Reflecting What Matters: Same-Surgery References for Postoperative Clinical Note Generation

Seungmi Yu, Somin Song, Hyeryun Park, Jinwook Choi


Abstract
Generating the first postoperative outpatient note requires selecting which information from heterogeneous clinical records should be reflected in the final note, rather than merely summarizing all inputs. We evaluate this task on an original 170-case set of de-identified clinical cases collected at Seoul National University Hospital (SNUH), involving two surgical divisions and five physicians. We then extend the evaluation to 1,329 cases across 10 surgery groups within the same institution to examine whether the main trends persist at a larger scale. We introduce physician- and surgery-specific same-surgery references: structured reflection maps that capture how information is selected and rewritten in prior same-surgery cases. Experiments show that these references become most effective when carried into the merge stage, suggesting that the main bottleneck is deciding what to reflect across records. We further show that cross-patient references can induce unsupported transfer from prior cases. To analyze this trade-off, we use a human-validated two-source FactScore that checks each generated fact against both the source records and the physician-written note. A lightweight grounding constraint reduces hallucination while maintaining or improving alignment with physician-written notes across divisions and LLMs.
Anthology ID:
2026.findings-emnlp.1291
Volume:
Findings of the Association for Computational Linguistics: EMNLP 2026
Month:
October
Year:
2026
Address:
Budapest, Hungary
Editors:
Hung-Yi Lee, Sunipa Dev, Jessy Li, Desmond Elliott
Venue:
Findings
SIG:
SIGDAT
Publisher:
Association for Computational Linguistics
Note:
Pages:
27314–27326
Language:
URL:
https://aclanthology.org/2026.findings-emnlp.1291/
DOI:
10.18653/2026.findings-emnlp.1291
Bibkey:
Cite (ACL):
Seungmi Yu, Somin Song, Hyeryun Park, and Jinwook Choi. 2026. Reflecting What Matters: Same-Surgery References for Postoperative Clinical Note Generation. In Findings of the Association for Computational Linguistics: EMNLP 2026, pages 27314–27326, Budapest, Hungary. Association for Computational Linguistics.
Cite (Informal):
Reflecting What Matters: Same-Surgery References for Postoperative Clinical Note Generation (Yu et al., Findings 2026)
Copy Citation:
PDF:
https://aclanthology.org/2026.findings-emnlp.1291.pdf