analiza aiqbench
This research introduces a marked time-to-event pretraining objective that jointly models event timing and continuous measurements, addressing a key limitation in existing EHR foundation models that rely solely on next-token prediction. By capturing the full structure of electronic health records, this approach yields more generalizable representations and improves performance on regression and time-to-event tasks beyond traditional classification metrics. The broader implication for the field is that pretraining objectives must explicitly account for the structural nuances of clinical data to effectively expand downstream capabilities.
One Loss to Rule Them All: Marked Time-to-Event for Structured EHR Foundation Models
arXiv:2602.00541v2 Announce Type: replace Abstract: Clinical events captured in Electronic Health Records (EHR) are irregularly sampled and may consist of a mixture of discrete events and numerical measurements, such as laboratory values or treatment dosages. The sequential nature of EHR, analogous to natural language, has motivated the use of next-token prediction to train prior EHR Foundation Models (FMs) over events. However, this training fails to capture the full structure of EHR. When a given event occurs must be captured, but the event value (abnormal lab) also modulates the likelihood of other clinical events. Most existing EHR FMs do not jointly model this likelihood and are unable to capture the full observation process, impacting downstream capabilities. We propose ORA, a marked time-to-event pretraining objective that jointly models event timing and associated measurements. Across multiple datasets, downstream tasks, and model backbones, this objective consistently yields more generalizable representations than next-token prediction and pretraining losses that ignore continuous measurements. Importantly, the proposed objective yields improvements beyond traditional classification evaluation, including better regression and time-to-event prediction. Beyond introducing a new family of FMs, our ablations suggest a broader takeaway: pretraining objectives that account for EHR structure are critical for expanding downstream capabilities and generalizability.
Abstract:Clinical events captured in Electronic Health Records (EHR) are irregularly sampled and may consist of a mixture of discrete events and numerical measurements, such as laboratory values or treatment dosages. The sequential nature of EHR, analogous to natural language, has motivated the use of next-token prediction to train prior EHR Foundation Models (FMs) over events. However, this training fails to capture the full structure of EHR. When a given event occurs must be captured, but the event value (abnormal lab) also modulates the likelihood of other clinical events. Most existing EHR FMs do not jointly model this likelihood and are unable to capture the full observation process, impacting downstream capabilities. We propose ORA, a marked time-to-event pretraining objective that jointly models event timing and associated measurements. Across multiple datasets, downstream tasks, and model backbones, this objective consistently yields more generalizable representations than next-token prediction and pretraining losses that ignore continuous measurements. Importantly, the proposed objective yields improvements beyond traditional classification evaluation, including better regression and time-to-event prediction. Beyond introducing a new family of FMs, our ablations suggest a broader takeaway: pretraining objectives that account for EHR structure are critical for expanding downstream capabilities and generalizability.
Machine Learning (cs.LG)
arXiv:2602.00541 [cs.LG]
(or arXiv:2602.00541v2 [cs.LG] for this version)
https://doi.org/10.48550/arXiv.2602.00541 Focus to learn more arXiv-issued DOI via DataCite
arXivLabs is a framework that allows collaborators to develop and share new arXiv features directly on our website.
Both individuals and organizations that work with arXivLabs have embraced and accepted our values of openness, community, excellence, and user data privacy. arXiv is committed to these values and only works with partners that adhere to them.
Have an idea for a project that will add value for arXiv's community? Learn more about arXivLabs.
Text integral sub licența deschisă a publicației · 287 cuvinte