Abdulkadir Külçe, Alihan Esen, Cağla Fikir +4cs.AI cs.CL
This paper presents ECHO (Enhanced Care \& Health Observer), a locally-deployable conversational health assistant for long-term chronic care management. ECHO integrates three complementary software modules developed under shared supervision as a unified system. The core module is an agentic chatbot built on a ReAct loop orchestrated via LangGraph, equipped with 17 clinical tools and a temporal knowledge graph for persistent cross-session memory; it achieves a 94.9\% tool-execution pass rate across a 59-scenario benchmark with GPT-5 Mini. A two-stage hybrid safety layer intercepts all incoming queries: a rule-based layer handles explicit crisis signals and jailbreak attempts in under 1ms, while a signed graph neural network (GNN) with APPNP-style propagation classifies boundary cases by clinical intent, achieving 88.8\% accuracy and 90.6\% unsafe recall on a 2,537-query annotated Turkish health dataset while outperforming zero-shot LLM baselines including Llama 3.3 70B. A multimodal speech assessment module combining Whisper acoustic encoding and BERT text encoding with cross-attention fusion estimates emotion, depression, and pain, reaching a mean macro F1 of 0.652. The full system is implemented as a web application that can run entirely on consumer hardware, with no patient data transmitted to external services, supporting compliance with GDPR and KVKK.
Dysarthria severity assessment is essential for therapy planning and longitudinal monitoring, yet manual perceptual rating is time-consuming and variable across clinicians. Although deep learning models achieve strong performance, their black-box nature limits clinical adoption. Existing speech explainability methods typically provide acoustic feature importance scores that are difficult for end-users to interpret. We propose an influence-based, instance-level explainability framework that explains each decision through supportive and competing training samples. Using gradient-based influence approximations, we compute per-utterance influence scores to identify supportive and competing training samples for each prediction. Controlled deletion experiments from 5 to 20 percent validate the explanations, showing that removing highly influential samples systematically shifts predictions. This approach provides auditable explanations by linking decisions to perceptible reference cases.