COACH meets QUORUM: A Framework and Pipeline for Aligning User, Expert and Developer Perspectives in LLM-generated Health Counselling

Systems that collect data on sleep, mood, and activities can provide valuable lifestyle counselling to populations affected by chronic disease and its consequences. Such systems are, however, challenging to develop; besides reliably extracting patterns from user-specific data, systems should also contextualise these patterns with validated medical knowledge to ensure the quality of counselling, and generate counselling that is relevant to a real user. We present QUORUM, a new evaluation framework that unifies these developer-, expert-, and user-centric perspectives, and show with a real case study that it meaningfully tracks convergence and divergence in stakeholder perspectives. We also present COACH, a Large Language Model-driven pipeline to generate personalised lifestyle counselling for our Healthy Chronos use case, a diary app for cancer patients and survivors. Applying our framework shows that overall, users, medical experts, and developers converge on the opinion that the generated counselling is relevant, of good quality, and reliable. However, stakeholders also diverge on the tone of the counselling, sensitivity to errors in pattern-extraction, and potential hallucinations. These findings highlight the importance of multi-stakeholder evaluation for consumer health language technologies and illustrate how a unified evaluation framework can support trustworthy, patient-centered NLP systems in real-world settings.

Out of the Box, into the Clinic? Evaluating State-of-the-Art ASR for Clinical Applications for Older Adults

Voice-controlled interfaces can support older adults in clinical contexts, with chatbots being a prime example, but reliable Automatic Speech Recognition (ASR) for underrepresented groups remains a bottleneck. This study evaluates state-of-the-art ASR models on language use of older Dutch adults, who interacted with the Welzijn.AI chatbot designed for geriatric contexts. We benchmark generic multilingual ASR models, and models fine-tuned for Dutch spoken by older adults, while also considering processing speed. Our results show that generic multilingual models outperform fine-tuned models, which suggests recent ASR models can generalise well out of the box to realistic datasets. Furthermore, our results suggest that truncating existing architectures is helpful in balancing the accuracy-speed trade-off, though we also identify some cases with high WER due to hallucinations.

A Review of Challenges in Speech-based Conversational AI for Elderly Care

Artificially intelligent systems optimized for speech conversation are appearing at a fast pace. Such models are interesting from a healthcare perspective, as these voice-controlled assistants may support the elderly and enable remote health monitoring. The bottleneck for efficacy, however, is how well these devices work in practice and how the elderly experience them, but research on this topic is scant. We review elderly use of voice-controlled AI and highlight various user- and technology-centered issues, that need to be considered before effective speech-controlled AI for elderly care can be realized.

The Curious Case of Representational Alignment: Unravelling Visio-Linguistic Tasks in Emergent Communication

Natural language has the universal properties of being compositional and grounded in reality. The emergence of linguistic properties is often investigated through simulations of emergent communication in referential games. However, these experiments have yielded mixed results compared to similar experiments addressing linguistic properties of human language. Here we address representational alignment as a potential contributing factor to these results. Specifically, we assess the representational alignment between agent image representations and between agent representations and input images. Doing so, we confirm that the emergent language does not appear to encode human-like conceptual visual features, since agent image representations drift away from inputs whilst inter-agent alignment increases. We moreover identify a strong relationship between inter-agent alignment and topographic similarity, a common metric for compositionality, and address its consequences. To address these issues, we introduce an alignment penalty that prevents representational drift but interestingly does not improve performance on a compositional discrimination task. Together, our findings emphasise the key role representational alignment plays in simulations of language emergence.