@inproceedings{kim-etal-2026-clinicast,
    title = "{C}lini{CAST}: Benchmarking Acoustic Grounding and Text Dominance in Medical Triage",
    author = "Kim, Kyusik  and
      Yoo, Hyunwoo  and
      Choi, Jaehoon  and
      Kim, Kitae  and
      Rosen, Gail  and
      Suh, Bongwon",
    editor = "Liakata, Maria  and
      Moreira, Viviane P.  and
      Zhang, Jiajun  and
      Jurgens, David",
    booktitle = "Findings of the {A}ssociation for {C}omputational {L}inguistics: {ACL} 2026",
    month = jul,
    year = "2026",
    address = "San Diego, California, United States",
    publisher = "Association for Computational Linguistics",
    url = "https://preview.aclanthology.org/ingest-acl/2026.findings-acl.2056/",
    pages = "41321--41343",
    ISBN = "979-8-89176-395-1",
    abstract = "Recent Large Audio-Language Models (LALMs) integrate acoustic capabilities into reasoning, yet whether they reliably ground clinical judgments in audible evidence remains unproven. We introduce CliniCAST (\textbf{Clini}cal \textbf{C}ontrolled \textbf{A}coustic \textbf{S}ynthetic \textbf{T}riage), a controlled benchmark that disentangles clinically meaningful acoustic cues from lexical content and speaker demographics. CliniCAST comprises 5{,}856 synthetic samples across 12 disease conditions: 4{,}800 audio samples forming 2{,}400 tagged{--}untagged pairs for five-level emergency triage, and 1{,}056 audio{--}text inconsistent samples in which reassuring speech is paired with high-risk acoustic cues. Evaluating a diverse suite of audio-capable foundation models, we find that LALMs exhibit fragile acoustic grounding and a pronounced ``text dominance'' failure mode: reassuring lexical content suppresses response to audible distress signals even under safety-critical conditions. Age and gender interactions are weak across conditions, indicating that the primary failure mode is insufficient cross-modal integration rather than demographic bias. These results suggest current LALMs are not yet robust enough for high-stakes medical triage, and motivate training objectives that explicitly enforce reliance on clinically grounded audible evidence."
}