Recent advances in large language models (LLMs) have shown potential in clinical text summarization, but their ability to handle long patient trajectories with multi-modal data spread across time remains underexplored. This study systematically evaluates several state-of-the-art open-source LLMs, their Retrieval Augmented Generation (RAG) variants and chain-of-thought (CoT) prompting on long-context clinical summarization and prediction. We examine their ability to synthesize structured and unstructured Electronic Health Records (EHR) data while reasoning over temporal coherence, by re-engineering existing tasks, including discharge summarization and diagnosis prediction from two publicly available EHR datasets. Our results indicate that long context windows improve input integration but do not consistently enhance clinical reasoning, and LLMs are still struggling with temporal progression and rare disease prediction. While RAG shows improvements in hallucination in some cases, it does not fully address these limitations. Our work fills the gap in long clinical text summarization, establishing a foundation for evaluating LLMs with multi-modal data and temporal reasoning.

In this paper we describe the development of a text-to-speech system for Māori ‘Avaiki Nui (Cook Islands Māori). We provide details about the process of community-collaboration that was followed throughout the project, a continued engagement where we are trying to develop speech and language technology for the benefit of the community. During this process we gathered a group of recordings that we used to train a TTS system. When training we used two approaches, the HMM-system MaryTTS (Schröder et al., 2011) and the deep learning system FastSpeech2 (Ren et al., 2020). We performed two evaluation tasks on the models: First, we measured their quality by having the synthesized speech transcribed by ASR. The human produced ground truth had lower error rates (CER=4.3, WER=18), but the FastSpeech2 audio has lower error rates (CER=11.8 and WER=42.7) than the MaryTTS voice (CER=17.9 and WER=48.1). The second evaluation was a survey amongst speakers of the language so they could judge the voice’s quality. The ground truth was rated with the highest quality (MOS=4.6), but the FastSpeech2 voice had an overall quality of MOS=3.2, which was significantly higher than that of the MaryTTS synthesized recordings (MOS=2.0). We intend to use the FastSpeech2 model to create language learning tools for community members both on the Cook Islands and in the diaspora.