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Main Authors: Yin, Kejing, Xu, Haizhou, Yao, Wenfang, Liu, Chen, Chen, Zijie, Cheung, Yui Haang, Cheung, William K., Qin, Jing
Format: Preprint
Published: 2026
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Online Access:https://arxiv.org/abs/2602.23614
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author Yin, Kejing
Xu, Haizhou
Yao, Wenfang
Liu, Chen
Chen, Zijie
Cheung, Yui Haang
Cheung, William K.
Qin, Jing
author_facet Yin, Kejing
Xu, Haizhou
Yao, Wenfang
Liu, Chen
Chen, Zijie
Cheung, Yui Haang
Cheung, William K.
Qin, Jing
contents Machine learning holds promise for advancing clinical decision support, yet it remains unclear when multimodal learning truly helps in practice, particularly under modality missingness and fairness constraints. In this work, we conduct a systematic benchmark of multimodal fusion between Electronic Health Records (EHR) and chest X-rays (CXR) on standardized cohorts from MIMIC-IV and MIMIC-CXR, aiming to answer four fundamental questions: when multimodal fusion improves clinical prediction, how different fusion strategies compare, how robust existing methods are to missing modalities, and whether multimodal models achieve algorithmic fairness. Our study reveals several key insights. Multimodal fusion improves performance when modalities are complete, with gains concentrating in diseases that require complementary information from both EHR and CXR. While cross-modal learning mechanisms capture clinically meaningful dependencies beyond simple concatenation, the rich temporal structure of EHR introduces strong modality imbalance that architectural complexity alone cannot overcome. Under realistic missingness, multimodal benefits rapidly degrade unless models are explicitly designed to handle incomplete inputs. Moreover, multimodal fusion does not inherently improve fairness, with subgroup disparities mainly arising from unequal sensitivity across demographic groups. To support reproducible and extensible evaluation, we further release a flexible benchmarking toolkit that enables plug-and-play integration of new models and datasets. Together, this work provides actionable guidance on when multimodal learning helps, when it fails, and why, laying the foundation for developing clinically deployable multimodal systems that are both effective and reliable. The open-source toolkit can be found at https://github.com/jakeykj/CareBench.
format Preprint
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institution arXiv
publishDate 2026
record_format arxiv
spellingShingle When Does Multimodal Learning Help in Healthcare? A Benchmark on EHR and Chest X-Ray Fusion
Yin, Kejing
Xu, Haizhou
Yao, Wenfang
Liu, Chen
Chen, Zijie
Cheung, Yui Haang
Cheung, William K.
Qin, Jing
Machine Learning
Artificial Intelligence
Machine learning holds promise for advancing clinical decision support, yet it remains unclear when multimodal learning truly helps in practice, particularly under modality missingness and fairness constraints. In this work, we conduct a systematic benchmark of multimodal fusion between Electronic Health Records (EHR) and chest X-rays (CXR) on standardized cohorts from MIMIC-IV and MIMIC-CXR, aiming to answer four fundamental questions: when multimodal fusion improves clinical prediction, how different fusion strategies compare, how robust existing methods are to missing modalities, and whether multimodal models achieve algorithmic fairness. Our study reveals several key insights. Multimodal fusion improves performance when modalities are complete, with gains concentrating in diseases that require complementary information from both EHR and CXR. While cross-modal learning mechanisms capture clinically meaningful dependencies beyond simple concatenation, the rich temporal structure of EHR introduces strong modality imbalance that architectural complexity alone cannot overcome. Under realistic missingness, multimodal benefits rapidly degrade unless models are explicitly designed to handle incomplete inputs. Moreover, multimodal fusion does not inherently improve fairness, with subgroup disparities mainly arising from unequal sensitivity across demographic groups. To support reproducible and extensible evaluation, we further release a flexible benchmarking toolkit that enables plug-and-play integration of new models and datasets. Together, this work provides actionable guidance on when multimodal learning helps, when it fails, and why, laying the foundation for developing clinically deployable multimodal systems that are both effective and reliable. The open-source toolkit can be found at https://github.com/jakeykj/CareBench.
title When Does Multimodal Learning Help in Healthcare? A Benchmark on EHR and Chest X-Ray Fusion
topic Machine Learning
Artificial Intelligence
url https://arxiv.org/abs/2602.23614