# Budget-Aware Routing for Long Clinical Text

arXiv: https://arxiv.org/abs/2605.00336 · HTML: https://mlsanity.com/paper/2605.00336/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 8 of its 24 references that are in the map.
- First posted on arXiv 1 May 2026.

## Builds on (most cited first, 8 of 8)

- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [LongBench: A Bilingual, Multitask Benchmark for Long Context Understanding](https://mlsanity.com/paper/2308.14508/) (2023)
- [Get To The Point: Summarization with Pointer-Generator Networks](https://mlsanity.com/paper/1704.04368/) (2017)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [Text Summarization with Pretrained Encoders](https://mlsanity.com/paper/1908.08345/) (2019)
- [A Discourse-Aware Attention Model for Abstractive Summarization of Long Documents](https://mlsanity.com/paper/1804.05685/) (2018)
- [BIGPATENT: A Large-Scale Dataset for Abstractive and Coherent Summarization](https://mlsanity.com/paper/1906.03741/) (2019)

## Abstract (arXiv)

A key challenge for large language models is token cost per query and overall deployment cost. Clinical inputs are long, heterogeneous, and often redundant, while downstream tasks are short and high stakes. We study budgeted context selection, where a subset of document units is chosen under a strict token budget so an off-the-shelf generator can meet fixed cost and latency constraints. We cast this as a knapsack-constrained subset selection problem with two design choices, unitization that defines document segmentation and selection that determines which units are kept. We propose RCD, a monotone submodular objective that balances relevance, coverage, and diversity. We compare sentence, section, window, and cluster-based unitization, and introduce a routing heuristic that adapts to the budget regime. Experiments on MIMIC discharge notes, Cochrane abstracts, and L-Eval show that optimal strategies depend on the evaluation setting. Positional heuristics perform best at low budgets in extractive tasks, while diversity-aware methods such as MMR improve LLM generation. Selector choice matters more than unitization, with cluster-based grouping reducing performance and other schemes behaving similarly. ROUGE saturates for LLM summaries, while BERTScore better reflects quality differences. We release our code at https://github.com/stone-technologies/ACLbudgetpaper.