Large language models have made abstractive summarization remarkably fluent, but generated summaries can hallucinate facts, posing serious risks in biomedical and clinical domains. We address this by removing generation from the pipeline and framing summarization as extractive sentence selection. Our Hybrid Hierarchical CNN-LSTM Summarizer uses stacked multi-kernel convolutions to compose sentence-level embeddings into richer inter-sentence representations, followed by a bidirectional LSTM to model long-range dependencies across the document. A lightweight scoring head assigns per-sentence importance scores and is trained end-to-end with binary cross-entropy against oracle extractive labels. At inference, a dynamic mean-plus-standard-deviation threshold with a top-3 fallback selects sentences directly from the source and chronologically reorders them into the final summary. Since every output sentence is copied from the input, the model avoids generation-induced factual drift. On PubMed, our architecture outperforms isolated CNN and LSTM baselines, while ablations show that wider convolutional receptive fields improve sentence scoring. On MIMIC-CXR and MIMIC-IV BHC, the model performs well on unstructured narratives but defaults toward positional baselines on highly templated reports. These results suggest that structural constraints can provide a reliable path toward factually grounded summarization systems that are trustworthy by design rather than by correction.
Figures & tables
Fig. 1: Overall architecture of the proposed Hybrid Hierarchical Stacked 1D-CNN-BiLSTM Summarizer, detailing tensor transformations and sequence dimensions at each pipeline stage.
Fig. 2: Conceptual flow of the hierarchical 1D-CNN stack. Lower-order sentence-level features are progressively composed into higher-order factual units layer by layer.
Model Architecture / Variant
ROUGE-1
ROUGE-2
ROUGE-L
Lead-3 Baseline
0.5439
0.5398
0.5421
TextRank Baseline
0.5628
0.5015
0.5419
BERTSUM Baseline
0.5581
0.5103
0.5439
Vanilla BERT + Proposed Stack
0.6780
0.6720
0.6788
Proposed Model (SciBERT + Stack)
0.7143
0.7090
0.7191
TABLE I: Performance Comparison on the PubMed Benchmark Dataset
Method
ROUGE-1
ROUGE-2
ROUGE-L
MIMIC-CXR Dataset
Lead-3 Baseline
0.1728
0.0773
0.1482
TextRank
0.1829
0.0762
0.1600
Proposed Model
0.1741
0.0773
0.1499
MIMIC-IV BHC Dataset
Lead-3 Baseline
0.2062
0.0708
0.1351
TABLE II: Comparative Benchmarking on MIMIC-CXR and MIMIC-IV BHC
Ablation Variant
ROUGE-1
ROUGE-2
ROUGE-L
CNN-Only
0.6339
0.6191
0.6312
LSTM-Only
0.6766
0.6712
0.6741
Proposed Full Stack
0.7143
0.7090
0.7191
TABLE III: Ablation Study: Component Isolation and Hybrid Coupling (PubMed)
Large language models (LLMs) have shown promise on summarization tasks, but they often produce hallucinations, which are unsupported or incorrect statements that limit their reliability in specialized healthcare applications. We introduce Hallucination Detection Guided Self-Refinement (HDSR), an inference-time method that leverages hallucination detectors to guide iterative summary revisions toward factual corrections. Building on this, we propose HDSR for Preference Learning (HDSR-PL), which converts detector-guided refinement trajectories into preference pairs for model finetuning. Extensive experiments show that our methods substantially reduce hallucinations for Llama and Gemma models in summarizing real-world clinical notes from MIMIC-IV-Note v2.2. For example, HDSR reduces 24% and HDSR-PL reduces 48% hallucinations in Llama-3.1-8B-Instruct. Importantly, both methods preserve summary fluency, coherence, and relevance according to human expert and LLM-Jury evaluations. Together, these results demonstrate that detection-informed refinement and preference learning offer an automated solution for improving factual faithfulness in clinical summarization.
Shamanth Kuthpadi Seethakantha, Dung Ngoc Thai, Vara Prasad Gudi +6
1Manning College of Information and Computer Sciences · 2Ensemble HP · 3Columbia University +1
Abstractive summarization models remain vulnerable to factual inconsistency, redundancy, and weak length control. We propose a modular generation-and-selection framework for sentence-budget-constrained summarization. A pretrained generator produces multiple candidate summaries, which are decomposed into sentence-level candidates. A combinatorial selector then constructs the final summary by balancing relevance, factuality, and redundancy under an explicit budget. The framework supports MMR, ILP, and a DPP-inspired log-determinant objective without retraining the generator. Experiments on CNN/DailyMail, Multi-News, FaithBench, and TofuEval show consistent improvements in factuality and source-grounding metrics, especially for multi-document summarization, at the cost of lower reference-overlap scores. Human evaluation further indicates higher perceived consistency, relevance, clarity, and conciseness, with a small reduction in coherence. These results show that decoupling generation from selection provides a model-agnostic mechanism for improving factual grounding. Code is available at https://anonymous.4open.science/r/bcfs-D05E/.
Large language models (LLMs) are increasingly used for medical summarization, but their outputs can omit medically important information and introduce unsupported claims. Existing error-detection methods produce heuristic or uncalibrated scores, providing no formal control over missed errors and no principled way to trade off safety against clinician review burden. We introduce Conformal Assessment for Risk Evaluation (CARE), a post-hoc, model-agnostic safety layer that uses conformal risk control to overlay calibrated omission and hallucination flags onto summaries from any LLM without retraining. CARE provides finite-sample, distribution-free guarantees through two controllers: a hallucination controller that bounds the probability of a document containing any unflagged hallucinated sentence, and an omission controller that bounds the expected fraction of important omissions not surfaced for review. Unlike hallucination detection, omissions depend jointly on whether a source sentence is important and whether it is covered by the summary. We show that calibrating only one dimension can violate the target risk bound, while marginal decompositions remain valid but overly conservative. By jointly calibrating over the full (τ,γ) threshold space, CARE preserves formal guarantees while surfacing up to 5× fewer sentences than alternative calibrated baselines. Across five medical summarization tasks, CARE satisfies the target risk bound at α=0.15 with 95% confidence across 100 calibration/test resplits, using only ~100 labeled documents per domain. In a preliminary clinician study (75 document reviews), calibrated flags improved omission detection by 28.6 percentage points on average. These results show that sentence-level safety guarantees are feasible for LLM-assisted medical summarization and offer a tunable mechanism for balancing residual risk and review effort.
Suhana Bedi, Bridget Lin, Anson Y. Zhou +5
Department of Biomedical Data Science, Stanford University · Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University · Department of Computer Science, Stanford University +2