# TCDiff: Triplex Cascaded Diffusion for High-fidelity Multimodal EHRs Generation with Incomplete Clinical Data

arXiv: https://arxiv.org/abs/2508.01615 · HTML: https://mlsanity.com/paper/2508.01615/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 14 of its 44 references that are in the map.
- First posted on arXiv 3 Aug 2025.

## Builds on (most cited first, 14 of 14)

- [Sentence-BERT: Sentence Embeddings using Siamese BERT-Networks](https://mlsanity.com/paper/1908.10084/) (2019)
- [Modeling Tabular data using Conditional GAN](https://mlsanity.com/paper/1907.00503/) (2019)
- [TabDDPM: Modelling Tabular Data with Diffusion Models](https://mlsanity.com/paper/2209.15421/) (2022)
- [MISA: Modality-Invariant and -Specific Representations for Multimodal Sentiment Analysis](https://mlsanity.com/paper/2005.03545/) (2020)
- [A Kernelized Stein Discrepancy for Goodness-of-fit Tests and Model Evaluation](https://mlsanity.com/paper/1602.03253/) (2016)
- [Generating Multi-label Discrete Patient Records using Generative Adversarial Networks](https://mlsanity.com/paper/1703.06490/) (2017)
- [Estimating Missing Data in Temporal Data Streams Using Multi-directional Recurrent Neural Networks](https://mlsanity.com/paper/1711.08742/) (2017)
- [Generating Synthetic Mixed-type Longitudinal Electronic Health Records for Artificial Intelligent Applications](https://mlsanity.com/paper/2112.12047/) (2021)
- [A Multifaceted Benchmarking of Synthetic Electronic Health Record Generation Models](https://mlsanity.com/paper/2208.01230/) (2022)
- [CorGAN: Correlation-Capturing Convolutional Generative Adversarial Networks for Generating Synthetic Healthcare Records](https://mlsanity.com/paper/2001.09346/) (2020)
- [MUFASA: Multimodal Fusion Architecture Search for Electronic Health Records](https://mlsanity.com/paper/2102.02340/) (2021)
- [Handling missing values in healthcare data: A systematic review of deep learning-based imputation techniques](https://mlsanity.com/paper/2210.08258/) (2022)
- [EHRDiff: Exploring Realistic EHR Synthesis with Diffusion Models](https://mlsanity.com/paper/2303.05656/) (2023)
- [Artificial Intelligence-Based Methods for Fusion of Electronic Health Records and Imaging Data](https://mlsanity.com/paper/2210.13462/) (2022)

## Abstract (arXiv)

The scarcity of large-scale and high-quality electronic health records (EHRs) remains a major bottleneck in biomedical research, especially as large foundation models become increasingly data-hungry. Synthesizing substantial volumes of de-identified and high-fidelity data from existing datasets has emerged as a promising solution. However, existing methods suffer from a series of limitations: they struggle to model the intrinsic properties of heterogeneous multimodal EHR data (e.g., continuous, discrete, and textual modalities), capture the complex dependencies among them, and robustly handle pervasive data incompleteness. These challenges are particularly acute in Traditional Chinese Medicine (TCM). To this end, we propose TCDiff (Triplex Cascaded Diffusion Network), a novel EHR generation framework that cascades three diffusion networks to learn the features of real-world EHR data, formatting a multi-stage generative process: Reference Modalities Diffusion, Cross-Modal Bridging, and Target Modality Diffusion. Furthermore, to validate our proposed framework, besides two public datasets, we also construct and introduce TCM-SZ1, a novel multimodal EHR dataset for benchmarking. Experimental results show that TCDiff consistently outperforms state-of-the-art baselines by an average of 10% in data fidelity under various missing rate, while maintaining competitive privacy guarantees. This highlights the effectiveness, robustness, and generalizability of our approach in real-world healthcare scenarios.