Transformer-Based Health Record Summarisation with Auditable Source Attribution: An Audit-Ready Methods Framework
DOI:
https://doi.org/10.66687/4xkjq158Keywords:
Artificial Intelligence, Machine Learning, Medical Informatics, Decision Support Systems, Clinical, Reproducibility of ResultsAbstract
Clinical summarisation systems can sound convincing while omitting decisive events or attributing facts to the wrong encounter. To address this, the study will measure whether source-linked transformer summaries reduce unverifiable statements without sacrificing important clinical detail. The research design centres on a blinded assessment of de-identified clinical narratives paired with evidence passages and structured omission/error rubrics. The choice of evaluation units and exclusion criteria is informed by the broader methodological record [3–7]. The analysis will contrast ordinary abstractive summaries, retrieval-supported summaries and provenance-constrained summaries. The audit-focused extension preserves processing logs, model decisions and exception handling for independent review. Enterprise-storage sources are used to specify constraints on data availability and provenance [1], with complementary infrastructure evidence defining practical recovery safeguards [2]. These citations are not treated as clinical effectiveness evidence. Assessment will focus on claim-level factual accuracy, critical omission rate, evidence traceability and clinician review time. The supporting evidence base motivates the chosen comparator conditions and robustness criteria [8–12]. Critical sensitivity checks address ambiguous documentation, conflicting observations, retrieval gaps and variations in note length. Further systems and modelling literature supplies context for the proposed sensitivity analyses [13–17]. Uncertain outcomes would be adjudicated with a predefined rubric, rather than silently recoded as successes. The expected output is a reusable evaluation framework with transparent uncertainty and reporting rules, informed by wider reproducibility literature [18–23].
References
[1] Mohammed Nazir. (2021). Automating Enterprise Storage Provisioning with PowerShell and Python: Effects on Deployment Time and Configuration Errors. Journal of Multidisciplinary Research and Integrated Sciences, 1(1), 43–55. https://jmris.com/index.php/jmris/article/view/2021P1V6
[2] Mohammed Nazir. (2024). Scenario-Based Disaster Recovery Training for Improving Incident-Response and RTO/RPO Decision-Making Among Enterprise Cloud Engineers. Journal of Computing, Intelligence and Information Sciences, 5(1). https://jciis.com/index.php/jciis/article/view/2024-01-05
[3] Esteva, A., Kuprel, B., Novoa, R. A., et al. (2017). Dermatologist-level classification of skin cancer with deep neural networks. Nature, 542, 115–118. https://www.nature.com/articles/nature21056
[4] Johnson, A., Pollard, T., & Mark, R. (2016). MIMIC-III Clinical Database, version 1.4. PhysioNet. https://physionet.org/content/mimiciii/1.4/
[5] McKinney, S. M., Sieniek, M., Godbole, V., et al. (2020). International evaluation of an AI system for breast cancer screening. Nature, 577, 89–94. https://www.nature.com/articles/s41586-019-1799-6
[6] Begum, M. H., Talukder, S. I., Ahmed, M. J., Khan, M. F. I., & Azam, M. A. (2025). XAI-Driven Multimodal Deep Learning for Early Sepsis Prediction in ICU. Journal of Science Technology and Social Transformation, 1(1), 30–41. https://jstst.info/j/article/view/25
[7] Jumper, J., Evans, R., Pritzel, A., et al. (2021). Highly accurate protein structure prediction with AlphaFold. Nature, 596, 583–589. https://www.nature.com/articles/s41586-021-03819-2
[8] Liu, X., Faes, L., Kale, A. U., et al. (2020). Reporting guidelines for clinical trial reports for interventions involving artificial intelligence: the CONSORT-AI extension. Nature Medicine, 26, 1364–1374. https://www.nature.com/articles/s41591-020-1034-x
