# Enhancing In-Hospital Mortality Prediction Using Multi-Representational Learning with LLM-Generated Expert Summaries

arXiv: https://arxiv.org/abs/2411.16818 · HTML: https://mlsanity.com/paper/2411.16818/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 6 of its 10 references that are in the map.
- First posted on arXiv 25 Nov 2024.

## Builds on (most cited first, 6 of 6)

- [On the Opportunities and Risks of Foundation Models](https://mlsanity.com/paper/2108.07258/) (2021)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [Just Ask for Calibration: Strategies for Eliciting Calibrated Confidence Scores from Language Models Fine-Tuned with Human Feedback](https://mlsanity.com/paper/2305.14975/) (2023)
- [Attend and Diagnose: Clinical Time Series Analysis using Attention Models](https://mlsanity.com/paper/1711.03905/) (2017)
- [Learning Tasks for Multitask Learning: Heterogenous Patient Populations in the ICU](https://mlsanity.com/paper/1806.02878/) (2018)

## Built on by (most cited first, 2 of 2)

- [OC-Distill: Ontology-aware Contrastive Learning with Cross-Modal Distillation for ICU Risk Prediction](https://mlsanity.com/paper/2604.16878/) (2026)
- [Transparent Early ICU Mortality Prediction with Clinical Transformer and Per-Case Modality Attribution](https://mlsanity.com/paper/2511.15847/) (2025)

## Abstract (arXiv)

To evaluate a multi-representational framework in which large language model (LLM)-generated expert summaries of intensive care unit (ICU) notes are fused with physiology for in-hospital mortality (IHM) prediction, and to determine how much of the resulting gain is non-redundant with the notes themselves. Using MIMIC-III (19,211 first ICU stays, 12.83% mortality), we encoded 48-hour physiology, clinical notes, and LLM summaries generated under a prompt forbidding prognostication, then fused them. Redundancy was assessed by ridge recoverability, linear probes, and retrained ablations substituting a note-orthogonal residual or a patient-shuffled summary embedding. On 3,843 held-out stays, fusion reached AUPRC 0.4977/AUROC 0.8429 versus 0.3625/0.7770 for physiology alone. Ridge regression from note embeddings explained 40.8% of summary-embedding variance. The note-orthogonal residual retained a minority of the gain (+0.0258 AUPRC, 95% CI 0.005--0.047; 28%), while patient-shuffled summaries fell below the reference. Summaries improve prediction patient-specifically, but predominantly by reorganizing information the notes already contain.