{"id":"https://openalex.org/W7166557530","doi":"https://doi.org/10.48550/arxiv.2606.27973","title":"From Black-Box to Clinical Insight: A Multi-Stage Explainable Framework for Speech-Based Cognitive Impairment Detection","display_name":"From Black-Box to Clinical Insight: A Multi-Stage Explainable Framework for Speech-Based Cognitive Impairment Detection","publication_year":2026,"publication_date":"2026-06-26","ids":{"openalex":"https://openalex.org/W7166557530","doi":"https://doi.org/10.48550/arxiv.2606.27973"},"language":null,"primary_location":{"id":"doi:10.48550/arxiv.2606.27973","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2606.27973","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":"2331-8422","issn":["2331-8422"],"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Preprint"},"type":"preprint","indexed_in":["datacite"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.48550/arxiv.2606.27973","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5139626405","display_name":"Yasaman Haghbin","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Haghbin, Yasaman","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5139616468","display_name":"Sina Rashidi","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Rashidi, Sina","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5139609985","display_name":"Ali Zolnour","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Zolnour, Ali","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5044010718","display_name":"Fatemeh Taherinezhad","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Taherinezhad, Fatemeh","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5139605039","display_name":"Ali Fartoot","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Fartoot, Ali","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5118785872","display_name":"Hossein Azadmaleki","orcid":"https://orcid.org/0009-0008-4284-9869"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Azadmaleki, Hossein","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5111443161","display_name":"Noble","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Noble, James M","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5139597884","display_name":"Maryam Dadkhah","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Dadkhah, Maryam","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5074942621","display_name":"Maryam Zolnoori","orcid":"https://orcid.org/0000-0003-4484-2990"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Zolnoori, Maryam","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.36010000109672546,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.36010000109672546,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.26420000195503235,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10465","display_name":"Neurobiology of Language and Bilingualism","score":0.04800000041723251,"subfield":{"id":"https://openalex.org/subfields/2805","display_name":"Cognitive Neuroscience"},"field":{"id":"https://openalex.org/fields/28","display_name":"Neuroscience"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/workflow","display_name":"Workflow","score":0.6359000205993652},{"id":"https://openalex.org/keywords/usability","display_name":"Usability","score":0.6022999882698059},{"id":"https://openalex.org/keywords/pipeline","display_name":"Pipeline (software)","score":0.5034000277519226},{"id":"https://openalex.org/keywords/pupillary-response","display_name":"Pupillary response","score":0.49129998683929443},{"id":"https://openalex.org/keywords/cognition","display_name":"Cognition","score":0.4805999994277954},{"id":"https://openalex.org/keywords/cognitive-impairment","display_name":"Cognitive impairment","score":0.45719999074935913},{"id":"https://openalex.org/keywords/narrative","display_name":"Narrative","score":0.4325000047683716},{"id":"https://openalex.org/keywords/security-token","display_name":"Security token","score":0.38280001282691956}],"concepts":[{"id":"https://openalex.org/C177212765","wikidata":"https://www.wikidata.org/wiki/Q627335","display_name":"Workflow","level":2,"score":0.6359000205993652},{"id":"https://openalex.org/C170130773","wikidata":"https://www.wikidata.org/wiki/Q216378","display_name":"Usability","level":2,"score":0.6022999882698059},{"id":"https://openalex.org/C204321447","wikidata":"https://www.wikidata.org/wiki/Q30642","display_name":"Natural language processing","level":1,"score":0.552299976348877},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.5490000247955322},{"id":"https://openalex.org/C43521106","wikidata":"https://www.wikidata.org/wiki/Q2165493","display_name":"Pipeline (software)","level":2,"score":0.5034000277519226},{"id":"https://openalex.org/C149288182","wikidata":"https://www.wikidata.org/wiki/Q7260673","display_name":"Pupillary response","level":3,"score":0.49129998683929443},{"id":"https://openalex.org/C169900460","wikidata":"https://www.wikidata.org/wiki/Q2200417","display_name":"Cognition","level":2,"score":0.4805999994277954},{"id":"https://openalex.org/C2984915365","wikidata":"https://www.wikidata.org/wiki/Q5141203","display_name":"Cognitive