[9] Singhal, K., Azizi, S., Tu, T., et al. (2023). Large language models encode clinical knowledge. Nature, 620, 172–180. https://www.nature.com/articles/s41586-023-06291-2
[10] Lundberg, S. M., & Lee, S.-I. (2017). A Unified Approach to Interpreting Model Predictions. Advances in Neural Information Processing Systems, 30. https://arxiv.org/abs/1705.07874
[11] Alagappan, R. et al. (2019). Protocol-Aware Recovery for Consensus-Based Storage. USENIX ATC '19. https://www.usenix.org/conference/atc19/presentation/alagappan
[12] Vaswani, A., Shazeer, N., Parmar, N., et al. (2017). Attention Is All You Need. Advances in Neural Information Processing Systems, 30. https://arxiv.org/abs/1706.03762
[13] Guo, C. et al. (2017). On Calibration of Modern Neural Networks. Proceedings of Machine Learning Research, 70, 1321–1330. https://proceedings.mlr.press/v70/guo17a.html
[14] Zhou, W. et al. (2025). 3L-Cache: Low Overhead and Precise Learning-based Eviction Policy for Caches. USENIX FAST '25. https://www.usenix.org/conference/fast25/presentation/zhou-wenbin
[15] Jiao, B., Goel, A. & Wang, A.-I.A. (2025). Silhouette: Leveraging Consistency Mechanisms to Detect Bugs in Persistent Memory-Based File Systems. USENIX FAST '25. https://www.usenix.org/conference/fast25/presentation/jiao
[16] Xu, J. et al. (2021). Anomaly Transformer: Time Series Anomaly Detection with Association Discrepancy. arXiv:2110.02642. https://arxiv.org/abs/2110.02642
[17] Khan, M. F. I., Begum, M. H., Rahman, M. A., Limon, G. Q., Azam, M. A., & Masum, A. K. M. (2025). A comprehensive review of advances in transformer, GAN, and attention mechanisms: Their role in multimodal learning and applications across NLP. International Journal of Science and Research Archive, 15(1), 454–459. https://ijsra.net/content/comprehensive-review-advances-transformer-gan-and-attention-mechanisms-their-role
[18] Cao, Z., Kuenning, G. & Zadok, E. (2020). Carver: Finding Important Parameters for Storage System Tuning. USENIX FAST '20. https://www.usenix.org/conference/fast20/presentation/cao-zhen
[19] Mahdisoltani, F., Stefanovici, I. & Schroeder, B. (2017). Proactive Error Prediction to Improve Storage System Reliability. USENIX ATC '17. https://www.usenix.org/conference/atc17/technical-sessions/presentation/mahdisoltani
[20] Cidon, A. et al. (2013). Copysets: Reducing the Frequency of Data Loss in Cloud Storage. USENIX ATC '13. https://www.usenix.org/conference/atc13/technical-sessions/presentation/cidon
[21] Nachman, A., Yadgar, G. & Sheinvald, S. (2020). GoSeed: Generating an Optimal Seeding Plan for Deduplicated Storage. USENIX FAST '20. https://www.usenix.org/conference/fast20/presentation/nachman
[22] Levi, A. et al. (2024). Physical vs. Logical Indexing with IDEA: Inverted Deduplication-Aware Index. USENIX FAST '24. https://www.usenix.org/conference/fast24/presentation/levi
[23] Patel, T. et al. (2020). Uncovering Access, Reuse, and Sharing Characteristics of I/O-Intensive Files on Large-Scale Production HPC Systems. USENIX FAST '20. https://www.usenix.org/conference/fast20/presentation/patel-hpc-systems
Published
Issue
Section
License
Copyright (c) 2026 Julia Pakuła

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright in their published work. Unless an individual Version of Record identifies different terms, JMRIS articles are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0): https://creativecommons.org/licenses/by/4.0/. This permits sharing and adaptation, including commercial use, with appropriate attribution, a link to the license, and indication of changes. Third-party material may be subject to separate terms. Existing articles retain the license originally granted to their Version of Record; a policy update does not retrospectively replace that license.