clinical documentation teams

Abstract: In mental health care, reasoning over patient journeys is a key task for clinicians. Yet these journeys, encompassing a longitudinal progression of biological, psychological, and social events, are often spread across disparate unstructured text narratives, making temporal recovery challenging. We present CliniCIRCA, a multi-stage LLM framework for Calendar-anchored, Imprecision-aware Reconstruction of Clinical Annals. To our knowledge, CliniCIRCA is the first to temporally classify clinical events across unstructured discharge summaries without event-level timestamps. From 14,882 MIMIC-III mental health admissions, we first construct a benchmark of 52 discharge summaries on which CliniCIRCA produces 15,891 temporally tagged events. After correcting 629 errors based on a clinician-in-the-loop evaluation, we produce verified gold-standard labels. Finally, the corrected timelines drive a temporally grounded summarization stage that compresses each source 1.52 times into a date-grouped chronological record. We then scale the framework to generate 1,000 silver-standard timelines and evaluate them as training data. Compared with zero- and few-shot prompting, instruction tuning generally improves five open-weight models on event extraction, temporal tagging, and summarization across silver and clinician-verified evaluations.

Abstract: Large language models have made abstractive summarization remarkably fluent, but generated summaries can hallucinate facts, posing serious risks in biomedical and clinical domains. We address this by removing generation from the pipeline and framing summarization as extractive sentence selection. Our Hybrid Hierarchical CNN-LSTM Summarizer uses stacked multi-kernel convolutions to compose sentence-level embeddings into richer inter-sentence representations, followed by a bidirectional LSTM to model long-range dependencies across the document. A lightweight scoring head assigns per-sentence importance scores and is trained end-to-end with binary cross-entropy against oracle extractive labels. At inference, a dynamic mean-plus-standard-deviation threshold with a top-3 fallback selects sentences directly from the source and chronologically reorders them into the final summary. Since every output sentence is copied from the input, the model avoids generation-induced factual drift. On PubMed, our architecture outperforms isolated CNN and LSTM baselines, while ablations show that wider convolutional receptive fields improve sentence scoring. On MIMIC-CXR and MIMIC-IV BHC, the model performs well on unstructured narratives but defaults toward positional baselines on highly templated reports. These results suggest that structural constraints can provide a reliable path toward factually grounded summarization systems that are trustworthy by design rather than by correction.