arXiv:2604.04614cs.LGcs.AI2026-04

用点云建模不完整电子病历,提升住院死亡预测准确率

A Clinical Point Cloud Paradigm for In-Hospital Mortality Prediction from Multi-Level Incomplete Multimodal EHRs

  • 将临床事件视为4维空间中的点,统一处理时间、模态、内容和病例关系
  • 在多个数据集上实现当前最佳性能,对缺失数据具有强鲁棒性
  • 适合处理真实医疗数据中常见的不完整、稀疏标签问题,临床实用性强

基于深度学习的多模态电子健康记录(EHR)建模已成为临床诊断与风险预测的重要方法。然而,由于临床流程多样性和隐私限制,原始EHR本质上存在多层次不完整性,包括采样不规则、模态缺失和标签稀疏,导致时间错位、模态失衡和监督不足。现有大多数多模态方法假设数据相对完整,即使针对不完整性的方法也通常仅解决其中一两个问题,常依赖严格的时序或模态对齐,或直接丢弃不完整数据,可能扭曲原始临床语义。为此,我们提出HealthPoint(HP),一种统一的临床点云范式,用于处理多层级不完整的EHR。HP将异构临床事件表示为由内容、时间、模态和病例构成的连续4维空间中的点。为建模任意点对间的交互,引入低秩关系注意力机制,高效捕捉四维空间中的高阶依赖。进一步设计分层交互与采样策略,在细粒度建模与计算效率间取得平衡。基于此框架,HP支持灵活的事件级交互与细粒度自监督,促进模态恢复并有效利用无标签数据。在大规模EHR风险预测数据集上的实验表明,HP在不同不完整性程度下均持续达到当前最优性能,且具备强鲁棒性。

原文摘要 · Abstract (English)

Deep learning-based modeling of multimodal Electronic Health Records (EHRs) has become an important approach for clinical diagnosis and risk prediction. However, due to diverse clinical workflows and privacy constraints, raw EHRs are inherently multi-level incomplete, including irregular sampling, missing modalities, and sparse labels. These issues cause temporal misalignment, modality imbalance, and limited supervision. Most existing multimodal methods assume relatively complete data, and even methods designed for incompleteness usually address only one or two of these issues in isolation. As a result, they often rely on rigid temporal/modal alignment or discard incomplete data, which may distort raw clinical semantics. To address this problem, we propose HealthPoint (HP), a unified clinical point cloud paradigm for multi-level incomplete EHRs. HP represents heterogeneous clinical events as points in a continuous 4D space defined by content, time, modality, and case. To model interactions between arbitrary point pairs, we introduce a Low-Rank Relational Attention mechanism that efficiently captures high-order dependencies across these four dimensions. We further develop a hierarchical interaction and sampling strategy to balance fine-grained modeling and computational efficiency. Built on this framework, HP enables flexible event-level interaction and fine-grained self-supervision, supporting robust modality recovery and effective use of unlabeled data. Experiments on large-scale EHR datasets for risk prediction show that HP consistently achieves state-of-the-art performance and strong robustness under varying degrees of incompleteness.

医疗AI点云建模不完整数据风险预测

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