# QU-NLP at ArchEHR-QA 2026: Two-Stage QLoRA Fine-Tuning of Qwen3-4B for Patient-Oriented Clinical Question Answering and Evidence Sentence Alignment

arXiv: https://arxiv.org/abs/2604.14175 · HTML: https://mlsanity.com/paper/2604.14175/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 6 of its 20 references that are in the map.
- First posted on arXiv 26 Mar 2026.

## Builds on (most cited first, 6 of 6)

- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [AlignScore: Evaluating Factual Consistency with a Unified Alignment Function](https://mlsanity.com/paper/2305.16739/) (2023)
- [emrQA: A Large Corpus for Question Answering on Electronic Medical Records](https://mlsanity.com/paper/1809.00732/) (2018)
- [ACI-BENCH: a Novel Ambient Clinical Intelligence Dataset for Benchmarking Automatic Visit Note Generation](https://mlsanity.com/paper/2306.02022/) (2023)
- [A Dataset for Addressing Patient's Information Needs related to Clinical Course of Hospitalization](https://mlsanity.com/paper/2506.04156/) (2025)

## Abstract (arXiv)

We present a unified system addressing both Subtask 3 (answer generation) and Subtask 4 (evidence sentence alignment) of the ArchEHR-QA Shared Task. For Subtask 3, we apply two-stage Quantised Low-Rank Adaptation (QLoRA) to Qwen3-4B loaded in 4-bit NF4 quantisation: first on 30,000 samples from the emrQA-MedSQuAD corpus to establish clinical domain competence, then on the 20 annotated development cases to learn the task-specific output style. Our system achieves an overall score of 32.87 on the official test-2026 split (BLEU = 9.42, ROUGE-L = 27.04, SARI = 55.42, BERTScore = 43.00, AlignScore = 25.28, MEDCON = 37.04). For Subtask 4, we develop a weighted ensemble of three retrieval methods - BM25 with relative thresholding, TF-IDF cosine similarity, and a fine-tuned cross-encoder - to identify note sentences supporting a given gold answer, achieving a micro-F1 of 67.16 on the 100-case test set. Experiments reveal that both subtasks expose the same fundamental challenge: 20 annotated training cases are insufficient to distinguish relevant from irrelevant clinical sentences, pointing to data augmentation as the highest-leverage future direction.