融合电子病历与心电图数据,提升心血管疾病预测精度
MedM2T: A MultiModal Framework for Time-Aware Modeling with Electronic Health Record and Electrocardiogram Data
- 设计时序感知多模态框架,灵活处理不规则医疗时间序列
- 在三个临床任务中实现优于或相当的性能,如心血管预测AUROC达0.932
- 适合需要融合多源医疗数据进行疾病风险评估的研究者使用
医学数据具有固有的多模态性和异构时间结构,建模难度大。我们提出MedM2T,一种时序感知的多模态框架,以应对这些挑战。MedM2T包含:(i) 稀疏时间序列编码器,灵活处理不规则、稀疏的时间序列;(ii) 分层时序感知融合机制,捕捉多条密集时间序列(如心电图)中的微观与宏观时序模式;(iii) 双模态注意力机制,提取跨模态交互,可扩展至任意模态数量。为缓解不同模态间的粒度差异,MedM2T采用模态专用预训练编码器,并在共享编码器内对齐特征。我们在MIMIC-IV和MIMIC-IV-ECG数据集上评估了MedM2T,涵盖慢性与急性疾病动态的三项任务:90天心血管疾病(CVD)预测、院内死亡率预测和重症监护病房住院时长(LOS)回归。结果表明,其性能优于或相当于当前最先进的多模态学习框架和时间序列模型,在CVD预测中达到AUROC 0.932、AUPRC 0.670;死亡率预测中为AUROC 0.868、AUPRC 0.470;LOS回归的平均绝对误差(MAE)为2.33。这些结果凸显了MedM2T的鲁棒性与广泛适用性,使其成为临床预测的有力工具。代码已开源:https://github.com/DHLab-TSENG/MedM2T。
原文摘要 · Abstract (English)
The inherent multimodality and heterogeneous temporal structures of medical data pose significant challenges for modeling. We propose MedM2T, a time-aware multimodal framework designed to address these complexities. MedM2T integrates: (i) Sparse Time Series Encoder to flexibly handle irregular and sparse time series, (ii) Hierarchical Time-Aware Fusion to capture both micro- and macro-temporal patterns from multiple dense time series, such as ECGs, and (iii) Bi-Modal Attention to extract cross-modal interactions, which can be extended to any number of modalities. To mitigate granularity gaps between modalities, MedM2T uses modality-specific pre-trained encoders and aligns resulting features within a shared encoder. We evaluated MedM2T on MIMIC-IV and MIMIC-IV-ECG datasets for three tasks that encompass chronic and acute disease dynamics: 90-day cardiovascular disease (CVD) prediction, in-hospital mortality prediction, and ICU length-of-stay (LOS) regression. MedM2T achieved superior or comparable performance relative to state-of-the-art multimodal learning frameworks and existing time series models, achieving an AUROC of 0.932 and an AUPRC of 0.670 for CVD prediction; an AUROC of 0.868 and an AUPRC of 0.470 for mortality prediction; and Mean Absolute Error (MAE) of 2.33 for LOS regression. These results highlight the robustness and broad applicability of MedM2T, positioning it as a promising tool in clinical prediction. We provide the implementation of MedM2T at https://github.com/DHLab-TSENG/MedM2T.
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