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.