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.

Step-by-step reasoning has become a standard approach for large language models (LLMs) to tackle complex tasks. While this paradigm has proven effective, it raises a fundamental question: How can we verify that an LLM’s reasoning is accurately grounded in knowledge? To address this question, we introduce a novel evaluation suite that systematically assesses the knowledge grounding of intermediate reasoning. Our framework comprises three key components. (1) Principal Knowledge Collection, a large-scale repository of atomic knowledge essential for reasoning. Based on the collection, we propose (2) knowledge-grounded evaluation metrics designed to measure how well models recall and apply prerequisite knowledge in reasoning. These metrics are computed by our (3) evaluator LLM, a lightweight model optimized for cost-effective and reliable metric computation. Our evaluation suite demonstrates remarkable effectiveness in identifying missing or misapplied knowledge elements, providing crucial insights for uncovering fundamental reasoning deficiencies in LLMs. Beyond evaluation, we demonstrate how these metrics can be integrated into preference optimization, showcasing further applications of knowledge-grounded evaluation. Our evaluation suite is publicly available.

Recent advancements in large language models (LLM) capable of processing extremely long texts highlight the need for a dedicated evaluation benchmark to assess their long-context capabilities. However, existing methods, like the needle-in-a-haystack test, do not effectively assess whether these models fully utilize contextual information, raising concerns about the reliability of current evaluation techniques. To thoroughly examine the effectiveness of existing benchmarks, we introduce a new metric called information coverage (IC), which quantifies the proportion of the input context necessary for answering queries. Our findings indicate that current benchmarks exhibit low IC; although the input context may be extensive, the actual usable context is often limited. To address this, we present ETHIC, a novel benchmark designed to assess LLMs’ ability to leverage the entire context. Our benchmark comprises 1,986 test instances spanning four long-context tasks with high IC scores in the domains of books, debates, medicine, and law. Our evaluations reveal significant performance drops in contemporary LLMs, highlighting a critical challenge in managing long contexts. Our benchmark is available at https://github.com/dmis-lab/ETHIC.