From Fuzzy Speech to Medical Insight: Benchmarking LLMs on Noisy Patient Narratives

Abstract

The widespread adoption of large language models (LLMs) in healthcare raises critical questions about their ability to interpret patient-generated narratives, which are often informal, ambiguous, and noisy. Existing benchmarks typically rely on clean, structured clinical text, offering limited insight into model performance under realistic conditions. In this work, we present a novel synthetic dataset designed to simulate patient self-descriptions characterized by varying levels of linguistic noise, fuzzy language, and layperson terminology. Our dataset comprises clinically consistent scenarios annotated with ground-truth diagnoses, spanning a spectrum of communication clarity to reflect diverse real-world reporting styles. Using this benchmark, we fine-tune and evaluate several state-of-the-art models (LLMs), including BERT-based and encoder-decoder T5 models. To support reproducibility and future research, we release the Noisy Diagnostic Benchmark (NDB), a structured dataset of noisy, synthetic patient descriptions designed to stress-test and compare the diagnostic capabilities of large language models (LLMs) under realistic linguistic conditions. We made the benchmark available for the community: https://github.com/lielsheri/PatientSignal