Clinical notes in Electronic Health Records (EHRs) capture rich temporal information on events, clinician reasoning, and lifestyle factors often missing from structured data. Leveraging them for predictive modeling can be impactful for timely identification of chronic diseases. However, they present core natural language processing (NLP) challenges: long text, irregular event distribution, complex temporal dependencies, privacy constraints, and resource limitations. We present two complementary methods for temporally and contextually grounded risk prediction from longitudinal notes. First, we introduce HITGNN, a hierarchical temporal graph neural network that integrates intranote temporal event structures, inter-visit dynamics, and medical knowledge to model patient trajectories with fine-grained temporal granularity. Second, we propose REVEAL, a lightweight test-time framework that distills LLMs’ reasoning into smaller verifier models. Applied to opportunistic screening for Type 2 Diabetes (T2D) using temporally realistic cohorts curated from private and public hospital corpora, HITGNN achieves the highest predictive accuracy—especially for near-term risk—while preserving privacy and limiting reliance on large proprietary models. REVEAL enhances sensitivity to true T2D cases and retains explanatory reasoning. Our ablations confirm the value of temporal structure and knowledge augmentation, and fairness analysis shows HITGNN performs more equitably across subgroups.

Large language models (LLMs) are increasingly used to support question answering and decision-making in high-stakes, domain-specific settings such as natural hazard response and infrastructure planning, where effective answers must convey fine-grained, decision-critical details. However, existing evaluation frameworks for retrieval-augmented generation (RAG) and open-ended question answering primarily rely on surface-level similarity, factual consistency, or semantic relevance, and often fail to assess whether responses provide the specific information required for domain-sensitive decisions. To address this gap, we propose a multi-dimensional, reference-free evaluation framework that assesses LLM outputs along four complementary dimensions: specificity, context utilization, robustness to paraphrasing and semantic perturbations, and answer relevance. We introduce ClimateRiskQA, a curated dataset of 1,412 domain-specific question–answer pairs spanning 40 professional roles and seven natural hazard types, and further evaluate on PubMedQA to examine cross-domain generalization. We also conduct human evaluation to assess inter-annotator agreement and alignment between model outputs and human judgments, which highlights the inherent subjectivity of open-ended, domain-specific evaluation. Our results show that no single metric sufficiently captures answer quality in isolation and demonstrate the need for structured, multi-metric evaluation frameworks when deploying LLMs in high-stakes applications.

Temporal information extraction from unstructured text is essential for contextualizing events and deriving actionable insights, particularly in the medical domain. We address the task of extracting clinical events and their temporal relations using the well-studied I2B2 2012 Temporal Relations Challenge corpus. This task is inherently challenging due to complex clinical language, long documents, and sparse annotations. We introduce GraphTREx, a novel method integrating span-based entity-relation extraction, clinical large pre-trained language models (LPLMs), and Heterogeneous Graph Transformers (HGT) to capture local and global dependencies. Our HGT component facilitates information propagation across the document through innovative global landmarks that bridge distant entities and improves the state-of-the-art with 5.5% improvement in the tempeval F1 score over the previous best and up to 8.9% improvement on long-range relations, which presents a formidable challenge. We further demonstrate generalizability by establishing a strong baseline on the E3C corpus. Not only does this work advance temporal information extraction, but also lays the groundwork for improved diagnostic and prognostic models through enhanced temporal reasoning.

Community question answering forums provide a convenient platform for people to source answers to their questions including those related to healthcare from the general public. The answers to user queries are generally long and contain multiple different perspectives, redundancy or irrelevant answers. This presents a novel challenge for domain-specific concise and correct multi-answer summarization which we propose in this paper.

We describe our approach for the 1st Computational Linguistics Lay Summary Shared Task CL-LaySumm20. The task is to produce non-technical summaries of scholarly documents. The summary should be within easy grasp of a layman who may not be well versed with the domain of the research article. We propose a two step divide-and-conquer approach. First, we judiciously select segments of the documents that are not overly pedantic and are likely to be of interest to the laity, and over-extract sentences from each segment using an unsupervised network based method. Next, we perform abstractive summarization on these extractions and systematically merge the abstractions. We run ablation studies to establish that each step in our pipeline is critical for improvement in the quality of lay summary. Our approach leverages state-of-the-art pre-trained deep neural network based models as zero-shot learners to achieve high scores on the task.