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Lars Maaløe

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Published work

12 published item(s)

preprint2026arXiv

Symphony for Speech-to-Text: Supporting Real-Time Medical Voice Interfaces

After decades of use in dictation and, more recently, ambient documentation, speech is emerging as a primary modality for interacting with technology and AI in healthcare. Yet medical speech recognition remains difficult: systems must capture specialized terminology, resolve contextual ambiguity, and render measurements, abbreviations, and clinical shorthand precisely. Existing solutions are typically optimized either for general-purpose transcription or narrow dictation workflows, limiting their reliability in safety-critical settings and their usefulness for broader clinical workflows. We introduce Symphony for Speech-to-Text, a medical-grade speech recognition system for real-time streaming and batch file-based clinical use. Symphony decomposes the transcription process into specialized components for recognition, formatting, and contextual correction to optimize medical term recall while producing clinically structured text in real time and adapting across use cases. Evaluations on public benchmark and medical speech datasets show that Symphony substantially outperforms state-of-the-art systems in clinical settings while matching or exceeding them in general-domain settings, suggesting robust generalization rather than overfitting. We release a clinical benchmark dataset to support reliable validation and further progress in medical speech recognition. Symphony is available through a production-grade API for live dictation, conversational transcription, and batch audio file processing.

preprint2022arXiv

A Brief Overview of Unsupervised Neural Speech Representation Learning

Unsupervised representation learning for speech processing has matured greatly in the last few years. Work in computer vision and natural language processing has paved the way, but speech data offers unique challenges. As a result, methods from other domains rarely translate directly. We review the development of unsupervised representation learning for speech over the last decade. We identify two primary model categories: self-supervised methods and probabilistic latent variable models. We describe the models and develop a comprehensive taxonomy. Finally, we discuss and compare models from the two categories.

preprint2022arXiv

Benchmarking Generative Latent Variable Models for Speech

Stochastic latent variable models (LVMs) achieve state-of-the-art performance on natural image generation but are still inferior to deterministic models on speech. In this paper, we develop a speech benchmark of popular temporal LVMs and compare them against state-of-the-art deterministic models. We report the likelihood, which is a much used metric in the image domain, but rarely, or incomparably, reported for speech models. To assess the quality of the learned representations, we also compare their usefulness for phoneme recognition. Finally, we adapt the Clockwork VAE, a state-of-the-art temporal LVM for video generation, to the speech domain. Despite being autoregressive only in latent space, we find that the Clockwork VAE can outperform previous LVMs and reduce the gap to deterministic models by using a hierarchy of latent variables.

preprint2022arXiv

Hierarchical VAEs Know What They Don't Know

Deep generative models have been demonstrated as state-of-the-art density estimators. Yet, recent work has found that they often assign a higher likelihood to data from outside the training distribution. This seemingly paradoxical behavior has caused concerns over the quality of the attained density estimates. In the context of hierarchical variational autoencoders, we provide evidence to explain this behavior by out-of-distribution data having in-distribution low-level features. We argue that this is both expected and desirable behavior. With this insight in hand, we develop a fast, scalable and fully unsupervised likelihood-ratio score for OOD detection that requires data to be in-distribution across all feature-levels. We benchmark the method on a vast set of data and model combinations and achieve state-of-the-art results on out-of-distribution detection.

preprint2022arXiv

Model-agnostic out-of-distribution detection using combined statistical tests

We present simple methods for out-of-distribution detection using a trained generative model. These techniques, based on classical statistical tests, are model-agnostic in the sense that they can be applied to any differentiable generative model. The idea is to combine a classical parametric test (Rao's score test) with the recently introduced typicality test. These two test statistics are both theoretically well-founded and exploit different sources of information based on the likelihood for the typicality test and its gradient for the score test. We show that combining them using Fisher's method overall leads to a more accurate out-of-distribution test. We also discuss the benefits of casting out-of-distribution detection as a statistical testing problem, noting in particular that false positive rate control can be valuable for practical out-of-distribution detection. Despite their simplicity and generality, these methods can be competitive with model-specific out-of-distribution detection algorithms without any assumptions on the out-distribution.

preprint2021arXiv

Do End-to-End Speech Recognition Models Care About Context?

