Mr.Dec: Daily-Scale Longitudinal Multimodal Modeling for 30-Day Readmission Prediction
Mr.Dec: Daily-Scale Longitudinal Multimodal Modeling for 30-Day Readmission Prediction
Mr.Dec：用于30天再入院预测的日尺度纵向多模态建模
Abstract: Predicting 30-day hospital readmission is essential for assessing patient stability and optimizing healthcare resources. As clinical risk evolves with the accumulation of evidence during hospitalization, capturing these dynamic trajectories is essential. However, many existing approaches compress the complex longitudinal history into fixed representations, often losing the granular, day-level clinical signals that reflect a patient’s evolving physiological state.
摘要： 预测患者30天内再入院对于评估患者病情稳定性和优化医疗资源配置至关重要。随着住院期间临床证据的积累，临床风险也在不断演变，因此捕捉这些动态轨迹显得尤为必要。然而，许多现有方法将复杂的纵向病史压缩为固定表征，往往丢失了反映患者生理状态演变的细粒度、日级临床信号。
To address this, we propose Mr.Dec (Multimodal Readmission-risk prediction Decoder), which models each admission as a natural chronological sequence of daily multimodal events. By leveraging a Transformer Decoder, Mr.Dec integrates daily Electronic Health Record (EHR) updates and intermittent Chest X-ray (CXR) findings in a time-aligned stream, reflecting the actual clinical workflow.
为了解决这一问题，我们提出了 Mr.Dec（多模态再入院风险预测解码器），它将每次住院过程建模为每日多模态事件的自然时间序列。通过利用 Transformer 解码器，Mr.Dec 将每日电子健康记录（EHR）更新与间歇性的胸部 X 光（CXR）检查结果整合到一个时间对齐的数据流中，从而真实反映了临床工作流程。
To ensure robustness, we utilize Disease-Specific Supervised Contrastive Learning as an auxiliary regularization to induce a diagnosis-aware structure in the latent space. Evaluations on the MIMIC-IV and MIMIC-CXR datasets show that Mr.Dec achieves state-of-the-art performance by preserving the integrity of the clinical sequence. Furthermore, our model identifies “Critical Days” within an admission, providing actionable and clinically grounded interpretations for real-time risk stratification.
为了确保稳健性，我们利用疾病特异性监督对比学习作为辅助正则化手段，在潜在空间中诱导产生具有诊断感知能力的结构。在 MIMIC-IV 和 MIMIC-CXR 数据集上的评估表明，Mr.Dec 通过保持临床序列的完整性，实现了最先进的性能。此外，我们的模型能够识别住院期间的“关键日”，为实时风险分层提供了可操作且具有临床依据的解释。
Code is available at: https://github.com/minjunkim/MrDec