# Trajectory-Aware Clinical Risk Prediction via Severity-Grounded Knowledge Graphs and Retrieval-Augmented Generation

arXiv: https://arxiv.org/abs/2607.18270 · HTML: https://mlsanity.com/paper/2607.18270/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 29 of its 58 references that are in the map.
- First posted on arXiv 2 Jun 2026.

## Builds on (most cited first, 29 of 29)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Lost in the Middle: How Language Models Use Long Contexts](https://mlsanity.com/paper/2307.03172/) (2023)
- [SimCSE: Simple Contrastive Learning of Sentence Embeddings](https://mlsanity.com/paper/2104.08821/) (2021)
- [An Empirical Evaluation of Generic Convolutional and Recurrent Networks for Sequence Modeling](https://mlsanity.com/paper/1803.01271/) (2018)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [ClinicalBERT: Modeling Clinical Notes and Predicting Hospital Readmission](https://mlsanity.com/paper/1904.05342/) (2019)
- [RETAIN: An Interpretable Predictive Model for Healthcare using Reverse Time Attention Mechanism](https://mlsanity.com/paper/1608.05745/) (2016)
- [Benchmarking Retrieval-Augmented Generation for Medicine](https://mlsanity.com/paper/2402.13178/) (2024)
- [RECOMP: Improving Retrieval-Augmented LMs with Compression and Selective Augmentation](https://mlsanity.com/paper/2310.04408/) (2023)
- [GRAM: Graph-based Attention Model for Healthcare Representation Learning](https://mlsanity.com/paper/1611.07012/) (2016)
- [Searching for Best Practices in Retrieval-Augmented Generation](https://mlsanity.com/paper/2407.01219/) (2024)
- [GraphCare: Enhancing Healthcare Predictions with Personalized Knowledge Graphs](https://mlsanity.com/paper/2305.12788/) (2023)
- [ConCare: Personalized Clinical Feature Embedding via Capturing the Healthcare Context](https://mlsanity.com/paper/1911.12216/) (2019)
- [AdaCare: Explainable Clinical Health Status Representation Learning via Scale-Adaptive Feature Extraction and Recalibration](https://mlsanity.com/paper/1911.12205/) (2019)
- [StageNet: Stage-Aware Neural Networks for Health Risk Prediction](https://mlsanity.com/paper/2001.10054/) (2020)
- [A Multimodal Transformer: Fusing Clinical Notes with Structured EHR Data for Interpretable In-Hospital Mortality Prediction](https://mlsanity.com/paper/2208.10240/) (2022)
- [Reasoning-Enhanced Healthcare Predictions with Knowledge Graph Community Retrieval](https://mlsanity.com/paper/2410.04585/) (2024)
- [CPLLM: Clinical Prediction with Large Language Models](https://mlsanity.com/paper/2309.11295/) (2023)
- [BIDER: Bridging Knowledge Inconsistency for Efficient Retrieval-Augmented LLMs via Key Supporting Evidence](https://mlsanity.com/paper/2402.12174/) (2024)
- [ColaCare: Enhancing Electronic Health Record Modeling through Large Language Model-Driven Multi-Agent Collaboration](https://mlsanity.com/paper/2410.02551/) (2024)
- [TAPER: Time-Aware Patient EHR Representation](https://mlsanity.com/paper/1908.03971/) (2019)
- [RAM-EHR: Retrieval Augmentation Meets Clinical Predictions on Electronic Health Records](https://mlsanity.com/paper/2403.00815/) (2024)
- [Context-aware Health Event Prediction via Transition Functions on Dynamic Disease Graphs](https://mlsanity.com/paper/2112.05195/) (2021)
- [EMERGE: Enhancing Multimodal Electronic Health Records Predictive Modeling with Retrieval-Augmented Generation](https://mlsanity.com/paper/2406.00036/) (2024)
- [Large Language Model Capabilities in Perioperative Risk Prediction and Prognostication](https://mlsanity.com/paper/2401.01620/) (2024)
- [PRISM: Mitigating EHR Data Sparsity via Learning from Missing Feature Calibrated Prototype Patient Representations](https://mlsanity.com/paper/2309.04160/) (2023)
- [Neural networks versus Logistic regression for 30 days all-cause readmission prediction](https://mlsanity.com/paper/1812.09549/) (2018)
- [Bio+Clinical BERT, BERT Base, and CNN Performance Comparison for Predicting Drug-Review Satisfaction](https://mlsanity.com/paper/2308.03782/) (2023)

## Abstract (arXiv)

While Electronic Health Records (EHRs) offer a wealth of clinical data, effectively augmenting a patient's records with heterogeneous external knowledge to predict the patient's clinical risk remains a significant challenge. Existing methods fail to capture disease severity, treatment responses, and nuanced clinical progression, due to data sparsity and the underutilization of unstructured clinical notes. To address these challenges, we propose TRACER (a trajectory-aware and clinically grounded prediction framework) that (1) constructs a medical knowledge graph enriched with severity information from medical literature, (2) retrieves clinically relevant, severity-weighted paths of a patient's progression from the knowledge graph, (3) extracts clinically relevant events from unstructured clinical notes, and (4) augments patient context with similar peer cases. Experiments on the MIMIC-III and MIMIC-IV datasets demonstrate large gains over state-of-the-art baselines, with up to 28.5% increase in Macro F1 score for the mortality prediction task, and 19.7% increase for the readmission prediction task.