# Neural at ArchEHR-QA 2026: One Method Fits All: Unified Prompt Optimization for Clinical QA over EHRs

arXiv: https://arxiv.org/abs/2605.10877 · HTML: https://mlsanity.com/paper/2605.10877/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 10 of its 24 references that are in the map.
- First posted on arXiv 11 May 2026.

## Builds on (most cited first, 10 of 10)

- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [Large Language Models as Optimizers](https://mlsanity.com/paper/2309.03409/) (2023)
- [DSPy: Compiling Declarative Language Model Calls into Self-Improving Pipelines](https://mlsanity.com/paper/2310.03714/) (2023)
- [Optimizing Instructions and Demonstrations for Multi-Stage Language Model Programs](https://mlsanity.com/paper/2406.11695/) (2024)
- [AlignScore: Evaluating Factual Consistency with a Unified Alignment Function](https://mlsanity.com/paper/2305.16739/) (2023)
- [PromptAgent: Strategic Planning with Language Models Enables Expert-level Prompt Optimization](https://mlsanity.com/paper/2310.16427/) (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)
- [Neural at ArchEHR-QA 2025: Agentic Prompt Optimization for Evidence-Grounded Clinical Question Answering](https://mlsanity.com/paper/2506.10751/) (2025)

## Abstract (arXiv)

Automated question answering (QA) over electronic health records (EHRs) demands precise evidence retrieval, faithful answer generation, and explicit grounding of answers in clinical notes. In this work, we present Neural1.5, our method for the ArchEHR-QA 2026 shared task at CL4Health@LREC 2026, which comprises four subtasks: question interpretation, evidence identification, answer generation, and evidence alignment. Our approach decouples the task into independent, modular stages and employs DSPy"s MIPROv2 optimizer to automatically discover high-performing prompts, jointly tuning instructions and few-shot demonstrations for each stage. Within every stage, self-consistency voting over multiple stochastic inference runs suppresses spurious errors and improves reliability, while stage-specific verification mechanisms (e.g., self-reflection and chain-of-verification for alignment) further refine output quality. Among all teams that participated in all four subtasks, our method ranks second overall (mean rank 4.00), placing 4th, 1st, 4th, and 7th on Subtasks 1-4, respectively. These results demonstrate that systematic, per-stage prompt optimization combined with self-consistency mechanisms is a cost-effective alternative to model fine-tuning for multifaceted clinical QA.