# Scale-to-Dialogue: Low-Burden Elicitation of Daily Premenstrual Symptom Ratings with Small Language Models

arXiv: https://arxiv.org/abs/2608.08746 · HTML: https://mlsanity.com/paper/2608.08746/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 4 of its 14 references that are in the map.
- First posted on arXiv 9 Aug 2026.

## Builds on (most cited first, 4 of 4)

- [Qwen2.5 Technical Report](https://mlsanity.com/paper/2412.15115/) (2024)
- [Smarter, Better, Faster, Longer: A Modern Bidirectional Encoder for Fast, Memory Efficient, and Long Context Finetuning and Inference](https://mlsanity.com/paper/2412.13663/) (2024)
- [A Dialogue System for Assessing Activities of Daily Living: Improving Consistency with Grounded Knowledge](https://mlsanity.com/paper/2307.07544/) (2023)
- [Conversational AI for Automated Patient Questionnaire Completion: Development Insights and Design Principles](https://mlsanity.com/paper/2602.19507/) (2026)

## Abstract (arXiv)

Prospective daily symptom tracking is central to premenstrual health assessment, but repeated ordinal forms impose substantial response burden. We formulate conversational administration as an ordinal label-recovery problem: the system actively elicits a small set of symptom clusters and maps each response to the original severity labels. We used 3,320 complete participant-days from the mcPHASES dataset, covering cramps, mood swing, fatigue, sleep issues, stress, and bloating on a six-level scale. Six participants were reserved for development and 36 for a frozen evaluation comprising 360 participant-days and 2,160 item labels. A ModernBERT evidence gate detected whether a symptom was expressed, and Qwen2.5-1.5B-Instruct produced deterministic structured severity scores. Fixed six-item questioning achieved a quadratic weighted kappa of 0.976, whereas three joint symptom-cluster questions achieved 0.913, 97.45% agreement within one severity level, and 80.94% recall for moderate-or-higher symptoms while reducing questions by 50%. Open-first adaptive policies required 3.92-5.98 questions and produced lower agreement than the corresponding fixed policies. Participant-cluster bootstrap analysis estimated a kappa difference of -0.062 (95% CI -0.076 to -0.048) between the three-cluster and six-item strategies. Active cluster-level elicitation provides a direct, local-model route from natural conversation to reusable daily symptom labels.