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Jun 17

When De-noising Hurts: A Systematic Study of Speech Enhancement Effects on Modern Medical ASR Systems

Speech enhancement methods are commonly believed to improve the performance of automatic speech recognition (ASR) in noisy environments. However, the effectiveness of these techniques cannot be taken for granted in the case of modern large-scale ASR models trained on diverse, noisy data. We present a systematic evaluation of MetricGAN-plus-voicebank denoising on four state-of-the-art ASR systems: OpenAI Whisper, NVIDIA Parakeet, Google Gemini Flash 2.0, Parrotlet-a using 500 medical speech recordings under nine noise conditions. ASR performance is measured using semantic WER (semWER), a normalized word error rate (WER) metric accounting for domain-specific normalizations. Our results reveal a counterintuitive finding: speech enhancement preprocessing degrades ASR performance across all noise conditions and models. Original noisy audio achieves lower semWER than enhanced audio in all 40 tested configurations (4 models x 10 conditions), with degradations ranging from 1.1% to 46.6% absolute semWER increase. These findings suggest that modern ASR models possess sufficient internal noise robustness and that traditional speech enhancement may remove acoustic features critical for ASR. For practitioners deploying medical scribe systems in noisy clinical environments, our results indicate that preprocessing audio with noise reduction techniques might not just be computationally wasteful but also be potentially harmful to the transcription accuracy.

  • 11 authors
·
Dec 19, 2025

Real-Time Multimodal Cognitive Assistant for Emergency Medical Services

Emergency Medical Services (EMS) responders often operate under time-sensitive conditions, facing cognitive overload and inherent risks, requiring essential skills in critical thinking and rapid decision-making. This paper presents CognitiveEMS, an end-to-end wearable cognitive assistant system that can act as a collaborative virtual partner engaging in the real-time acquisition and analysis of multimodal data from an emergency scene and interacting with EMS responders through Augmented Reality (AR) smart glasses. CognitiveEMS processes the continuous streams of data in real-time and leverages edge computing to provide assistance in EMS protocol selection and intervention recognition. We address key technical challenges in real-time cognitive assistance by introducing three novel components: (i) a Speech Recognition model that is fine-tuned for real-world medical emergency conversations using simulated EMS audio recordings, augmented with synthetic data generated by large language models (LLMs); (ii) an EMS Protocol Prediction model that combines state-of-the-art (SOTA) tiny language models with EMS domain knowledge using graph-based attention mechanisms; (iii) an EMS Action Recognition module which leverages multimodal audio and video data and protocol predictions to infer the intervention/treatment actions taken by the responders at the incident scene. Our results show that for speech recognition we achieve superior performance compared to SOTA (WER of 0.290 vs. 0.618) on conversational data. Our protocol prediction component also significantly outperforms SOTA (top-3 accuracy of 0.800 vs. 0.200) and the action recognition achieves an accuracy of 0.727, while maintaining an end-to-end latency of 3.78s for protocol prediction on the edge and 0.31s on the server.

  • 7 authors
·
Mar 10, 2024