CAP: A Source-Grounded Proposition Scaffold for Faithful Clinical Dialogue-to-Note Generation

Hyunkyung Lee, Jisoo Jung, Jeonguk Lee, Jaehyo Yoo, Wooseok Han, Minkyu Kim, Gibaeg Kim


Abstract
Clinical dialogue-to-note generation is challenging because clinically salient evidence is noisy, distributed across turns, and often revised later in the encounter. Direct transcript-only prompting and coarse intermediate scaffolds can therefore suffer from omissions, section leakage, unsupported fill-in, and brittle final-state tracking. We propose Clinical Atomic Propositions (CAPs), a dialogue-aware intermediate representation for faithful clinical note generation. CAPs extract source-grounded clinical assertions while preserving modifiers such as verification status, temporality, speaker/source, and action type. We also study an optional event consolidation layer that groups CAPs into problem-oriented care bundles before note rendering. We evaluate five methods on a 197-case ACI-Bench cohort: a transcript-only baseline, prompt-based reimplementations of Cluster2Sent and MEDSUM-ENT, CAP, and CAP+Event. The main task uses a sectioned-note template, with SOAP-template rendering and transcript-free rendering reported as ablations. We use MEDSUM-ENT-style GPT-R/P/F1 metrics and a proposition-grounded semCAP-R/P/F1 audit to measure concept-level and source-grounded faithfulness, complemented by case-level win/tie/loss analysis and clinician deep review. Results show that CAP improves preservation of transcript-grounded clinical propositions while remaining competitive on concept-level GPT metrics. CAP+Event is not uniformly better than CAP, but qualitative and boundary analyses show when problem-oriented consolidation can improve organization and when compression can introduce omissions. We release code, prompts, intermediate representations, generated notes, and evaluation artifacts at a public repository.
Anthology ID:
2026.bionlp-1.46
Volume:
BioNLP 2026
Month:
July
Year:
2026
Address:
San Diego, California
Editors:
Dina Demner-Fushman, Sophia Ananiadou, Kirk Roberts, Junichi Tsujii
Venues:
BioNLP | WS
SIG:
Publisher:
Association for Computational Linguistics
Note:
Pages:
572–594
Language:
URL:
https://preview.aclanthology.org/ingest-acl-workshops/2026.bionlp-1.46/
DOI:
Bibkey:
Cite (ACL):
Hyunkyung Lee, Jisoo Jung, Jeonguk Lee, Jaehyo Yoo, Wooseok Han, Minkyu Kim, and Gibaeg Kim. 2026. CAP: A Source-Grounded Proposition Scaffold for Faithful Clinical Dialogue-to-Note Generation. In BioNLP 2026, pages 572–594, San Diego, California. Association for Computational Linguistics.
Cite (Informal):
CAP: A Source-Grounded Proposition Scaffold for Faithful Clinical Dialogue-to-Note Generation (Lee et al., BioNLP 2026)
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PDF:
https://preview.aclanthology.org/ingest-acl-workshops/2026.bionlp-1.46.pdf