Disentangled Fine-Grained Prototype Learning for Incomplete Image-Tabular Classification

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.

Tabular Foundation Models have recently established the state of the art in supervised tabular learning, by leveraging pretraining to learn generalizable representations of numerical and categorical structured data. However, they lack native support for unstructured modalities such as text and image, and rely on frozen, pretrained embeddings to process them. On established Multimodal Tabular Learning benchmarks, we show that tuning the embeddings to the task improves performance. Existing benchmarks, however, often focus on the mere co-occurrence of modalities; this leads to high variance across datasets and masks the benefits of task-specific tuning. To address this gap, we introduce MulTaBench, a benchmark of 40 datasets, split equally between image-tabular and text-tabular tasks. We focus on predictive tasks where the modalities provide complementary predictive signal, and where generic embeddings lose critical information, necessitating Target-Aware Representations that are aligned with the task. Our experimental results demonstrate that the gains from target-aware representation tuning generalize across both text and image modalities, several tabular learners, encoder scales, and embedding dimensions. MulTaBench constitutes the largest image-tabular benchmarking effort to date, spanning high-impact domains such as healthcare and e-commerce. It is designed to enable the research of novel architectures which incorporate joint modeling and target-aware representations, paving the way for the development of novel Multimodal Tabular Foundation Models.