Is Clinical Text Enough? A Multimodal Study on Mortality Prediction in Heart Failure Patients

Fuente: arXiv
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Auteurs principaux: Khettari, Oumaima El, Barthet, Virgile, Hocquet, Guillaume, Weller, Joconde, Morin, Emmanuel, Zweigenbaum, Pierre
Format: Preprint
Publié: 2026
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author Khettari, Oumaima El
Barthet, Virgile
Hocquet, Guillaume
Weller, Joconde
Morin, Emmanuel
Zweigenbaum, Pierre
author_facet Khettari, Oumaima El
Barthet, Virgile
Hocquet, Guillaume
Weller, Joconde
Morin, Emmanuel
Zweigenbaum, Pierre
contents Accurate short-term mortality prediction in heart failure (HF) remains challenging, particularly when relying on structured electronic health record (EHR) data alone. We evaluate transformer-based models on a French HF cohort, comparing text-only, structured-only, multimodal, and LLM-based approaches. Our results show that enriching clinical text with entity-level representations improves prediction over CLS embeddings alone, and that supervised multimodal fusion of text and structured variables achieves the best overall performance. In contrast, large language models perform inconsistently across modalities and decoding strategies, with text-only prompts outperforming structured or multimodal inputs. These findings highlight that entity-aware multimodal transformers offer the most reliable solution for short-term HF outcome prediction, while current LLM prompting remains limited for clinical decision support.
format Preprint
id arxiv_https___arxiv_org_abs_2604_01924
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Is Clinical Text Enough? A Multimodal Study on Mortality Prediction in Heart Failure Patients
Khettari, Oumaima El
Barthet, Virgile
Hocquet, Guillaume
Weller, Joconde
Morin, Emmanuel
Zweigenbaum, Pierre
Computation and Language
Accurate short-term mortality prediction in heart failure (HF) remains challenging, particularly when relying on structured electronic health record (EHR) data alone. We evaluate transformer-based models on a French HF cohort, comparing text-only, structured-only, multimodal, and LLM-based approaches. Our results show that enriching clinical text with entity-level representations improves prediction over CLS embeddings alone, and that supervised multimodal fusion of text and structured variables achieves the best overall performance. In contrast, large language models perform inconsistently across modalities and decoding strategies, with text-only prompts outperforming structured or multimodal inputs. These findings highlight that entity-aware multimodal transformers offer the most reliable solution for short-term HF outcome prediction, while current LLM prompting remains limited for clinical decision support.
title Is Clinical Text Enough? A Multimodal Study on Mortality Prediction in Heart Failure Patients
topic Computation and Language
url https://arxiv.org/abs/2604.01924