalable alternative to clinical cognitive assessment.
ClaMPAPP: Hybrid LLM-ML system uses language models as interfaces for pediatric appendicitis diagnosis
Researchers introduce ClaMPAPP, a hybrid clinical decision support system that uses an LLM solely for structured feature extraction from free-text clinical notes, then passes validated features to an XGBoost classifier for final diagnosis. Evaluated on two independent German pediatric appendicitis cohorts, ClaMPAPP outperformed end-to-end LLM baselines on diagnostic performance and showed greater robustness to narrative reordering. The work formalizes an 'LLM-as-interface, ML-as-predictor' design pattern that separates natural-language usability from predictive inference, offering a more auditable pathway for clinical AI.
Hop-count taxonomy predicts LLM failure on clinical EHR question answering across architectures
Researchers introduce a 'hop-count' taxonomy — the number of distinct inferential steps required to answer a clinical EHR question — as a principled predictor of LLM failure, finding monotone accuracy decline with reasoning depth across Claude Sonnet, GPT-4o, and GPT-5. The pattern holds across two providers and two OpenAI generations, with odds ratios per hop of 0.58–0.80, and is not explained by EHR context truncation. Extended thinking (chain-of-thought) did not significantly flatten the accuracy-depth curve, though token usage scaled with hop count. The findings ground transformer compositionality limits in a clinically consequential domain and suggest hop count as a deployment risk-stratification tool.
Automated ICD Classification of Psychiatric Diagnoses Using NLP and LLMs
This study evaluates NLP and ML approaches for automating the mapping of free-text psychiatric descriptions to ICD diagnostic codes, using a dataset of 145,513 Spanish clinical records. Methods range from classical BoW/TF-IDF representations to transformer-based embeddings including e5_large, BioLORD, and Llama-3-8B. Fine-tuned e5_large achieved the best performance with a micro-F1 of 0.866, outperforming classical methods by capturing semantic nuance and medical terminology. The work highlights challenges of long-tail label distributions and ambiguity specific to psychiatric clinical language.
LLMs predict dementia and depression severity from clinical interview transcripts in zero-shot and feature-extraction settings
Researchers evaluate three open-weights LLMs (Mistral 3.1, DeepHermes, Qwen3) for predicting dementia and depression severity from speech transcripts of 154 German-speaking patients in standardized clinical interviews. The study introduces a new observer-based Global Depression Scale (GDS-D) and tests both zero-shot prediction and LLM-based feature extraction for Support Vector Regression. Zero-shot performs well for depression (MAE 0.60), while structured feature extraction reduces dementia assessment error by up to 35%; pause-enriched automatic transcripts match human transcription quality, suggesting viable fully-automated screening pipelines.