# Transformer representation learning is necessary for dynamic multi-modal physiological data on small-cohort patients

arXiv: https://arxiv.org/abs/2504.04120 · HTML: https://mlsanity.com/paper/2504.04120/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 17 of its 48 references that are in the map.
- First posted on arXiv 5 Apr 2025.

## Builds on (most cited first, 17 of 17)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Exploring the Limits of Transfer Learning with a Unified Text-to-Text Transformer](https://mlsanity.com/paper/1910.10683/) (2019)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [End-to-End Object Detection with Transformers](https://mlsanity.com/paper/2005.12872/) (2020)
- [Informer: Beyond Efficient Transformer for Long Sequence Time-Series Forecasting](https://mlsanity.com/paper/2012.07436/) (2020)
- [A Time Series is Worth 64 Words: Long-term Forecasting with Transformers](https://mlsanity.com/paper/2211.14730/) (2022)
- [Autoformer: Decomposition Transformers with Auto-Correlation for Long-Term Series Forecasting](https://mlsanity.com/paper/2106.13008/) (2021)
- [iTransformer: Inverted Transformers Are Effective for Time Series Forecasting](https://mlsanity.com/paper/2310.06625/) (2023)
- [Medformer: A Multi-Granularity Patching Transformer for Medical Time-Series Classification](https://mlsanity.com/paper/2405.19363/) (2024)
- [Self-Supervised Learning of Time Series Representation via Diffusion Process and Imputation-Interpolation-Forecasting Mask](https://mlsanity.com/paper/2405.05959/) (2024)
- [Series2Vec: Similarity-based Self-supervised Representation Learning for Time Series Classification](https://mlsanity.com/paper/2312.03998/) (2023)
- [ADAPT: Multimodal Learning for Detecting Physiological Changes under Missing Modalities](https://mlsanity.com/paper/2407.03836/) (2024)
- [Towards dynamic multi-modal phenotyping using chest radiographs and physiological data](https://mlsanity.com/paper/2111.02710/) (2021)
- [Multimodal Physiological Signals Representation Learning via Multiscale Contrasting for Depression Recognition](https://mlsanity.com/paper/2406.16968/) (2024)

## Abstract (arXiv)

Postoperative delirium (POD), a severe neuropsychiatric complication affecting nearly 50% of high-risk surgical patients, is defined as an acute disorder of attention and cognition, It remains significantly underdiagnosed in the intensive care units (ICUs) due to subjective monitoring methods. Early and accurate diagnosis of POD is critical and achievable. Here, we propose a POD prediction framework comprising a Transformer representation model followed by traditional machine learning algorithms. Our approaches utilizes multi-modal physiological data, including amplitude-integrated electroencephalography (aEEG), vital signs, electrocardiographic monitor data as well as hemodynamic parameters. We curated the first multi-modal POD dataset encompassing two patient types and evaluated the various Transformer architectures for representation learning. Empirical results indicate a consistent improvements of sensitivity and Youden index in patient TYPE I using Transformer representations, particularly our fusion adaptation of Pathformer. By enabling effective delirium diagnosis from postoperative day 1 to 3, our extensive experimental findings emphasize the potential of multi-modal physiological data and highlight the necessity of representation learning via multi-modal Transformer architecture in clinical diagnosis.