Benchmarking LLM Summaries of Multimodal Clinical Time Series for Remote Monitoring

Large language models (LLMs) can generate fluent clinical summaries of remote therapeutic monitoring time series. However, it remains unclear whether these narratives faithfully capture clinically significant events, such as sustained abnormalities. Existing evaluation metrics primarily focus on semantic similarity and linguistic quality, leaving event-level correctness largely unmeasured. To address this gap, we introduce an event-based evaluation framework for multimodal time-series summarization using the Technology-Integrated Health Management (TIHM)-1.5 dementia monitoring dataset. Clinically grounded daily events are derived through rule-based abnormal thresholds and temporal persistence criteria. Model-generated summaries are then aligned with these structured facts. Our evaluation protocol measures abnormality recall, duration recall, measurement coverage, and hallucinated event mentions. We benchmark three approaches: zero-shot prompting, statistical prompting, and a vision-based pipeline that uses rendered time-series visualizations. The results reveal a striking decoupling between conventional metrics and clinical event fidelity. Models that achieve high semantic similarity scores often exhibit near-zero abnormality recall. In contrast, the vision-based approach demonstrates the strongest event alignment, achieving 45.7% abnormality recall and 100% duration recall. These findings underscore the importance of event-aware evaluation to ensure reliable clinical time-series summarization.

MENDR: Manifold Explainable Neural Data Representations

Foundation models for electroencephalography (EEG) signals have recently demonstrated success in learning generalized representations of EEGs, outperforming specialized models in various downstream tasks. However, many of these models lack transparency in their pretraining dynamics and offer limited insight into how well EEG information is preserved within their embeddings. For successful clinical integration, EEG foundation models must ensure transparency in pretraining, downstream fine-tuning, and the interpretability of learned representations. Current approaches primarily operate in the temporal domain, overlooking advancements in digital signal processing that enable the extraction of deterministic and traceable features, such as wavelet-based representations. We propose MENDR (Manifold Explainable Neural Data Representations), a filter bank-based EEG foundation model built on a novel Riemannian Manifold Transformer architecture to resolve these issues. MENDR learns symmetric positive definite matrix embeddings of EEG signals and is pretrained on a large corpus comprising over 4,000 hours of EEG data, decomposed via discrete wavelet packet transforms into multi-resolution coefficients. MENDR significantly enhances interpretability by visualizing symmetric positive definite embeddings as geometric ellipsoids and supports accurate reconstruction of EEG signals from learned embeddings. Evaluations across multiple clinical EEG tasks demonstrate that MENDR achieves near state-of-the-art performance with substantially fewer parameters, underscoring its potential for efficient, interpretable, and clinically applicable EEG analysis.