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Cross-Lingual Clinical Annotation Projection as Constrained Text Generation: A Six-Language Study

arxiv.org/abs/2609.11450

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Updated 5 h ago · first seen 11 Sept 2026

paper_01M294G4Q931KVSK4P8RE59R2Q

Published
11 Sept 2026
T1 · 5 h ago
arXiv
2609.11450
T1 · 5 h ago
Category
cs.CL
T1 · 5 h ago

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Background: To determine whether cross-lingual clinical annotation projection can be formulated as a text-preserving, document-level generative task that produces verifiable character-level annotations for multilingual clinical corpus construction, and to characterize its robustness and computational trade-offs relative to candidate-based projection pipelines. Methods: We developed a constrained LLM projection workflow that inserts entity tags directly into immutable target-language text, followed by deterministic validation and character-offset reconstruction. We evaluated it alongside supervised candidate-span projection and hybrid ML-LLM refinement for transferring Spanish Disease, Symptom, and Procedure annotations into six languages. Evaluation used MultiClinAI gold standard with strict span matching and character-overlap F1 Results: Direct LLM projection achieved the strongest and most consistent performance. GLM 5.2 obtained a mean Strict F1 of 0.9201 across 18 language-entity combinations, while locally deployable Gemma4:31B achieved 0.9133. The best LLM configuration improved Strict F1 over the previous state of the art in all 18 settings, by 0.0564-0.1512, yielding 55,416 grounded mentions with reconstructed offsets. Conclusions: Direct LLM-based projection enables high-quality multilingual clinical annotation transfer and provides a practical approach for extending clinical NLP resources to languages with fewer annotated datasets and language-specific tools. Combined with local inference and deterministic validation, it can substantially reduce expert time and cost for multilingual clinical corpus construction.currentcurrentarXiv (Atom API + RSS)T1highdeterministic

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