Contrastive Learning on Multimodal Analysis of Electronic Health Records

Abstract

Electronic health record (EHR) systems capture a wealth of multimodal clinical data, encompassing both structured clinical codes and unstructured clinical notes. Yet, many EHR-focused studies have traditionally examined these modalities in isolation or combined them using simplistic methods, overlooking the intrinsic synergy between them. In reality, these modalities are deeply interconnected, each containing clinically relevant and complementary information that, when integrated effectively, can provide a more comprehensive understanding of patient health. Despite the success of multimodal contrastive learning in vision-language applications, its potential remains under-explored in multimodal EHR, particularly in terms of theoretical understanding. To support statistical analysis of multimodal EHR data, we propose a multimodal feature embedding generative model and design a multimodal contrastive loss to learn EHR feature representations. Our theoretical analysis demonstrates the effectiveness of multimodal learning over single-modality learning and connects the solution of the loss function to the singular value decomposition of a pointwise mutual information matrix. This connection leads to a privacy-preserving algorithm tailored for multimodal EHR representation learning. Simulation studies show that the proposed algorithm performs well under a variety of configurations. We further validate its clinical utility using real-world EHR data.