Risk-Aware Hybrid Selective Classification for HIV Suspicion Identification in Spanish Clinical Notes
This paper proposes a hybrid selective classification framework for clinical NLP that explicitly handles both aleatoric and epistemic uncertainty to avoid overconfident predictions in medical triage settings. The system combines Mondrian conformal prediction with a Multi-Centroid Mahalanobis Distance veto, evaluated on HIV suspicion identification in Spanish clinical notes. The authors demonstrate that standard uncertainty metrics and baseline classifiers suffer coverage collapse under strict reliability constraints, while their dual-verification approach isolates a trustworthy operational domain. The work critiques inflated benchmark metrics that arise from forcing deterministic classification on inherently ambiguous clinical instances.
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IndicBERT-HPA: Reliability-Oriented Multilingual Orthopedic Decision Support with Selective Verification Deferral
This paper presents a framework for classifying free-text orthopedic clinical notes in English, Hindi, and Punjabi, introducing IndicBERT-HPA, a domain-adaptive encoder augmented with language-aware orthopedic adapter heads. The system is evaluated against multilingual transformers, a DistilBERT baseline, and zero-shot LLMs, with zero-shot LLMs found substantially less effective than task-adapted encoders for closed-set clinical classification. IndicBERT-HPA achieves Macro-F1 of 0.8792 and AUPRC of 0.902 under natural clinical prevalence. A deterministic selective-verification layer combining confidence gating, evidence-consistency checking, and language-risk screening improves accuracy from 71.5% to 84.4% at 72.3% coverage on a 5,000-record held-out set.
Sentence-Level Clinical Provenance Categorization for Multidisciplinary Hospital Summarization Using Fine-Tuned Llama-3
This pilot study presents a pipeline for categorizing sentence-level clinical provenance across multi-source hospital notes, targeting structured summarization in high-complexity settings like the NICU. The authors fine-tune Llama-3 8B and 70B models on MedSecId (MIMIC-III annotations), achieving Macro F1 above 92% in-domain. Cross-domain evaluation reveals a scale-dependent transfer effect: SFT substantially improves the 70B model (+7% Macro F1) but yields only marginal gains for the 8B model. A quantized fine-tuned 70B model outperforms its full-precision baseline while reducing compute, suggesting quantized adaptation is viable for structured clinical NLP tasks.
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.
Reverse Probing: Supervised Token-level Uncertainty Quantification for LLMs in Clinical Text
The paper introduces Reverse Probing, a novel uncertainty quantification framework designed specifically for clinical text summarization that estimates token-level uncertainty from pre-existing labeled summaries rather than sampling new outputs. It extracts uncertainty signals from four categories of internal model activations, treating text as a probe into the model's internal state. Evaluated on two expert-annotated clinical datasets, it outperforms eight adapted baselines on all metrics, achieving up to 4× higher AUPRC while reducing inference time and compute. Feature analysis identifies delta energy and neighborhood context as the most consistent predictors of uncertainty across models.
Clinically grounded privacy evaluation framework reveals high memorization risk in medical LMs
Researchers introduce a tiered adversarial framework for evaluating privacy leakage in medical language models, moving beyond simple training-text recovery to realistic clinical threat models. Applied to an LM pretrained on 378k clinical notes, the framework finds that routine encounter metadata (name, DOB, provider, visit date) elicits high verbatim memorization and sensitive-diagnosis recovery (AUROC 0.91 for abortion, 0.81 for HIV). The study also finds that exact-match memorization overstates disclosure risk because 36% of memorized tokens reflect templated documentation. The work provides a practical contextual privacy evaluation methodology for medical LMs trained on longitudinal patient data.
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.
Evidence-Augmented ML for Self-Harm Surveillance in Emergency Department Triage Notes
Researchers developed a three-stage pipeline combining traditional machine learning with LLM-based screening and evidence extraction to detect self-harm in Australian emergency department triage notes. The system achieved AUPRCs around 0.88 in both internal and external validation, and transferred to two external hospital sites without site-specific retraining. A notable capability is identifying the primary self-harm method with 95% accuracy, enabling more granular public health surveillance beyond binary classification.
ClinEnv: Interactive Multi-Stage Long-Horizon EHR Benchmark for Clinical Agent Evaluation
ClinEnv is a new interactive benchmark that evaluates LLMs as attending physicians over real inpatient admissions using a Longitudinal Inpatient Simulation paradigm. Each case is decomposed into sequential decision stages where models must query four specialized agents before committing to medications, procedures, and diagnoses. Across seven evaluated models, the best achieves only 0.31 decision F1, with a sharp gap between diagnosis recovery (0.51 F1) and management actions (0.17 F1). The benchmark uniquely measures information-acquisition process quality alongside outcome quality, exposing a gap invisible to static or outcome-only evaluations.