Chronic osteomyelitis presents substantial prognostic challenges due to its high recurrence risk and complex postoperative recovery trajectories. Traditional assessment often relies on manual scoring systems, which limit scalability, efficiency, and consistency in clinical practice. Furthermore, the heterogeneous nature of clinical data poses challenges for current multimodal learning approaches that require aligned inputs and large annotated datasets. In this work, we propose RAG4Outcome, a retrieval-augmented generation (RAG) framework for prognostic prediction in chronic osteomyelitis. Our method integrates multimodal clinical data, including PET-CT imaging reports, structured surgical and diagnostic records, and unstructured follow-up notes, into a unified prediction pipeline. By combining a domain-specific retrieval corpus with expert-guided prompting, the framework enables more interpretable, evidence-grounded, and clinically reliable prognosis. Preliminary results on real-world cases demonstrate promising effectiveness and clinical alignment, highlighting the potential of RAG4Outcome for AI-assisted infection management and postoperative decision support.
Chronic Kidney Disease (CKD) affects nearly 10% of the global population and often progresses to end-stage renal failure. Accurate prognosis prediction is vital for timely interventions and resource optimization. We present a transformer-based framework for predicting CKD progression using multi-modal electronic health records (EHR) from the Seoul National University Hospital OMOP Common Data Model. Our approach (\textbf{ProQ-BERT}) integrates demographic, clinical, and laboratory data, employing quantization-based tokenization for continuous lab values and attention mechanisms for interpretability. The model was pretrained with masked language modeling and fine-tuned for binary classification tasks predicting progression from stage 3a to stage 5 across varying follow-up and assessment periods. Evaluated on a cohort of 91,816 patients, our model consistently outperformed CEHR-BERT, achieving ROC-AUC up to 0.995 and PR-AUC up to 0.989 for short-term prediction. These results highlight the effectiveness of transformer architectures and temporal design choices in clinical prognosis modeling, offering a promising direction for personalized CKD care.
Predicting future clinical outcomes from electronic health records (EHR) remains challenging due to the complexity and heterogeneity of patient data. LLMs have shown strong potential for such predictive tasks, yet existing approaches mainly focus on enhancing medical knowledge through distillation or RAG while relying on the model's internal ability to interpret contextual information. In this work, we present ReMedi (Reasoner for Medical Clinical Prediction), a framework for improving clinical outcome prediction from EHR. ReMedi generates rationale-answer pairs using a challenging sample regeneration mechanism for complex clinical questions, which leverages ground-truth answers as hints to enhance reasoning for further fine-tuning and preference tuning. ReMedi integrates ground-truth outcome guidance into the preference data construction loop, regenerating rationale-answer variants. By tuning on these rationale-answer pairs, the model improves its predictive performance. Experiments on multiple EHR prediction tasks demonstrate substantial gains of up to 19.9 percent over state-of-the-art baselines in terms of F1 score, underscoring ReMedi's effectiveness in real-world clinical prediction.
Electronic health record (EHR) data are inherently multimodal, and leveraging multiple modalities can improve predictive performance. However, most existing approaches rely on deep fusion, which obscures how individual modalities contribute to predictions and limits the interpretability of multimodal reasoning. We propose an explicit multimodal routing framework for clinical prediction that enables interpretable, robust, and auditable reasoning across three EHR modalities: structured longitudinal variables (L), clinical notes (N), and chest X-rays (I). Our model constructs discrete unimodal, directional bimodal, and trimodal routes to capture both individual modality signals and asymmetric cross-modal interactions. To audit multimodal reasoning and assess robustness, we introduce inference-time route masking, which simulates missing modalities and reweights the remaining routes without retraining. We analyze changes in performance and routing weights under these scenarios to understand model decision-making. We evaluate our framework on multi-label phenotype prediction (K = 25) and binary ICU mortality prediction using trimodal patient stays from MIMIC-IV, revealing systematic differences in modality reliance across clinical condition groups. Overall, our framework offers a transparent, auditable, and practical approach to multimodal clinical prediction, providing interpretability, robustness, and insights into how different data sources drive model decisions.