UIC-AIHealth4All at ArchEHR-QA 2026: Answer-First Evidence Grounding for Clinical Question Answering

We describe the UIC-AIHealth4All system for ArchEHR-QA 2026, a shared task on grounded question answering from electronic health records. We participated in Subtasks 2 (evidence identification), 3 (answer generation), and 4 (answer-evidence alignment). For Subtasks 2 and 3, we propose an answer-first pipeline in which the model generates candidate answers citing specific note sentences before classifying the full evidence set, exploiting the asymmetry between judging relevance in the abstract versus relative to a generated answer. For Subtask 4, we apply self-consistency voting over five independent model calls, retaining links by vote threshold. Our pipeline ranked third on evidence identification (Strict Micro F1 62.90), ninth on answer generation (Overall 31.90), and fifth on answer-evidence alignment (F1 79.81). A post-hoc linguistic analysis of 45 stylistic features reveals that model outputs remain 3.2 Flesch-Kincaid grade levels harder to read than clinician-authored references despite matching their word and sentence counts, suggesting readability warrants explicit optimization in clinical NLP systems. Code and prompts are available at https://github.com/mo-arvan/archehr-qa-2026-uic-aihealth4all.