# Discriminative Representation Learning for Clinical Prediction

arXiv: https://arxiv.org/abs/2603.20921 · HTML: https://mlsanity.com/paper/2603.20921/

## Key facts

- Cited by 2 papers in the map (data through 7 Oct 2026).
- Builds on 79 of its 118 references that are in the map.
- First posted on arXiv 21 Mar 2026.

## Builds on (most cited first, 30 of 79)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [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)
- [High-Resolution Image Synthesis with Latent Diffusion Models](https://mlsanity.com/paper/2112.10752/) (2021)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Emerging Properties in Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.14294/) (2021)
- [Photorealistic Text-to-Image Diffusion Models with Deep Language Understanding](https://mlsanity.com/paper/2205.11487/) (2022)
- [FlashAttention-2: Faster Attention with Better Parallelism and Work Partitioning](https://mlsanity.com/paper/2307.08691/) (2023)
- [Towards Robust Monocular Depth Estimation: Mixing Datasets for Zero-shot Cross-dataset Transfer](https://mlsanity.com/paper/1907.01341/) (2019)
- [4D Spatio-Temporal ConvNets: Minkowski Convolutional Neural Networks](https://mlsanity.com/paper/1904.08755/) (2019)
- [iBOT: Image BERT Pre-Training with Online Tokenizer](https://mlsanity.com/paper/2111.07832/) (2021)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [CrossViT: Cross-Attention Multi-Scale Vision Transformer for Image Classification](https://mlsanity.com/paper/2103.14899/) (2021)
- [Contrastive Representation Distillation](https://mlsanity.com/paper/1910.10699/) (2019)
- [CCNet: Criss-Cross Attention for Semantic Segmentation](https://mlsanity.com/paper/1811.11721/) (2018)
- [Time-LLM: Time Series Forecasting by Reprogramming Large Language Models](https://mlsanity.com/paper/2310.01728/) (2023)
- [TotalSegmentator: robust segmentation of 104 anatomical structures in CT images](https://mlsanity.com/paper/2208.05868/) (2022)
- [Bag of Tricks for Image Classification with Convolutional Neural Networks](https://mlsanity.com/paper/1812.01187/) (2018)
- [Med-BERT: pre-trained contextualized embeddings on large-scale structured electronic health records for disease prediction](https://mlsanity.com/paper/2005.12833/) (2020)
- [SegMamba: Long-range Sequential Modeling Mamba For 3D Medical Image Segmentation](https://mlsanity.com/paper/2401.13560/) (2024)
- [Self-Supervised Contrastive Pre-Training For Time Series via Time-Frequency Consistency](https://mlsanity.com/paper/2206.08496/) (2022)
- [Foundation Models for Time Series Analysis: A Tutorial and Survey](https://mlsanity.com/paper/2403.14735/) (2024)
- [Cross Attention Network for Few-shot Classification](https://mlsanity.com/paper/1910.07677/) (2019)

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

- [WISTERIA: Learning Clinical Representations from Noisy Supervision via Multi-View Consistency in Electronic Health Records](https://mlsanity.com/paper/2605.09765/) (2026)
- [AURORA: Contextual Orthogonalization for Geometric Representation Learning in Healthcare Foundation Models](https://mlsanity.com/paper/2605.17765/) (2026)

## Abstract (arXiv)

Foundation models in healthcare have largely adopted self supervised pretraining objectives inherited from natural language processing and computer vision, emphasizing reconstruction and large scale representation learning prior to downstream adaptation. We revisit this paradigm in outcome centric clinical prediction settings and argue that, when high quality supervision is available, direct outcome alignment may provide a stronger inductive bias than generative pretraining. We propose a supervised deep learning framework that explicitly shapes representation geometry by maximizing inter class separation relative to within class variance, thereby concentrating model capacity along clinically meaningful axes. Across multiple longitudinal electronic health record tasks, including mortality and readmission prediction, our approach consistently outperforms masked, autoregressive, and contrastive pretraining baselines under matched model capacity. The proposed method improves discrimination, calibration, and sample efficiency, while simplifying the training pipeline to a single stage optimization. These findings suggest that in low entropy, outcome driven healthcare domains, supervision can act as the statistically optimal driver of representation learning, challenging the assumption that large scale self supervised pretraining is a prerequisite for strong clinical performance.