Kejing Yin

Longitudinal multimodal data, including electronic health records (EHR) and sequential chest X-rays (CXRs), is critical for modeling disease progression, yet remains underutilized due to two key challenges: (1) redundancy in consecutive CXR sequences, where static anatomical regions dominate over clinically-meaningful dynamics, and (2) temporal misalignment between sparse, irregular imaging and continuous EHR data. We introduce DiPro, a novel framework that addresses these challenges through region-aware disentanglement and multi-timescale alignment. First, we disentangle static (anatomy) and dynamic (pathology progression) features in sequential CXRs, prioritizing disease-relevant changes. Second, we hierarchically align these static and dynamic CXR features with asynchronous EHR data via local (pairwise interval-level) and global (full-sequence) synchronization to model coherent progression pathways. Extensive experiments on the MIMIC dataset demonstrate that DiPro could effectively extract temporal clinical dynamics and achieve state-of-the-art performance on both disease progression identification and general ICU prediction tasks.

Vision-language models have been explored for radiology report generation with promising results. Yet, uncertainty elaborated in findings and the reasoning process for reaching clinical impressions are seldom explicitly modeled, reducing the clinical accuracy and trustworthiness of the generated reports. We present CURV, a novel framework that alleviates the limitations through integrated awareness of uncertainty and explicit reasoning capabilities. Our approach consists of three key components: (1) an uncertainty modeling mechanism that teaches the model to recognize and express appropriate levels of diagnostic confidence, (2) a structured reasoning framework that generates intermediate explanatory steps connecting visual findings to clinical impressions, and (3) a reasoning coherence reward that ensures logical consistency among findings, reasoning, and impressions. We implement CURV through a three-stage training pipeline that combines uncertainty-aware fine-tuning, reasoning initialization, and reinforcement learning. In particular, we adopt a comprehensive reward function addresses multiple aspects of report quality, incorporating medical term matching, uncertainty expression evaluation, and semantic coherence evaluation. Experimental results demonstrate that CURV generates clinically relevant reports with appropriate uncertainty expressions and transparent reasoning traces, significantly outperforming previous methods. CURV represents a substantial advancement toward interpretable and trustworthy AI-generated radiology reports, with broader implications for the deployment of vision-language models in high-stakes clinical environments where uncertainty awareness and reasoning transparency are essential.

Integrating multi-modal clinical data, such as electronic health records (EHR) and chest X-ray images (CXR), is particularly beneficial for clinical prediction tasks. However, in a temporal setting, multi-modal data are often inherently asynchronous. EHR can be continuously collected but CXR is generally taken with a much longer interval due to its high cost and radiation dose. When clinical prediction is needed, the last available CXR image might have been outdated, leading to suboptimal predictions. To address this challenge, we propose DDL-CXR, a method that dynamically generates an up-to-date latent representation of the individualized CXR images. Our approach leverages latent diffusion models for patient-specific generation strategically conditioned on a previous CXR image and EHR time series, providing information regarding anatomical structures and disease progressions, respectively. In this way, the interaction across modalities could be better captured by the latent CXR generation process, ultimately improving the prediction performance. Experiments using MIMIC datasets show that the proposed model could effectively address asynchronicity in multimodal fusion and consistently outperform existing methods.

The combination of electronic health records (EHR) and medical images is crucial for clinicians in making diagnoses and forecasting prognoses. Strategically fusing these two data modalities has great potential to improve the accuracy of machine learning models in clinical prediction tasks. However, the asynchronous and complementary nature of EHR and medical images presents unique challenges. Missing modalities due to clinical and administrative factors are inevitable in practice, and the significance of each data modality varies depending on the patient and the prediction target, resulting in inconsistent predictions and suboptimal model performance. To address these challenges, we propose DrFuse to achieve effective clinical multi-modal fusion. It tackles the missing modality issue by disentangling the features shared across modalities and those unique within each modality. Furthermore, we address the modal inconsistency issue via a disease-wise attention layer that produces the patient- and disease-wise weighting for each modality to make the final prediction. We validate the proposed method using real-world large-scale datasets, MIMIC-IV and MIMIC-CXR. Experimental results show that the proposed method significantly outperforms the state-of-the-art models.

Predictive analysis of electronic health records (EHR) is a fundamental task that could provide actionable insights to help clinicians improve the efficiency and quality of care. EHR are commonly recorded in binary format and contain inevitable missing data. The nature of missingness may vary by patients, clinical features, and time, which incurs observation bias. It is essential to account for the binary missingness and observation bias or the predictive performance could be substantially compromised. In this paper, we develop a propensity-adjusted temporal network (PATNet) to conduct data imputation and predictive analysis simultaneously. PATNet contains three subnetworks: 1) an imputation subnetwork that generates the initial imputation based on historical observations, 2) a propensity subnetwork that infers the patient-, feature-, and time-dependent propensity scores, and 3) a prediction subnetwork that produces the missing-informative prediction using the propensity-adjusted imputations and the missing probabilities. To allow the propensity scores to be inferred from data, we use the expectation-maximization (EM) algorithm to learn the imputation and propensity subnetworks and incorporate a low-rank constraint via PARAFAC2 approximation. Extensive evaluation using the MIMIC-III and eICU datasets demonstrates that PATNet outperforms the state-of-the-art methods in terms of binary data imputation, disease progression modeling, and mortality prediction tasks.