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Thank you both.

Lunis--I've gone ahead and ordered DNS Pro 11 + Med Vocab from you on the strength of your recommendation.  But I'm still curious--the gist of prior discussions is that Medical is in a class by itself, engineered differently, so to speak, and not 'just' Pro + specialized vocab/language models.  If I understood those discussions rightly (a big if), I get it that 11 is such a big improvement over 10.1 that the equation has changed (DNS Pro 11 +Vocab > Med 10.1).  If you get a chance, though, I'd love to hear your thoughts about what difference Medical makes.

mcampbell--Very interesting that accuracy improves with running notes through the Accuracy Center.  Again, someone just listening to the discussions on ver. 11 would be struck by 'accuracy improved right out of the box without training,' and might presume that the addition of medical vocabulary would prempt the need for running notes.  Good to know.

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Lunis et al.,

First of all, the rules of the game have changed. Beginning with DNS 11, the EULA (End-User License Agreement) prohibits third-party vocabularies containing vocabulary that includes enhanced Language Models for versions of Dragon NaturallySpeaking below the Professional versions (Legal, Professional, or Medical). That is, it is perfectly permissible to distribute third-party vocabularies, particularly specialty vocabularies, such as medical, specialties or legal vocabularies, for DNS Home or Premium (DNS 11) that do not incorporate any related Language Models. This is why Voctool.exe has been eliminated from DNS 11.

You can't talk about accuracy relative to any version of DNS if you're simply going to talk about the General-Large vocabulary. There are no differences in terms of accuracy among any of the versions of DNS relative to the general vocabulary. There never has been from DNS 4.0 right on up through DNS 11. The Language Model in all versions for the General-Large vocabulary is identical. Therefore, talking about differences in accuracy among the various flavors of DNS (Home, Premium, Professional, Legal, or Medical) is a complete non sequitur. Accuracy is the same. The only difference as regards accuracy applies to the specialty vocabularies in those versions of DNS (Legal, or Medical) that contain such because these specialty vocabularies also include a related specialty Language Model. The only thing that these Language Models to is improve the accuracy of DNS relative to the specialty vocabularies. If you want to see the difference, try using DNS 10 Medical with the Cardiology medical vocabulary and language model and try to dictate a standard e-mail. This is simply because these Language Models are not designed for standard dictation. They are designed specifically for the specialty Incorporated into specific specialty vocabularies.

I generally concur with Lunis' assessment with regard to overall accuracy and third-party vocabularies sans Language Models specifically based on such, but this again is kind of a non sequitur. Any Professional version of DNS allows the user to create their own "Language Model" even in the absence of the Voctool.exe in DNS 11 versions because you can still adapt your user to your writing style by analyzing documents, which creates additions to the User slot that are just as effective as if you were able to use Voctool.exe and use the Middle slot. Not having accessibility to the Middle slot is not a significant disadvantage when using the current "Learn from specific documents" in the DNS 11 Accuracy Center. One of the reasons why this was eliminated in DNS 11, aside from preventing third-party developers from creating vocabulary/Language Model (Middle slot) vocabularies, the Middle slot was abused in most cases because it simply wasn't necessary, and still is currently unnecessary, and the way it was being used didn't really add any significant degree of improved accuracy even with specialty vocabularies. The User slot is sufficient for 99% of all cases.

So, if you import a collection of specially vocabulary words, you can always create your own adaptation to the current Language Model by using the "Learn from specific documents". Accuracy will improve for specialty circumstances, such as filling out patient records yada yada yada where specific vocabularies are required by using this method. For the most part, they will be just as accurate as if you were using DNS Medical with both the specialty vocabularies and the associated Language Model. So, there is no reason to be overly concerned because the differences in accuracy are inconsequential and often not noticeable. Any arguments to the contrary are simply moot.

Be careful what you wish for.  You may find that what you get is not what you expect, or what you want. - Aesop (620 BC - 700 BC modern interpretation)