Structured Disagreement in Health-Literacy Annotation: Epistemic Stability, Conceptual Difficulty, and Agreement-Stratified Inference

Olga Kellert, Sriya Kondury, Candice Koo, Nemika Tyagi, Steffen Eikenberry


Abstract
Annotation pipelines in Natural Language Processing (NLP) commonly assume a single latent ground truth per instance and resolve disagreement through label aggregation. Perspectivist approaches challenge this view by treating disagreement as potentially informative rather than erroneous. We present a large-scale analysis of graded health-literacy annotations from 6,323 open-ended COVID-19 responses collected in Ecuador and Peru. Each response was independently labeled by multiple annotators using proportional correctness scores, allowing us to analyze the full distribution of judgments rather than aggregated labels. Variance decomposition shows that question-level conceptual difficulty accounts for substantially more variance than annotator identity, indicating that disagreement is structured by the task itself rather than driven by individual raters. Agreement-stratified analyses further reveal that key social-scientific effects, including country, education, and urban-rural differences, vary in magnitude and in some cases reverse direction depending on levels of inter-annotator agreement. These findings suggest that graded health-literacy evaluation contains both epistemically stable and unstable components, and that aggregating across them can obscure important inferential differences. We therefore argue that strong perspectivist modeling is not only conceptually justified but statistically necessary for valid inference in graded interpretive tasks.
Anthology ID:
2026.nlperspectives-1.8
Volume:
Proceedings of the the fifth edition of NLPerspectives
Month:
May
Year:
2026
Address:
Palma, Mallorca (Spain)
Editors:
Shiran Dudy, Gavin Abercrombie, Valerio Basile, Elisa Leonardelli, Simona Frenda
Venues:
NLPerspectives | WS
SIG:
Publisher:
ELRA Language Resources Association (ELRA)
Note:
Pages:
76–83
Language:
External URL:
https://lrec.elra.info/lrec2026-ws-nlperspectives-08
DOI:
10.63317/597f9ocduw7b
Bibkey:
Cite (ACL):
Olga Kellert, Sriya Kondury, Candice Koo, Nemika Tyagi, and Steffen Eikenberry. 2026. Structured Disagreement in Health-Literacy Annotation: Epistemic Stability, Conceptual Difficulty, and Agreement-Stratified Inference. In Proceedings of the the fifth edition of NLPerspectives, pages 76–83, Palma, Mallorca (Spain). ELRA Language Resources Association (ELRA).
Cite (Informal):
Structured Disagreement in Health-Literacy Annotation: Epistemic Stability, Conceptual Difficulty, and Agreement-Stratified Inference (Kellert et al., NLPerspectives 2026)
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