Resilient Vision-Tabular Multimodal Learning under Modality Missingness
Authors: Camillo Maria Caruso, Valerio Guarrasi, Paolo Soda
Organizations: Research Unit of Artificial Intelligence and Computer Systems, Department of Engineering, Università Campus Bio-Medico di Roma, Roma, Italy, Europe · Department of Diagnostics and Intervention, Radiation Physics, Biomedical Engineering, Umeå University, Umeå, Sweden, Europe
Abstract
Multimodal deep learning has shown strong potential in medical applications by integrating heterogeneous data sources such as medical images and structured clinical variables. However, most existing approaches implicitly assume complete modality availability, an assumption that rarely holds in real-world clinical settings where entire modalities and individual features are frequently missing. In this work, we propose a multimodal transformer framework for joint vision-tabular learning explicitly designed to operate under pervasive modality missingness, without relying on imputation or heuristic model switching. The architecture integrates three components: a vision, a tabular, and a multimodal fusion encoder. Unimodal representations are weighted through learnable modality tokens and fused via intermediate fusion with masked self-attention, which excludes missing tokens and modalities from information aggregation and gradient propagation. To further enhance resilience, we introduce a modality-dropout regularization strategy that stochastically removes available modalities during training, encouraging the model to exploit complementary information under partial data availability. We evaluate our approach on the MIMIC-CXR dataset paired with structured clinical data from MIMIC-IV for multilabel classification of 14 diagnostic findings with incomplete annotations. Two parallel systematic stress-test protocols progressively increase training and inference missingness in each modality separately, spanning fully multimodal to fully unimodal scenarios. Across all missingness regimes, the proposed method consistently outperforms representative baselines, showing smoother performance degradation and improved robustness. Ablation studies further demonstrate that attention-level masking and intermediate fusion with joint fine-tuning are key to resilient multimodal inference.
While multimodal data integrating diverse imaging and clinical tabular records is crucial for accurate medical diagnosis, the arbitrary absence of specific modalities is prevalent in clinical practice, severely degrading the performance of multimodal models. Existing methods either discard missing modalities, leading to information loss, or struggle to synthesize them without capturing complex inter-modal dependencies. To address these limitations, we propose a novel Context-driven Missing-Modality Learning (CMML) framework, which sequentially performs modality synthesis and semantic alignment to achieve robust diagnosis under arbitrary missing conditions. Specifically, we design a Cascade Residual Transformer-based Autoencoder (CRTA) that leverages learnable context tokens acting as dataset-level semantic prior to capture inter-modal dependencies and synthesize key missing representations. These representations are further enriched by modality-specific memory banks. To resolve the discrepancy between original available and synthesized representations, we transform the learned context tokens into instance-adaptive semantic references by infusing multimodal representations from the CRTA's outputs. This reference guides the alignment of heterogeneous modality representations into a unified space, where class-aware contrastive refinement is finally applied to explore discriminative diagnostic cues. Extensive evaluations on skin lesion (Derm7pt), ocular disease (ODIR), and meningioma (MEN) datasets demonstrate that CMML significantly outperforms state-of-the-art (SOTA) methods, yielding AVG AUC improvements of 1.26%, 0.97%, and 1.32%, respectively.
This paper addresses the missing-modality challenge in multi-modal learning by introducing Unsupervised Learning for Missing Modalities in Multi-Modal Learning (UL4M4), a flexible framework that imputes missing feature embeddings in a task-independent manner before supervised prediction. We propose modality-specific normalization and a novel partial-modality distance metric to enable fair clustering of incomplete observations, capturing cross-modal structures while preserving scale-invariance across varying dimensionalities and modality counts. Cluster centers from this unsupervised stage guide an iterative greedy imputation process for any missing modalities during training or inference, supporting arbitrary numbers of modalities and arbitrary missing patterns per sample. The imputation module is lightweight, uses frozen encoders, and decouples from the downstream task, allowing easy integration with any fusion/prediction architecture. Extensive experiments under diverse and highly incomplete regimes demonstrate UL4M4's robustness, achieving, to the best of our knowledge, the first consistent F1-Micro scores above 0.7 on challenging missing configurations even when more than 50% of modality slots are missing. Results are also stable across cluster sizes and significantly outperform state-of-the-art baselines. Code is available here: https://github.com/h-ismkhan/Multimodal-Learning-with-Missing-Modalities-via-Unsupervised-Learning.
Learning with missing modalities is a fundamental challenge in multimodal robot learning, as real-world robotic systems often operate in environments with incomplete sensor data. Attention-based models are appealing for processing multimodal data because they can handle multiple modalities with a single backbone network. However, most multimodal models assume that all modalities are available during both training and inference, limiting their applicability in robotic perception and decision-making. In this paper, we introduce a multimodal model designed to handle missing modalities during both training and inference. The model is formulated as a conditional variational autoencoder (CVAE) and incorporates a transformer-based architecture that leverages attention mechanisms to learn a unified, fixed-dimensional representation, even when some modalities are missing. We show that our proposed model can be trained with missing modalities while approximating a robust representation of all modalities. We evaluate our approach on five multimodal datasets across two robot learning tasks: human trajectory prediction and robot manipulation forecasting. Experimental results demonstrate that our model effectively learns from incomplete data and is superior to prior multimodal fusion approaches.