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

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.

Neural at ArchEHR-QA 2025: Agentic Prompt Optimization for Evidence-Grounded Clinical Question Answering

Automated question answering (QA) over electronic health records (EHRs) can bridge critical information gaps for clinicians and patients, yet it demands both precise evidence retrieval and faithful answer generation under limited supervision. In this work, we present Neural, the runner-up in the BioNLP 2025 ArchEHR-QA shared task on evidence-grounded clinical QA. Our proposed method decouples the task into (1) sentence-level evidence identification and (2) answer synthesis with explicit citations. For each stage, we automatically explore the prompt space with DSPy's MIPROv2 optimizer, jointly tuning instructions and few-shot demonstrations on the development set. A self-consistency voting scheme further improves evidence recall without sacrificing precision. On the hidden test set, our method attains an overall score of 51.5, placing second stage while outperforming standard zero-shot and few-shot prompting by over 20 and 10 points, respectively. These results indicate that data-driven prompt optimization is a cost-effective alternative to model fine-tuning for high-stakes clinical QA, advancing the reliability of AI assistants in healthcare.