The two most common paradigms for end-to-end speech recognition are connectionist temporal classification (CTC) and attention-based encoder-decoder (AED) models. It has been argued that the latter is better suited for learning an implicit language model. We test this hypothesis by measuring temporal context sensitivity and evaluate how the models perform when we constrain the amount of contextual information in the audio input. We find that the AED model is indeed more context sensitive, but that the gap can be closed by adding self-attention to the CTC model. Furthermore, the two models perform similarly when contextual information is constrained. Finally, in contrast to previous research, our results show that the CTC model is highly competitive on WSJ and LibriSpeech without the help of an external language model.

preprint2021arXiv

On Scaling Contrastive Representations for Low-Resource Speech Recognition

Recent advances in self-supervised learning through contrastive training have shown that it is possible to learn a competitive speech recognition system with as little as 10 minutes of labeled data. However, these systems are computationally expensive since they require pre-training followed by fine-tuning in a large parameter space. We explore the performance of such systems without fine-tuning by training a state-of-the-art speech recognizer on the fixed representations from the computationally demanding wav2vec 2.0 framework. We find performance to decrease without fine-tuning and, in the extreme low-resource setting, wav2vec 2.0 is inferior to its predecessor. In addition, we find that wav2vec 2.0 representations live in a low dimensional subspace and that decorrelating the features of the representations can stabilize training of the automatic speech recognizer. Finally, we propose a bidirectional extension to the original wav2vec framework that consistently improves performance.

preprint2020arXiv

MultiQT: Multimodal Learning for Real-Time Question Tracking in Speech

We address a challenging and practical task of labeling questions in speech in real time during telephone calls to emergency medical services in English, which embeds within a broader decision support system for emergency call-takers. We propose a novel multimodal approach to real-time sequence labeling in speech. Our model treats speech and its own textual representation as two separate modalities or views, as it jointly learns from streamed audio and its noisy transcription into text via automatic speech recognition. Our results show significant gains of jointly learning from the two modalities when compared to text or audio only, under adverse noise and limited volume of training data. The results generalize to medical symptoms detection where we observe a similar pattern of improvements with multimodal learning.

preprint2019arXiv

BIVA: A Very Deep Hierarchy of Latent Variables for Generative Modeling

With the introduction of the variational autoencoder (VAE), probabilistic latent variable models have received renewed attention as powerful generative models. However, their performance in terms of test likelihood and quality of generated samples has been surpassed by autoregressive models without stochastic units. Furthermore, flow-based models have recently been shown to be an attractive alternative that scales well to high-dimensional data. In this paper we close the performance gap by constructing VAE models that can effectively utilize a deep hierarchy of stochastic variables and model complex covariance structures. We introduce the Bidirectional-Inference Variational Autoencoder (BIVA), characterized by a skip-connected generative model and an inference network formed by a bidirectional stochastic inference path. We show that BIVA reaches state-of-the-art test likelihoods, generates sharp and coherent natural images, and uses the hierarchy of latent variables to capture different aspects of the data distribution. We observe that BIVA, in contrast to recent results, can be used for anomaly detection. We attribute this to the hierarchy of latent variables which is able to extract high-level semantic features. Finally, we extend BIVA to semi-supervised classification tasks and show that it performs comparably to state-of-the-art results by generative adversarial networks.

preprint2016arXiv

Auxiliary Deep Generative Models

Deep generative models parameterized by neural networks have recently achieved state-of-the-art performance in unsupervised and semi-supervised learning. We extend deep generative models with auxiliary variables which improves the variational approximation. The auxiliary variables leave the generative model unchanged but make the variational distribution more expressive. Inspired by the structure of the auxiliary variable we also propose a model with two stochastic layers and skip connections. Our findings suggest that more expressive and properly specified deep generative models converge faster with better results. We show state-of-the-art performance within semi-supervised learning on MNIST, SVHN and NORB datasets.

preprint2016arXiv

Ladder Variational Autoencoders

Variational Autoencoders are powerful models for unsupervised learning. However deep models with several layers of dependent stochastic variables are difficult to train which limits the improvements obtained using these highly expressive models. We propose a new inference model, the Ladder Variational Autoencoder, that recursively corrects the generative distribution by a data dependent approximate likelihood in a process resembling the recently proposed Ladder Network. We show that this model provides state of the art predictive log-likelihood and tighter log-likelihood lower bound compared to the purely bottom-up inference in layered Variational Autoencoders and other generative models. We provide a detailed analysis of the learned hierarchical latent representation and show that our new inference model is qualitatively different and utilizes a deeper more distributed hierarchy of latent variables. Finally, we observe that batch normalization and deterministic warm-up (gradually turning on the KL-term) are crucial for training variational models with many stochastic layers.

preprint2015arXiv

Recurrent Spatial Transformer Networks

We integrate the recently proposed spatial transformer network (SPN) [Jaderberg et. al 2015] into a recurrent neural network (RNN) to form an RNN-SPN model. We use the RNN-SPN to classify digits in cluttered MNIST sequences. The proposed model achieves a single digit error of 1.5% compared to 2.9% for a convolutional networks and 2.0% for convolutional networks with SPN layers. The SPN outputs a zoomed, rotated and skewed version of the input image. We investigate different down-sampling factors (ratio of pixel in input and output) for the SPN and show that the RNN-SPN model is able to down-sample the input images without deteriorating performance. The down-sampling in RNN-SPN can be thought of as adaptive down-sampling that minimizes the information loss in the regions of interest. We attribute the superior performance of the RNN-SPN to the fact that it can attend to a sequence of regions of interest.