Aimé Nun , Olivier Birot , Gaël Guibon , Frédéric Lapostolle , Ivan Lerner
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引用次数: 0
Abstract
Background
Dispatch Services (DS) are essential to Emergency Medical Services (EMS). Dispatchers enable patients to access medical assistance in emergencies, anytime and anywhere, within limited time and resources. AI-based decision-support tools hold great promise for dispatchers. Developing these tools requires medical field-specific data. Medical dispatch dialogue is unique: it is a brief phone exchange in an emergency, within a limited time frame, without a physical examination.
Objective
Our main objective was to (i) create an open French dataset of medical dispatch dialogues. Our secondary objectives were to (ii) develop a detailed medical dispatch scheme from this dataset using an unsupervised method, and (iii) provide a baseline evaluation of diarization and speech recognition models for this domain in French.
Methods
From 2022 to 2023, emergency medicine junior doctors simulated real-life medical dispatch calls. These calls were recorded and transcribed to form the SIMSAMU corpus. We developed a dispatch scheme based on (i) recording analysis, (ii) data-driven utterance typology, and (iii) domain expertise. Utterance typology was derived via hierarchical clustering of representations learned by finetuning BERT embeddings on SIMSAMU. Clusters were mapped to the Roter Interaction Analysis System (RIAS) and included in our dispatch scheme. SIMSAMU was used to train and evaluate state-of-the-art neural network models for diarization and speech recognition. Diarization used the PyaNet model, fine-tuned on the ESLO2 dataset. Speech recognition used a CTC model with pre-trained wav2vec 2.0 embedding, compared to the multilingual Whisper model. The CTC-wav2vec model was further fine-tuned on SIMSAMU and evaluated by leave-one-speaker-out cross-validation.
Results
The dataset consists of 61 audio recordings totaling 3 h 14 min. Four clusters were identified for callers and 3 for dispatchers. Two main dialogue phases were identified: interrogation and contractualization. The diarization model achieved a 10.4 % error rate. Speech recognition word error rates were 35.8 % for Whisper, 24.8 % for the CTC-wav2vec model fine-tuned on ESLO2, and 16.1 % after in-domain fine-tuning.
Conclusion
We propose a French open medical dispatch dialogue dataset and an expert-validated schema of the medical dispatch dialogue based on unsupervised analysis. Notable gaps in how well speech recognition models generalize underscore the need for targeted, in-domain fine-tuning in this specialized application. SIMSAMU is designed to support this effort by serving as a benchmark for evaluating domain-adapted speech recognition and dialogue modeling strategies.
期刊介绍:
To encourage the development of formal computing methods, and their application in biomedical research and medical practice, by illustration of fundamental principles in biomedical informatics research; to stimulate basic research into application software design; to report the state of research of biomedical information processing projects; to report new computer methodologies applied in biomedical areas; the eventual distribution of demonstrable software to avoid duplication of effort; to provide a forum for discussion and improvement of existing software; to optimize contact between national organizations and regional user groups by promoting an international exchange of information on formal methods, standards and software in biomedicine.
Computer Methods and Programs in Biomedicine covers computing methodology and software systems derived from computing science for implementation in all aspects of biomedical research and medical practice. It is designed to serve: biochemists; biologists; geneticists; immunologists; neuroscientists; pharmacologists; toxicologists; clinicians; epidemiologists; psychiatrists; psychologists; cardiologists; chemists; (radio)physicists; computer scientists; programmers and systems analysts; biomedical, clinical, electrical and other engineers; teachers of medical informatics and users of educational software.