OptiMed at ArchEHR-QA 2026: GEPA Prompt Optimization and Multi-Agent Majority Voting for EHR-Grounded Question Answering

Feras AlMannaa, Talia Tseriotou, Maria Liakata


Abstract
Despite the demonstrated promise of Large Language Models in medical question answering, existing work largely addresses closed-form, exam-style tasks and overlooks complex open-ended questions requiring reasoning over noisy, long clinical documents. In this work, we present our system, OptiMed, submitted to the ArchEHR-QA 2026 shared task on grounded clinical question answering over EHR notes. We combine GEPA, an evolutionary prompt optimization framework, with multi-agent majority voting across five diverse LLMs and a structured clinical abstraction strategy for question interpretation. OptiMed ranked 1st overall among teams completing all four subtasks with an average score of 52.0, achieving top AlignScore in both Question Interpretation and Answer Generation, reflecting strong factual grounding. GEPA optimization proved effective for structured tasks with sufficient development data, but failed to generalize on complex generative tasks under very limited number of supervisions. Multi-agent majority voting consistently lifted performance in evidence-oriented subtasks. Prompt analysis attributes GEPA’s gains to role prompting and procedural decomposition and failures to over-specification under limited supervision.
Anthology ID:
2026.cl4health-1.51
Volume:
Proceedings of the Third Workshop on Patient-Oriented Language Processing (CL4Health) @ LREC 2026
Month:
May
Year:
2026
Address:
Palma, Mallorca (Spain)
Editors:
Deepak Gupta, Paul Thompson, Sophia Ananiadou, Dina Demner-Fushman
Venues:
CL4Health | WS
SIG:
Publisher:
ELRA Language Resources Association (ELRA)
Note:
Pages:
539–550
Language:
External URL:
https://lrec.elra.info/lrec2026-ws-cl4health-51
DOI:
10.63317/5gyu3jbn755r
Bibkey:
Cite (ACL):
Feras AlMannaa, Talia Tseriotou, and Maria Liakata. 2026. OptiMed at ArchEHR-QA 2026: GEPA Prompt Optimization and Multi-Agent Majority Voting for EHR-Grounded Question Answering. In Proceedings of the Third Workshop on Patient-Oriented Language Processing (CL4Health) @ LREC 2026, pages 539–550, Palma, Mallorca (Spain). ELRA Language Resources Association (ELRA).
Cite (Informal):
OptiMed at ArchEHR-QA 2026: GEPA Prompt Optimization and Multi-Agent Majority Voting for EHR-Grounded Question Answering (AlMannaa et al., CL4Health 2026)
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