Abdolamir Karbalaie

Abdolamir Karbalaie, Fernando Seoane, Farhad Abtahi

Ambient AI "scribe" systems promise to reduce clinical documentation burden, but automatic speech recognition (ASR) errors can remain unnoticed without careful review, and high-quality human reference transcripts are often unavailable for calibrating uncertainty. We investigate whether cross-model disagreement among heterogeneous ASR systems can act as a reference-free uncertainty signal to prioritize human verification in medical transcription workflows. Using 50 publicly available medical education audio clips (8 h 14 min), we transcribed each clip with eight ASR systems spanning commercial APIs and open-source engines. We aligned multi-model outputs, built consensus pseudo-references, and quantified token-level agreement using a majority-strength metric; we further characterized disagreements by type (content vs. punctuation/formatting) and assessed per-model agreement via leave-one-model-out (jackknife) consensus scoring. Inter-model reliability was low (ICC[2,1] = 0.131), indicating heterogeneous failure modes across systems. Across 76,398 evaluated token positions, 72.1% showed near-unanimous agreement (7-8 models), while 2.5% fell into high-risk bands (0-3 models), with high-risk mass varying from 0.7% to 11.4% across accent groups. Low-agreement regions were enriched for content disagreements, with the content fraction increasing from 53.9% to 73.9% across quintiles of high-risk mass. These results suggest that cross-model disagreement provides a sparse, localizable signal that can surface potentially unreliable transcript spans without human-verified references, enabling targeted review; clinical accuracy of flagged regions remains to be established.

Farhad Abtahi, Abdolamir Karbalaie, Eduardo Illueca-Fernandez et al.

Metacognition, the ability to monitor and regulate one's own reasoning, remains under-evaluated in AI benchmarking. We introduce MEDLEY-BENCH, a benchmark of behavioural metacognition that separates independent reasoning, private self-revision, and socially influenced revision under genuine inter-model disagreement. The benchmark evaluates 35 models from 12 families on 130 ambiguous instances across five domains and reports two complementary scores: the Medley Metacognition Score (MMS), a tier-based aggregate of reflective updating, social robustness, and epistemic articulation, and the Medley Ability Score (MAS), derived from four metacognitive sub-abilities. Results show a robust evaluation/control dissociation: evaluation ability increases with model size within families, whereas control does not. In a follow-up progressive adversarial analysis of 11 models, we observed two behavioural profiles, i.e., models that revise primarily in response to argument quality and models that track consensus statistics. Under within-model relative profiling (ipsative scoring), evaluation was the weakest relative ability in all 35 models, indicating a systematic knowing/doing gap. Smaller and cheaper models often matched or outperformed larger counterparts, suggesting that metacognitive competence is not simply a function of scale. These findings position MEDLEY-BENCH as a tool for measuring belief revision under social pressure and suggest that future training should reward calibrated, proportional updating rather than output quality alone.