# Temporal Fusion Nexus: A task-agnostic multi-modal embedding model for clinical narratives and irregular time series in post-kidney transplant care

arXiv: https://arxiv.org/abs/2601.08503 · HTML: https://mlsanity.com/paper/2601.08503/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 35 of its 67 references that are in the map.
- First posted on arXiv 13 Jan 2026.

## Builds on (most cited first, 30 of 35)

- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
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- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Are Transformers Effective for Time Series Forecasting?](https://mlsanity.com/paper/2205.13504/) (2022)
- [Temporal Fusion Transformers for Interpretable Multi-horizon Time Series Forecasting](https://mlsanity.com/paper/1912.09363/) (2019)
- [Towards General Text Embeddings with Multi-stage Contrastive Learning](https://mlsanity.com/paper/2308.03281/) (2023)
- [Recurrent Neural Networks for Multivariate Time Series with Missing Values](https://mlsanity.com/paper/1606.01865/) (2016)
- [ClinicalBERT: Modeling Clinical Notes and Predicting Hospital Readmission](https://mlsanity.com/paper/1904.05342/) (2019)
- [Med-BERT: pre-trained contextualized embeddings on large-scale structured electronic health records for disease prediction](https://mlsanity.com/paper/2005.12833/) (2020)
- [BEHRT: Transformer for Electronic Health Records](https://mlsanity.com/paper/1907.09538/) (2019)
- [GatorTron: A Large Clinical Language Model to Unlock Patient Information from Unstructured Electronic Health Records](https://mlsanity.com/paper/2203.03540/) (2022)
- [Dipole: Diagnosis Prediction in Healthcare via Attention-based Bidirectional Recurrent Neural Networks](https://mlsanity.com/paper/1706.05764/) (2017)
- [Disentangled Representation Learning](https://mlsanity.com/paper/2211.11695/) (2022)
- [Self-Supervised Transformer for Sparse and Irregularly Sampled Multivariate Clinical Time-Series](https://mlsanity.com/paper/2107.14293/) (2021)
- [Time Series Prediction using Deep Learning Methods in Healthcare](https://mlsanity.com/paper/2108.13461/) (2021)
- [DrFuse: Learning Disentangled Representation for Clinical Multi-Modal Fusion with Missing Modality and Modal Inconsistency](https://mlsanity.com/paper/2403.06197/) (2024)
- [A Multimodal Transformer: Fusing Clinical Notes with Structured EHR Data for Interpretable In-Hospital Mortality Prediction](https://mlsanity.com/paper/2208.10240/) (2022)
- [Deep Representation Learning of Patient Data from Electronic Health Records (EHR): A Systematic Review](https://mlsanity.com/paper/2010.02809/) (2020)
- [Using Clinical Notes with Time Series Data for ICU Management](https://mlsanity.com/paper/1909.09702/) (2019)
- [Deep learning for temporal data representation in electronic health records: A systematic review of challenges and methodologies](https://mlsanity.com/paper/2107.09951/) (2021)
- [Handling missing values in healthcare data: A systematic review of deep learning-based imputation techniques](https://mlsanity.com/paper/2210.08258/) (2022)
- [DCI-ES: An Extended Disentanglement Framework with Connections to Identifiability](https://mlsanity.com/paper/2210.00364/) (2022)
- [DeepSOFA: A Continuous Acuity Score for Critically Ill Patients using Clinically Interpretable Deep Learning](https://mlsanity.com/paper/1802.10238/) (2018)
- [Reliable and Trustworthy Machine Learning for Health Using Dataset Shift Detection](https://mlsanity.com/paper/2110.14019/) (2021)
- [Multimodal data matters: language model pre-training over structured and unstructured electronic health records](https://mlsanity.com/paper/2201.10113/) (2022)
- [On the Importance of Clinical Notes in Multi-modal Learning for EHR Data](https://mlsanity.com/paper/2212.03044/) (2022)
- [Review of Disentanglement Approaches for Medical Applications -- Towards Solving the Gordian Knot of Generative Models in Healthcare](https://mlsanity.com/paper/2203.11132/) (2022)
- [Labrador: Exploring the Limits of Masked Language Modeling for Laboratory Data](https://mlsanity.com/paper/2312.11502/) (2023)

## Abstract (arXiv)

We introduce Temporal Fusion Nexus (TFN), a multi-modal and task-agnostic embedding model to integrate irregular time series and unstructured clinical narratives. We analysed TFN in post-kidney transplant (KTx) care, with a retrospective cohort of 3382 patients, on three key outcomes: graft loss, graft rejection, and mortality. Compared to state-of-the-art model in post KTx care, TFN achieved higher performance for graft loss (AUC 0.96 vs. 0.94) and graft rejection (AUC 0.84 vs. 0.74). In mortality prediction, TFN yielded an AUC of 0.86. TFN outperformed unimodal baselines (approx 10% AUC improvement over time series only baseline, approx 5% AUC improvement over time series with static patient data). Integrating clinical text improved performance across all tasks. Disentanglement metrics confirmed robust and interpretable latent factors in the embedding space, and SHAP-based attributions confirmed alignment with clinical reasoning. TFN has potential application in clinical tasks beyond KTx, where heterogeneous data sources, irregular longitudinal data, and rich narrative documentation are available.