The results support the use of this modular AI-assisted clinical documentation pipeline as a human-supervised draft-generation tool that still requires clinician review, local workflow evaluation, and prospective clinical validation before broader deployment.
Abstract
Clinical documentation in Electronic Health Records (EHRs) remains a substantial source of administrative burden for clinicians. In this study, we evaluate a modular AI-assisted clinical documentation pipeline using two complementary approaches: (1) a controlled benchmark based on multilingual synthetic clinical dialogues, and (2) an observational analysis of real-world usage traces from routine deployments. The benchmark enables systematic comparison of ASR–LLM configurations under fully controlled conditions, using metrics for transcription accuracy (Word Error Rate and Medical WER), report-generation quality, and modeled processing cost. Within this benchmark setting, Voxtral showed the strongest ASR performance among the evaluated models, while GPT-4o and Gemini 1.5 Pro showed the strongest report-generation performance under the automated evaluation used in this study. The real-world trace analysis should be interpreted as descriptive evidence of operational use, not as prospective clinical validation or as a direct evaluation of any single benchmarked configuration. Taken together, the results support the use of this pipeline as a human-supervised draft-generation tool that still requires clinician review, local workflow evaluation, and prospective clinical validation before broader deployment.
Bottom-up incremental scoring showed the closest alignment with human assessment in clinical AI evaluation, underscoring the need for standardised prompt architectures in clinical AI evaluation.
Current LLMs do not achieve inter-rater reliability levels comparable to medical professionals in clinical information extraction from ENT documentation, suggesting they are best suited for initial extraction with human verification rather than autonomous operation.
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M. U. K. Gunawardhna, Pirunthavi Wijikumar, D. Weerasinghe· Sri Lankan Journal of Applie...· 1 citation
The deployment of Large Language Models (LLMs) in high-stakes clinical settings demands rigorous and reliable evaluation. However, existing medical benchmarks remain static, suffering from two critical limitations: (1) data contamination, where test sets inadvertently leak into training corpora, leading to inflated per...
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Transformer-based language models have been applied across diverse clinical-note tasks, but the evidence base more strongly supports retrospective task feasibility than transportability, equitable performance, workflow benefit, or safe clinical deployment.