clinical research teams

Abstract: Although automatic detection of cognitive impairment from conversational speech is a promising way, it becomes less accurate, as large real-world datasets often contain unreliable diagnostic labels due to self-referral and limited clinical verification, and here we investigated whether neuropsychologically calibrated diagnostic relabeling improves it. We analysed 138 hours of conversational speech from 720 participants, recalibrating unreliable diagnostic labels using attention, executive function, and memory performance via external clinical thresholds, Gaussian, and normative z-score calibration. Transformer-based classifiers were trained using both original and recalibrated labels and evaluated internally on 150 clinically verified participants and externally on Pitt, ADReSS and PROCESS-2 datasets. Memory- and MoCA-based z-score calibration produced the greatest improvements. Using our internal dataset, $F_1$ increased from $0.70$ to $0.83$ ($+13\%$) and from $0.54$ to $0.66$ ($+12\%$) for binary and multiclass classification, respectively. For external validation, the increases are $+4\%$, $+5\%$ and $+9\%$ on Pitt, ADReSS and PROCESS-2 corpus. Neuropsychologically calibrated relabeling substantially improves speech-based cognitive assessment, highlighting label quality, rather than model architecture, as a critical bottleneck in clinical AI for dementia screening.

Abstract: Language models can score psychiatric questionnaires from speech, but agreement with self-report may reflect the questionnaire rather than the person. We introduce psychometric representational similarity analysis, a framework for comparing the structure of speech-derived scores, self-report, item wording and theory, and implement it alongside person-level construct scoring in COMPASS 2.0. We show how similarly worded items induce covariance without psychological signal. In pre-registered discovery and confirmation analyses of clinical interviews from 275 participants, language-derived symptom geometry resembled wording more than self-report, with no structure beyond wording detected by the registered tests. Geometric agreement with self-report survived assigning participants someone else's answers, whereas person-paired scores captured distress more than specific symptoms. Complementary analyses examined counselling quality and wording structure across 34 instruments and the Research Domain Criteria (RDoC) framework. These findings distinguish agreement about psychological structure from evidence that language-derived assessments track individual people.

Abstract: Clinical research in psychiatry increasingly relies on large scale collection of spoken language data to identify acoustic and linguistic biomarkers. Yet evolving consent and protocol requirements can oblige investigators to remove a designated speaker from multi-speaker recordings and to verify said removal at a scale infeasible for manual review of entire corpora. We study this verification problem for role-driven dyadic clinical dialogue in psychiatry and investigate it with two parallel, symmetric pipelines: confirming that clinician speech has been removed from psychiatric interview recordings, and confirming that patient speech has been removed from the same recordings. Each pipeline redacts the raw audio for its target role and then scans the surviving output with audio-language and large-language models to identify missed deletions. We evaluate this approach on a corpus of 48 dyadic recordings drawn from psychiatry settings, testing four open-weight models in an inference-only setting: Gemma-4-12B, Gemma-4-31B, Nemotron-3-Nano, and Nemotron-3-Nano-Omni. A disjunctive OR ensemble over fourteen model-view configurations had a combined F1 of 0.478 (precision 0.330, recall 0.870), an improvement over individual model estimates driven by recall gains that point to substantial complementarity across models and context views.