In this paper, we examine how well AI-generated multimodal stories align with the lived practices, relationships, language, values, and visual expectations of the communities they represent. We conduct a community-grounded mixed-methods evaluation with 19 culture representatives across five African communities, combining quantitative annotations with qualitative focus group discussions. We find that cultural alignment depends not simply on recognizable cultural markers, but on how those markers fit social, linguistic, procedural, and visual context. From these evaluations, we develop a taxonomy of cultural alignment comprising five broader cultural marker categories and eight recurring mechanisms of misalignment. We additionally evaluate five multimodal LLM judges to examine whether automated evaluation can approximate community-grounded judgments at scale. Judge reliability and score calibration vary substantially across communities, with no single judge performing consistently across all five settings. These findings motivate community-calibrated evaluation pipelines in which automated judges are validated against community judgments to determine where they can be trusted and where human review remains necessary.

Sentiment analysis in low-resource, culturally nuanced contexts challenges conventional NLP approaches that assume fixed labels and universal affective expressions. We present a diagnostic framework that treats sentiment as a context-dependent, culturally embedded construct, and evaluate how large language models (LLMs) reason about sentiment in informal, code-mixed WhatsApp messages from Nairobi youth health groups. Using human-annotated data, sentiment-flipped counterfactuals, and rubric-based explanation evaluation, we probe LLM interpretability, robustness, and alignment with human reasoning. Framing our evaluation through a social science measurement lens, we operationalize LLM outputs as an instrument for measuring the abstract concept of sentiment. Our findings reveal significant variation in model reasoning quality, with top-tier LLMs demonstrating greater interpretive stability, while smaller open-weight models in our study show reduced stability under ambiguity or sentiment shifts. This work highlights the need for culturally sensitive, reasoning-aware AI evaluation in complex, real-world communication.

This paper discusses the participation of the MSR MAIRA team in the Large-Scale Radiology Report Generation Shared Task Challenge, as part of the BioNLP workshop at ACL 2024. We present a radiology-specific multimodal model designed to generate radiological reports from chest X-Rays (CXRs). Our proposed model combines a CXR-specific image encoder RAD-DINO with a Large Language Model (LLM) based on Vicuna-7B, via a multi-layer perceptron (MLP) adapter. Both the adapter and the LLM have been fine-tuned in a single-stage training setup to generate radiology reports. Experimental results indicate that a joint training setup with findings and impression sections improves findings prediction. Additionally, incorporating lateral images alongside frontal images when available further enhances all metrics. More information and resources about MAIRA can be found on the project website: http://aka.ms/maira.

The recent success of general-domain large language models (LLMs) has significantly changed the natural language processing paradigm towards a unified foundation model across domains and applications. In this paper, we focus on assessing the performance of GPT-4, the most capable LLM so far, on the text-based applications for radiology reports, comparing against state-of-the-art (SOTA) radiology-specific models. Exploring various prompting strategies, we evaluated GPT-4 on a diverse range of common radiology tasks and we found GPT-4 either outperforms or is on par with current SOTA radiology models. With zero-shot prompting, GPT-4 already obtains substantial gains (≈ 10% absolute improvement) over radiology models in temporal sentence similarity classification (accuracy) and natural language inference (F₁). For tasks that require learning dataset-specific style or schema (e.g. findings summarisation), GPT-4 improves with example-based prompting and matches supervised SOTA. Our extensive error analysis with a board-certified radiologist shows GPT-4 has a sufficient level of radiology knowledge with only occasional errors in complex context that require nuanced domain knowledge. For findings summarisation, GPT-4 outputs are found to be overall comparable with existing manually-written impressions.