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Pratima Murthy

Publications and source records attributed to Pratima Murthy.

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SamaVaani: Auditing and Debiasing Multilingual Clinical ASR for Indian Languages

Automatic Speech Recognition (ASR) is increasingly used to document clinical encounters, yet its reliability in multilingual and demographically diverse Indian healthcare context remains largely unknown. In this study, we first conduct the systematic audit of ASR performance on real-world psychiatric interview data spanning Kannada, Hindi and Indian English, comparing eight state-of-the-art models including IndicWhisper, WhisperLargeV3, Sarvam, GoogleS2T, Gemma3n, OmniLingual, Vaani, and Gemini. Our results reveal substantial variability across models and languages, with some systems performing competitively in Indian English but failing in regional speech. We further fine-tune two of the best performing opensource models, i.e., Gemma3n and OmniLingual, using various methods. With this, we uncover systematic performance gaps tied to speaker role and gender, raising concerns about equitable deployment in clinical settings, which are further mitigated by fairness-aware fine-tuning. To this end, we propose SamaVaani, a unified debiasing technique that simultaneously improves ASR performance and improves fairness across demographic groups.

cs.CL

Benchmarking Motivational Interviewing Competence of Large Language Models

Motivational interviewing (MI) promotes behavioural change in substance use disorders. Its fidelity is measured using the Motivational Interviewing Treatment Integrity (MITI) framework. While large language models (LLMs) can potentially generate MI-consistent therapist responses, their competence using MITI is not well-researched, especially in real world clinical transcripts. We aim to benchmark MI competence of proprietary and open-source models compared to human therapists in real-world transcripts and assess distinguishability from human therapists. Methods: We shortlisted 3 proprietary and 7 open-source LLMs from LMArena, evaluated performance using MITI 4.2 framework on two datasets (96 handcrafted model transcripts, 34 real-world clinical transcripts). We generated parallel LLM-therapist utterances iteratively for each transcript while keeping client responses static, and ranked performance using a composite ranking system with MITI components and verbosity. We conducted a distinguishability experiment with two independent psychiatrists to identify human-vs-LLM responses. Results: All 10 tested LLMs had fair (MITI global scores >3.5) to good (MITI global scores >4) competence across MITI measures, and three best-performing models (gemma-3-27b-it, gemini-2.5-pro, grok-3) were tested on real-world transcripts. All showed good competence, with LLMs outperforming human-expert in Complex Reflection percentage (39% vs 96%) and Reflection-Question ratio (1.2 vs >2.8). In the distinguishability experiment, psychiatrists identified LLM responses with only 56% accuracy, with d-prime: 0.17 and 0.25 for gemini-2.5-pro and gemma-3-27b-it respectively. Conclusion: LLMs can achieve good MI proficiency in real-world clinical transcripts using MITI framework. These findings suggest that even open-source LLMs are viable candidates for expanding MI counselling sessions in low-resource settings.

cs.CL

ASR Under the Stethoscope: Evaluating Biases in Clinical Speech Recognition across Indian Languages

Automatic Speech Recognition (ASR) is increasingly used to document clinical encounters, yet its reliability in multilingual and demographically diverse Indian healthcare contexts remains largely unknown. In this study, we conduct the first systematic audit of ASR performance on real world clinical interview data spanning Kannada, Hindi, and Indian English, comparing leading models including Indic Whisper, Whisper, Sarvam, Google speech to text, Gemma3n, Omnilingual, Vaani, and Gemini. We evaluate transcription accuracy across languages, speakers, and demographic subgroups, with a particular focus on error patterns affecting patients vs. clinicians and gender based or intersectional disparities. Our results reveal substantial variability across models and languages, with some systems performing competitively on Indian English but failing on code mixed or vernacular speech. We also uncover systematic performance gaps tied to speaker role and gender, raising concerns about equitable deployment in clinical settings. By providing a comprehensive multilingual benchmark and fairness analysis, our work highlights the need for culturally and demographically inclusive ASR development for healthcare ecosystem in India.

cs.CL

Lost without translation -- Can transformer (language models) understand mood states?

Background: Large Language Models show promise in psychiatry but are English-centric. Their ability to understand mood states in other languages is unclear, as different languages have their own idioms of distress. Aim: To quantify the ability of language models to faithfully represent phrases (idioms of distress) of four distinct mood states (depression, euthymia, euphoric mania, dysphoric mania) expressed in Indian languages. Methods: We collected 247 unique phrases for the four mood states across 11 Indic languages. We tested seven experimental conditions, comparing k-means clustering performance on: (a) direct embeddings of native and Romanised scripts (using multilingual and Indic-specific models) and (b) embeddings of phrases translated to English and Chinese. Performance was measured using a composite score based on Adjusted Rand Index, Normalised Mutual Information, Homogeneity and Completeness. Results: Direct embedding of Indic languages failed to cluster mood states (Composite Score = 0.002). All translation-based approaches showed significant improvement. High performance was achieved using Gemini-translated English (Composite=0.60) and human-translated English (Composite=0.61) embedded with gemini-001. Surprisingly, human-translated English, further translated into Chinese and embedded with a Chinese model, performed best (Composite = 0.67). Specialised Indic models (IndicBERT and Sarvam-M) performed poorly. Conclusion: Current models cannot meaningfully represent mood states directly from Indic languages, posing a fundamental barrier to their psychiatric application for diagnostic or therapeutic purposes in India. While high-quality translation bridges this gap, reliance on proprietary models or complex translation pipelines is unsustainable. Models must first be built to understand diverse local languages to be effective in global mental health.

cs.CL

Local Obfuscation by GLINER for Impartial Context Aware Lineage: Development and evaluation of PII Removal system

Removing Personally Identifiable Information (PII) from clinical notes in Electronic Health Records (EHRs) is essential for research and AI development. While Large Language Models (LLMs) are powerful, their high computational costs and the data privacy risks of API-based services limit their use, especially in low-resource settings. To address this, we developed LOGICAL (Local Obfuscation by GLINER for Impartial Context-Aware Lineage), an efficient, locally deployable PII removal system built on a fine-tuned Generalist and Lightweight Named Entity Recognition (GLiNER) model. We used 1515 clinical documents from a psychiatric hospital's EHR system. We defined nine PII categories for removal. A modern-gliner-bi-large-v1.0 model was fine-tuned on 2849 text instances and evaluated on a test set of 376 instances using character-level precision, recall, and F1-score. We compared its performance against Microsoft Azure NER, Microsoft Presidio, and zero-shot prompting with Gemini-Pro-2.5 and Llama-3.3-70B-Instruct. The fine-tuned GLiNER model achieved superior performance, with an overall micro-average F1-score of 0.980, significantly outperforming Gemini-Pro-2.5 (F1-score: 0.845). LOGICAL correctly sanitised 95% of documents completely, compared to 64% for the next-best solution. The model operated efficiently on a standard laptop without a dedicated GPU. However, a 2% entity-level false negative rate underscores the need for human-in-the-loop validation across all tested systems. Fine-tuned, specialised transformer models like GLiNER offer an accurate, computationally efficient, and secure solution for PII removal from clinical notes. This "sanitisation at the source" approach is a practical alternative to resource-intensive LLMs, enabling the creation of de-identified datasets for research and AI development while preserving data privacy, particularly in resource-constrained environments.

cs.CL