Anchoring Clinical Events in Time: UID-Preserving Multimodal Reconstruction and Source-Grounded Adjudication
UID-preserving multimodal framework plus GAVEL LLM judge improves clinical timeline reconstruction, boosting event recovery 43% over prior matching.
The paper introduces a UID-preserving framework linking each narrative clinical event to its source span through text-only estimation, structured-evidence retrieval, timestamped source-row grounding, and joint revision. GAVEL, an LLM judge, compares UID-aligned timelines against narrative and structured records. Across six open-weight models and 40 mixed-critical-care summaries, GLM 5.2 multimodal revision improved temporal agreement without reducing event recovery and performed competitively with clinician annotations, while DeepSeek V3.2 did not benefit from multimodality. The pipeline achieves 43% increased event recovery with occurrence-level provenance.
- UIDs preserve event retention; source-row linkage supports temporal placement.
- GAVEL LLM judge findings mostly upheld by blinded human review.
- 43% increased event recovery with occurrence-level provenance.
- Multimodal revision helps GLM 5.2 but not DeepSeek V3.2.
Full article192 words · extracted from arxiv.org · click to collapse
Clinical timelines support treatment-window analysis and leakage-free modeling, but discharge summaries often obscure chronology and structured EHR tables describe only part of the patient course. We present a UID-preserving framework that links each narrative event occurrence to its source span and retains that identity through text-only estimation, structured-evidence retrieval, timestamped source-row grounding, and joint revision. We also present GAVEL, an LLM judge that compares two UID-aligned timelines against the narrative and structured record, to augment prior matching and temporal assessments. Across six open-weight models and 40 mixed-critical-care summaries, the GLM 5.2 multimodal revision, as compared to its text-only variant, improved temporal agreement without reducing event recovery and performed competitively with clinician annotations, while other model revisions showed smaller gains and lower overall performance. Ablations showed that UIDs primarily preserve event retention, whereas source-row linkage supports temporal placement. Blinded human review upheld most GAVEL findings, and controlled adjudication favored multimodal over text-only GLM 5.2 but did not for DeepSeek V3.2. In developing the UID and judge pipeline, we are able to demonstrate 43\% increased event recovery, a framework competitive with clinician annotations, and a system with occurrence-level provenance for both reconstruction and evaluation.
Text extracted automatically; images, tables and formatting may be missing. Original: https://arxiv.org/abs/2609.13062