Coverage-Controlled Preference Mining from Noisy Claim Verification for Evidence-Grounded Generation

Evidence-grounded generation produces summaries whose claims should be supported by supplied evidence, but claim-level verifiers provide noisy feedback and can reward models that simply say less. We study this problem in clinical Brief Hospital Course summarization, where outputs must remain grounded in patient-specific EHR evidence. We introduce VERI-DPO, a preference-mining framework that converts noisy claim verification into coverage-controlled summary-level preferences. For each evidence-window prompt, VERI-DPO samples multiple candidate summaries, decomposes them into claims, verifies each claim against patient evidence, and forms a preference pair only when the chosen summary has better aggregate verifier-estimated support while retaining comparable verifiable content. Standard Direct Preference Optimization then distills these pairs into a single-sample policy, avoiding inference-time reranking. On patient-disjoint MIMIC-III-Ext-VeriFact-BHC test data, VERI-DPO reduces Not Supported rates from 10.7% to 1.9% under the mining verifier and from 11.6% to 6.4% under a separately prompted GPT-4o judge. In 100 blinded pairwise assessments by two domain researchers, VERI-DPO is preferred over the base model 56 times versus 18 times for factual faithfulness. In a locked zero-shot MIMIC-IV-Ext-BHC transfer test with 1,000 patients and no model adaptation, VERI-DPO lowers Not Supported rates with nearly unchanged scored-claim counts. Multi-seed ablations show that verifier-guided pair construction drives the gains, while coverage and anti-degeneration controls prevent apparent factuality improvements from coming from shorter or less checkable outputs.