ShapKO: Shapley-Adaptive Modality Knockout for Robust Multimodal Learning

Multimodal clinical prediction faces three challenges: multiple foundation models (FMs) with complementary strengths per modality, pervasive missing modalities at training and test time, and sample-specific variation in modality contributions. We introduce MedMIX, a multimodal framework that combines intra-modality expert fusion, learned inter-modality fusion, and training-only large--small model collaboration for robust medical prediction under incomplete modalities. Within each modality, MedMIX aggregates complementary embeddings from multiple small expert models; across modalities, it performs learned fusion over available modalities; and during training, it leverages large teacher models to improve deployed representations without additional inference cost. Across three heterogeneous benchmarks (OpenI, MIMIC-IV-MM, and MMIST-ccRCC), MedMIX achieves consistently strong performance while remaining robust under controlled missing-modality perturbations, and further demonstrates sustained robustness under cross-cohort shift on MIMIC-III. These results highlight MedMIX as a practical framework that unifies within-modality expert collaboration, sample-specific cross-modality fusion, and efficient large--small model collaboration while remaining robust to incomplete modalities.

Multi-modal classification leverages complementary information across diverse data sources to enhance predictive performance. However, real-world scenarios subject to operational constraints, such as sensor failures or privacy restrictions, lead to inconsistent modality availability between training and inference times. To handle missing modalities, prior studies have mainly covered bimodal data setups and focused on designing robust fusion processes. Instead, we adopt a multi-modal co-learning framework that prioritizes inter-modal collaboration rather than multi-modal fusion. Specifically, we consider that any subset of modalities may be absent, without assuming predefined missing-modality patterns, an inference scenario we refer to as missing arbitrary modalities. To address this challenge, we introduce two alternative approaches that leverage information at both feature- and decision-level. Experiments on two multi-modal classification benchmarks demonstrate significant robustness gains in various missing modality conditions. The first method shows more robust behavior under minimal missing conditions, where a single modality is absent, whereas the second performs better under extreme missing conditions, where all-but-one modalities are missing. Our code is available at https://github.com/fmenat/Co4Miss.

Addressing missing modalities is an important challenge in multimodal image analysis and often relies on complex architectures that do not transfer easily to different datasets without architectural modifications or hyperparameter tuning. While most existing methods tackle this problem in feature space by engineering representations that are robust to missing inputs, we instead operate in weight space. We propose LARGO, a hypernetwork that compresses the $2^N-1$ dedicated missing-modality models into a single network by modelling the convolutional weights using the Canonical Polyadic (CP) tensor decomposition. Extensive experimental validation on BraTS 2018 (4 modalities, 15 scenarios) and ISLES 2022 (3 modalities, 7 scenarios) shows that our method ranks first in 47 out of 52 configurations, achieving average Dice improvements of +0.68$\%$ and +2.53$\%$ over state-of-the-art baselines (mmFormer, M$^{3}$AE, ShaSpec, SimMLM). A proof-of-concept experiment on avMNIST suggests that LARGO may extend beyond medical imaging to heterogeneous non-medical modalities.