Almost Clinical: Linguistic properties of synthetic electronic health records

This study evaluates the linguistic and clinical suitability of synthetic electronic health records in mental health. First, we describe the rationale and the methodology for creating the synthetic corpus. Second, we examine expressions of agency, modality, and information flow across four clinical genres (Assessments, Correspondence, Referrals and Care plans) with the aim to understand how LLMs grammatically construct medical authority and patient agency through linguistic choices. While LLMs produce coherent, terminology-appropriate texts that approximate clinical practice, systematic divergences remain, including registerial shifts, insufficient clinical specificity, and inaccuracies in medication use and diagnostic procedures. The results show both the potential and limitations of synthetic corpora for enabling large-scale linguistic research otherwise impossible with genuine patient records.