# Missingness as Signal: Channel-Independent Spectrogram Learning for Clinical Time Series Prediction

arXiv: https://arxiv.org/abs/2607.02938 · HTML: https://mlsanity.com/paper/2607.02938/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 13 of its 31 references that are in the map.
- First posted on arXiv 3 Jul 2026.

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

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks](https://mlsanity.com/paper/1905.11946/) (2019)
- [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)
- [FEDformer: Frequency Enhanced Decomposed Transformer for Long-term Series Forecasting](https://mlsanity.com/paper/2201.12740/) (2022)
- [AST: Audio Spectrogram Transformer](https://mlsanity.com/paper/2104.01778/) (2021)
- [Recurrent Neural Networks for Multivariate Time Series with Missing Values](https://mlsanity.com/paper/1606.01865/) (2016)
- [Multi-Time Attention Networks for Irregularly Sampled Time Series](https://mlsanity.com/paper/2101.10318/) (2021)
- [Set Functions for Time Series](https://mlsanity.com/paper/1909.12064/) (2019)
- [Time Series Prediction using Deep Learning Methods in Healthcare](https://mlsanity.com/paper/2108.13461/) (2021)
- [Comparison of Time-Frequency Representations for Environmental Sound Classification using Convolutional Neural Networks](https://mlsanity.com/paper/1706.07156/) (2017)

## Abstract (arXiv)

Clinical time series prediction in intensive care units remains challenging due to heterogeneous physiological variables and informative missingness. The presence or absence of a measurement can reflect clinical decisions and patient severity, and thus missingness can serve as a predictive signal rather than a simple data artifact. This work presents CISM, a Channel-Independent Spectrogram framework with a Missingness stream for clinical multivariate time series prediction. CISM converts each clinical variable into a variable-wise time-frequency spectrogram, preserves variable identity through variable-aligned encoding, and aligns an explicit missingness stream with the spectrogram representation. Experiments on an in-hospital mortality task derived from MIMIC-IV show that CISM achieves the highest mean AUROC (0.7225), AUPRC (0.3308), and F1 (0.3808) among the compared time series, missingness-aware, vision, and time-frequency baselines. Ablation studies further show that observation patterns provide a meaningful informative signal. Pixel-level mask injection improves performance over plain spectrogram inputs and recovers much of this predictive value. The aligned missingness stream contributes a further, complementary gain in both AUROC and AUPRC. These results highlight the importance of modeling observation patterns as structured signals in clinical time series prediction.