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This paper introduces GLR-MM, a graph-based framework designed to enhance early ICU mortality prediction by reconstructing missing data in multimodal chest X-ray and EHR inputs. By jointly leveraging within-patient and inter-patient evidence through local cross-modal and global graph-attention branches, the method significantly outperforms existing models under severe modality missingness (50%). This advancement addresses a critical gap in clinical AI where complete data is rarely available at prediction time, offering robust performance even when inputs are severely incomplete.
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GLR-MM: Graph-Based Global-Local Reconstruction for Robust Multimodal Chest X-ray and EHR Representation Learning under Missing Modalities

arXiv2 min read

arXiv:2609.23876v1 Announce Type: new Abstract: Clinical multimodal models must often predict before all chest X-ray (CXR) and electronic health record (EHR) inputs are available. Existing approaches align observed representations, model missingness, or reconstruct across modalities, but do not jointly exploit within-patient and clinically similar inter-patient evidence. We propose GLR-MM, a Graph-Based Global-Local Reconstruction framework for early ICU mortality prediction. It maps five CXR-EHR modalities to a shared space, reconstructs missing embeddings through complementary local cross-modal and global graph-attention branches, adaptively fuses their estimates, and optimizes class-balanced prediction, reconstruction, and contrastive objectives. On 9,620 MIMIC-derived ICU stays, we evaluate 10%, 30%, and 50% random modality missingness with shared deterministic masks. MUSE performs better under mild and moderate missingness, whereas GLR-MM achieves higher AUROC and AUPRC at 50% by 0.0088 and 0.0249, respectively. These results indicate that graph-guided reconstruction is most useful when inputs are severely incomplete.

Abstract:Clinical multimodal models must often predict before all chest X-ray (CXR) and electronic health record (EHR) inputs are available. Existing approaches align observed representations, model missingness, or reconstruct across modalities, but do not jointly exploit within-patient and clinically similar inter-patient evidence. We propose GLR-MM, a Graph-Based Global-Local Reconstruction framework for early ICU mortality prediction. It maps five CXR-EHR modalities to a shared space, reconstructs missing embeddings through complementary local cross-modal and global graph-attention branches, adaptively fuses their estimates, and optimizes class-balanced prediction, reconstruction, and contrastive objectives. On 9,620 MIMIC-derived ICU stays, we evaluate 10%, 30%, and 50% random modality missingness with shared deterministic masks. MUSE performs better under mild and moderate missingness, whereas GLR-MM achieves higher AUROC and AUPRC at 50% by 0.0088 and 0.0249, respectively. These results indicate that graph-guided reconstruction is most useful when inputs are severely incomplete.

Machine Learning (cs.LG); Artificial Intelligence (cs.AI)

arXiv:2609.23876 [cs.LG]

(or arXiv:2609.23876v1 [cs.LG] for this version)

https://doi.org/10.48550/arXiv.2609.23876 Focus to learn more arXiv-issued DOI via DataCite (pending registration)

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Full text under the publisher's open licence · 237 words

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