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:
- 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)
- PDF:
- https://preview.aclanthology.org/ingest-acl-workshops/2026.bionlp-1.46.pdf