# Assessing Multimodal Chronic Wound Embeddings with Expert Triplet Agreement

arXiv: https://arxiv.org/abs/2603.29376 · HTML: https://mlsanity.com/paper/2603.29376/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 13 of its 16 references that are in the map.
- First posted on arXiv 31 Mar 2026.

## Builds on (most cited first, 13 of 13)

- [RoBERTa: A Robustly Optimized BERT Pretraining Approach](https://mlsanity.com/paper/1907.11692/) (2019)
- [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)
- [Sigmoid Loss for Language Image Pre-Training](https://mlsanity.com/paper/2303.15343/) (2023)
- [FaceNet: A Unified Embedding for Face Recognition and Clustering](https://mlsanity.com/paper/1503.03832/) (2015)
- [Supervised Contrastive Learning](https://mlsanity.com/paper/2004.11362/) (2020)
- [MiniLM: Deep Self-Attention Distillation for Task-Agnostic Compression of Pre-Trained Transformers](https://mlsanity.com/paper/2002.10957/) (2020)
- [VICReg: Variance-Invariance-Covariance Regularization for Self-Supervised Learning](https://mlsanity.com/paper/2105.04906/) (2021)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [MedGemma Technical Report](https://mlsanity.com/paper/2507.05201/) (2025)
- [A Multimodal Vision Foundation Model for Clinical Dermatology](https://mlsanity.com/paper/2410.15038/) (2024)
- [Derm1M: A Million-scale Vision-Language Dataset Aligned with Clinical Ontology Knowledge for Dermatology](https://mlsanity.com/paper/2503.14911/) (2025)
- [A Vision-Language Foundation Model for Zero-shot Clinical Collaboration and Automated Concept Discovery in Dermatology](https://mlsanity.com/paper/2602.10624/) (2026)

## Abstract (arXiv)

Recessive dystrophic epidermolysis bullosa (RDEB) is a rare genetic skin disorder for which clinicians greatly benefit from finding similar cases using images and clinical text. However, off-the-shelf foundation models do not reliably capture clinically meaningful features for this heterogeneous, long-tail disease, and structured measurement of agreement with experts is challenging. To address these gaps, we propose evaluating embedding spaces with expert ordinal comparisons (triplet judgments), which are fast to collect and encode implicit clinical similarity knowledge. We further introduce TriDerm, a multimodal framework that learns interpretable wound representations from small cohorts by integrating wound imagery, boundary masks, and expert reports. On the vision side, TriDerm adapts visual foundation models to RDEB using wound-level attention pooling and non-contrastive representation learning. For text, we prompt large language models with comparison queries and recover medically meaningful representations via soft ordinal embeddings (SOE). We show that visual and textual modalities capture complementary aspects of wound phenotype, and that fusing both modalities yields 73.5% agreement with experts, outperforming the best off-the-shelf single-modality foundation model by over 5.6 percentage points. We make the expert annotation tool, model code and representative dataset samples publicly available.