The increasing utilization of patient portals has amplified clinicians’ workloads, primarily due to the necessity of addressing detailed patient inquiries related to their health concerns. The ArchEHR-QA 2025 shared task aims to alleviate this burden by automatically generating accurate, evidence-grounded responses to patients’ questions based on their Electronic Health Records (EHRs). This paper presents a six-stage multi-agent framework specifically developed to identify essential clinical sentences for answering patient questions, leveraging large language models (LLMs). Our approach begins with OpenAI’s o3 model generating focused medical context to guide downstream reasoning. In the subsequent stages, GPT-4.1-based agents assess the relevance of individual sentences, recruit domain experts, and consolidate their judgments to identify essential information for constructing coherent, evidence-grounded responses. Our framework achieved an Overall Factuality score of 62.0 and an Overall Relevance Score of 52.9 on the development set, and corresponding scores of 58.6 and 48.8, respectively, on the test set.

Generative models have become widely used in biomedical entity linking (BioEL) due to their excellent performance and efficient memory usage. However, these models are usually trained only with positive samples—entities that match the input mention’s identifier—and do not explicitly learn from hard negative samples, which are entities that look similar but have different meanings. To address this limitation, we introduce ANGEL (Learning from Negative Samples in Biomedical Generative Entity Linking), the first framework that trains generative BioEL models using negative samples. Specifically, a generative model is initially trained to generate positive entity names from the knowledge base for given input entities. Subsequently, both correct and incorrect outputs are gathered from the model’s top-k predictions. Finally, the model is updated to prioritize the correct predictions through preference optimization. Our models fine-tuned with ANGEL outperform the previous best baseline models by up to an average top-1 accuracy of 1.4% on five benchmarks. When incorporating our framework into pre-training, the performance improvement increases further to 1.7%, demonstrating its effectiveness in both the pre-training and fine-tuning stages. The code and model weights are available at https://github.com/dmis-lab/ANGEL.

Transforming natural language questions into SQL queries is crucial for precise data retrieval from electronic health record (EHR) databases. A significant challenge in this process is detecting and rejecting unanswerable questions that request information outside the database’s scope or exceed the system’s capabilities. In this paper, we introduce a novel text-to-SQL framework that focuses on standardizing the structure of questions into a templated format. Our framework begins by fine-tuning GPT-3.5-turbo, a powerful large language model (LLM), with detailed prompts involving the table schemas of the EHR database system. Our approach shows promising results on the EHRSQL-2024 benchmark dataset, part of the ClinicalNLP shared task. Although fine-tuning GPT achieves third place on the development set, it struggled with the diverse questions in the test set. With our framework, we improve our system’s adaptability and achieve fourth position in the official leaderboard of the EHRSQL-2024 challenge.

As the capabilities of Large Language Models (LLMs) expand, it becomes increasingly important to evaluate them beyond basic knowledge assessment, focusing on higher-level language understanding. This study introduces MultiPragEval, the first multilingual pragmatic evaluation of LLMs, designed for English, German, Korean, and Chinese. Comprising 1200 question units categorized according to Grice’s Cooperative Principle and its four conversational maxims, MultiPragEval enables an in-depth assessment of LLMs’ contextual awareness and their ability to infer implied meanings. Our findings demonstrate that Claude3-Opus significantly outperforms other models in all tested languages, establishing a state-of-the-art in the field. Among open-source models, Solar-10.7B and Qwen1.5-14B emerge as strong competitors. By analyzing pragmatic inference, we provide valuable insights into the capabilities essential for advanced language comprehension in AI systems.