impairment","level":3,"score":0.45719999074935913},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.43869999051094055},{"id":"https://openalex.org/C199033989","wikidata":"https://www.wikidata.org/wiki/Q1318295","display_name":"Narrative","level":2,"score":0.4325000047683716},{"id":"https://openalex.org/C48145219","wikidata":"https://www.wikidata.org/wiki/Q1335365","display_name":"Security token","level":2,"score":0.38280001282691956},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.38179999589920044},{"id":"https://openalex.org/C119857082","wikidata":"https://www.wikidata.org/wiki/Q2539","display_name":"Machine learning","level":1,"score":0.37950000166893005},{"id":"https://openalex.org/C2778755073","wikidata":"https://www.wikidata.org/wiki/Q10858537","display_name":"Scale (ratio)","level":2,"score":0.3441999852657318},{"id":"https://openalex.org/C161407221","wikidata":"https://www.wikidata.org/wiki/Q4382939","display_name":"Cognitive model","level":3,"score":0.3336000144481659},{"id":"https://openalex.org/C66322947","wikidata":"https://www.wikidata.org/wiki/Q11658","display_name":"Transformer","level":3,"score":0.3327000141143799},{"id":"https://openalex.org/C19768560","wikidata":"https://www.wikidata.org/wiki/Q320727","display_name":"Dependency (UML)","level":2,"score":0.28529998660087585},{"id":"https://openalex.org/C33724603","wikidata":"https://www.wikidata.org/wiki/Q812540","display_name":"Bayesian network","level":2,"score":0.28529998660087585},{"id":"https://openalex.org/C159032336","wikidata":"https://www.wikidata.org/wiki/Q2488768","display_name":"Non-monotonic logic","level":2,"score":0.27070000767707825},{"id":"https://openalex.org/C161301231","wikidata":"https://www.wikidata.org/wiki/Q3478658","display_name":"Knowledge representation and reasoning","level":2,"score":0.2669999897480011},{"id":"https://openalex.org/C180747234","wikidata":"https://www.wikidata.org/wiki/Q23373","display_name":"Cognitive psychology","level":1,"score":0.2669999897480011},{"id":"https://openalex.org/C195344581","wikidata":"https://www.wikidata.org/wiki/Q2555318","display_name":"Automated reasoning","level":2,"score":0.2578999996185303},{"id":"https://openalex.org/C50644808","wikidata":"https://www.wikidata.org/wiki/Q192776","display_name":"Artificial neural network","level":2,"score":0.2531999945640564}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.48550/arxiv.2606.27973","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2606.27973","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":"2331-8422","issn":["2331-8422"],"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":null,"raw_source_name":null,"raw_type":"Preprint"}],"best_oa_location":{"id":"doi:10.48550/arxiv.2606.27973","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2606.27973","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":"2331-8422","issn":["2331-8422"],"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Preprint"},"sustainable_development_goals":[{"score":0.6165545582771301,"display_name":"Quality Education","id":"https://metadata.un.org/sdg/4"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":[],"abstract_inverted_index":{"Speech-based":[0],"cognitive":[1,99],"impairment":[2],"detection":[3],"offers":[4],"a":[5,21,46,102],"noninvasive,":[6],"accessible":[7],"alternative":[8],"to":[9,75],"costly":[10],"biomarker":[11],"assays,":[12],"yet":[13],"transformer-based":[14],"models":[15],"remain":[16],"clinically":[17,31],"uninterpretable.":[18],"We":[19],"propose":[20],"multi-stage":[22],"explainability":[23],"framework":[24,71],"that":[25],"translates":[26],"black-box":[27],"transformer":[28],"predictions":[29],"into":[30],"grounded":[32],"narratives":[33],"by":[34],"integrating":[35],"SHapley":[36],"Additive":[37],"exPlanations":[38],"(SHAP)-based":[39],"token":[40],"attribution,":[41],"theory-informed":[42],"linguistic":[43],"features,":[44],"and":[45,84,101],"four-stage":[47],"LLM":[48],"reasoning":[49],"pipeline":[50],"using":[51],"LLaMA-3.1-70B-Instruct.":[52],"Built":[53],"on":[54,65,89],"the":[55,66,70],"SpeechCARE-Adaptive":[56],"Gating":[57],"Network":[58],"multimodal":[59],"screening":[60],"model":[61,73],"(F1":[62],"=":[63],"72.11%":[64],"NIA":[67],"PREPARE":[68],"benchmark),":[69],"maps":[72],"outputs":[74],"four":[76],"cognitive-linguistic":[77],"dimensions,":[78],"including":[79],"lexical":[80],"richness,":[81],"syntactic":[82],"complexity,":[83],"semantic":[85],"coherence.":[86],"Physician":[87],"evaluation":[88],"70":[90],"stratified":[91],"English":[92],"samples":[93],"demonstrated":[94],"strong":[95],"alignment":[96],"with":[97],"patient-level":[98],"profiles,":[100],"System":[103],"Usability":[104],"Scale":[105],"score":[106],"of":[107],"82/100":[108],"indicated":[109],"high":[110],"potential":[111],"for":[112],"clinical":[113],"workflow":[114],"integration.":[115]},"counts_by_year":[],"updated_date":"2026-07-28T07:46:37.118299","created_date":"2026-06-30T00:00:00"}
