Research on Multimodal Fusion of Temporal Electronic Medical Records

Abstract

The surge in deep learning-driven EMR research has centered on harnessing diverse data forms. Yet, the amalgamation of diverse modalities within time series data remains an underexplored realm. This study probes a multimodal fusion approach, merging temporal and non-temporal clinical notes along with tabular data. We leveraged data from 1271 myocardial infarction and 6450 stroke inpatients at a Beijing tertiary hospital. Our dataset encompassed static, and time series note data, coupled with static and time series table data. The temporal data underwent a preprocessing phase, padding to a 30-day interval, and segmenting into 3-day sub-sequences. These were fed into a long short-term memory (LSTM) network for sub-sequence representation. Multimodal attention gates were implemented for both static and temporal subsequence representations, culminating in fused representations. An attention-backtracking module was introduced for the latter, adept at capturing enduring dependencies in temporal fused representations. The concatenated results were channeled into an LSTM to yield the ultimate fused representation. Initially, two note modalities were designated as primary modes, and subsequently, the proposed fusion model was compared with comparative models including recent models such as Crossformer. The proposed model consistently exhibited superior predictive prowess in both tasks. Removing the attention-backtracking module led to performance decline. The proposed model consistently shows excellent predictive capabilities in both tasks. The proposed method not only effectively integrates data from the four modalities, but also has a good understanding of how to handle irregular time series data and lengthy clinical texts. An effective method is provided, which is expected to be more widely used in multimodal medical data representation.