# Large Language Models as Unified Multimodal Learners for Clinical Prediction

arXiv: https://arxiv.org/abs/2607.15380 · HTML: https://mlsanity.com/paper/2607.15380/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 14 of its 30 references that are in the map.
- First posted on arXiv 16 Jul 2026.

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

- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [Gemma 2: Improving Open Language Models at a Practical Size](https://mlsanity.com/paper/2408.00118/) (2024)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [Smarter, Better, Faster, Longer: A Modern Bidirectional Encoder for Fast, Memory Efficient, and Long Context Finetuning and Inference](https://mlsanity.com/paper/2412.13663/) (2024)
- [Scalable and accurate deep learning for electronic health records](https://mlsanity.com/paper/1801.07860/) (2018)
- [Using Clinical Notes with Time Series Data for ICU Management](https://mlsanity.com/paper/1909.09702/) (2019)
- [Large Language Models are Powerful Electronic Health Record Encoders](https://mlsanity.com/paper/2502.17403/) (2025)
- [Multimodal Fusion of EHR in Structures and Semantics: Integrating Clinical Records and Notes with Hypergraph and LLM](https://mlsanity.com/paper/2403.08818/) (2024)
- [MoMA: A Mixture-of-Multimodal-Agents Architecture for Enhancing Clinical Prediction Modelling](https://mlsanity.com/paper/2508.05492/) (2025)
- [Will Large Language Models Transform Clinical Prediction?](https://mlsanity.com/paper/2505.18246/) (2025)
- [LeMoF: Level-guided Multimodal Fusion for Heterogeneous Clinical Data](https://mlsanity.com/paper/2601.10092/) (2026)

## Abstract (arXiv)

Electronic health records combine free-text clinical narratives with structured measurements such as vital signs, laboratory values, and comorbidities. Yet most clinical prediction systems still rely on task-specific fusion architectures, pairing dedicated encoders for each modality with learned combination mechanisms that must be re-engineered for every new task and clinical setting. We propose a simpler alternative: convert all patient data, regardless of modality, into a single natural language sequence and fine-tune a pretrained language model end-to-end, with no architectural modification for fusion. We evaluate this approach across three clinically distinct prediction tasks: in-hospital mortality on MIMIC-III, graft failure prediction using longitudinal data from a German transplant center, and emergency triage classification from ambulance records - comparing encoder-based (ModernBERT) and decoder-based (Llama 3.1, Gemma, DeepSeek-R1-Qwen, Qwen3) fine-tuning against established multimodal baselines and, for graft failure, a gradient boosting model currently used in clinical practice for post-transplant patient management. Across all three tasks, unified textual serialization matches or exceeds task-specific multimodal baselines, and outperforms the clinically deployed gradient boosting system on graft failure prediction. These results indicate that a single serialization-based paradigm, without bespoke fusion architectures, is sufficient for multimodal clinical prediction - substantially reducing system complexity while matching or exceeding specialized designs.