Kyoka Ono

Simon A. Lee, Sujay Jain, Alex Chen et al.

In this work, we introduce the Multiple Embedding Model for EHR (MEME), an approach that serializes multimodal EHR tabular data into text using pseudo-notes, mimicking clinical text generation. This conversion not only preserves better representations of categorical data and learns contexts but also enables the effective employment of pretrained foundation models for rich feature representation. To address potential issues with context length, our framework encodes embeddings for each EHR modality separately. We demonstrate the effectiveness of MEME by applying it to several decision support tasks within the Emergency Department across multiple hospital systems. Our findings indicate that MEME outperforms traditional machine learning, EHR-specific foundation models, and general LLMs, highlighting its potential as a general and extendible EHR representation strategy.

Kyoka Ono, Simon A. Lee

Recent research has explored how Language Models (LMs) can be used for feature representation and prediction in tabular machine learning tasks. This involves employing text serialization and supervised fine-tuning (SFT) techniques. Despite the simplicity of these techniques, significant gaps remain in our understanding of the applicability and reliability of LMs in this context. Our study assesses how emerging LM technologies compare with traditional paradigms in tabular machine learning and evaluates the feasibility of adopting similar approaches with these advanced technologies. At the data level, we investigate various methods of data representation and curation of serialized tabular data, exploring their impact on prediction performance. At the classification level, we examine whether text serialization combined with LMs enhances performance on tabular datasets (e.g. class imbalance, distribution shift, biases, and high dimensionality), and assess whether this method represents a state-of-the-art (SOTA) approach for addressing tabular machine learning challenges. Our findings reveal current pre-trained models should not replace conventional approaches.