MedFiTRG: Jointly Learning Dynamic Temporal and Cross-Patient Graphs for Clinical Outcome Prediction

Abstract

Integrating heterogeneous clinical modalities, structured electronic health records (EHRs), clinical text, and medical imaging is crucial for reliable clinical prediction, yet real-world data are often sparse and imbalanced. Furthermore, prior approaches treat temporal dynamics and inter-patient relationships in isolation, overlooking the dynamic interaction of patient trajectories across populations. We introduce a modality-enhanced dynamic temporal relational graph (MedFiTRG), a unified framework that jointly models sparsity, temporal dynamics, and cross-patient relational dependencies. MedFiTRG leverages modulated graph neural networks (MGNN) to learn modality-aware embeddings, enabling meaningful representation of sparse modalities through adaptive feature modulation. These embeddings are integrated into a temporal relational graph (TRG), where directed intra-patient edges capture longitudinal progression and dynamic inter-patient edges model population-level similarities for synchronized temporal-relational reasoning. Extensive experiments on large-scale real-world datasets across four clinical tasks demonstrate that MedFiTRG achieves superior or comparable performance against state-of-the-art baselines, improving Macro-F1 from 0.155 to 0.310 for length of stay (LOS) classification and achieving an AUROC of 0.939 for mortality prediction (↑6.45%). The code is available at https://anonymous.4open.science/r/MedFiTRG-2714