# LUNG-KGMM: Knowledge-Guided Multimodal Learning for Lung Cancer Incidence Prediction

arXiv: https://arxiv.org/abs/2608.14657 · HTML: https://mlsanity.com/paper/2608.14657/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 11 of its 39 references that are in the map.
- First posted on arXiv 31 Jul 2026.

## Builds on (most cited first, 11 of 11)

- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Med-BERT: pre-trained contextualized embeddings on large-scale structured electronic health records for disease prediction](https://mlsanity.com/paper/2005.12833/) (2020)
- [RETAIN: An Interpretable Predictive Model for Healthcare using Reverse Time Attention Mechanism](https://mlsanity.com/paper/1608.05745/) (2016)
- [Doctor AI: Predicting Clinical Events via Recurrent Neural Networks](https://mlsanity.com/paper/1511.05942/) (2015)
- [TorchXRayVision: A library of chest X-ray datasets and models](https://mlsanity.com/paper/2111.00595/) (2021)
- [MedFuse: Multi-modal fusion with clinical time-series data and chest X-ray images](https://mlsanity.com/paper/2207.07027/) (2022)
- [DrFuse: Learning Disentangled Representation for Clinical Multi-Modal Fusion with Missing Modality and Modal Inconsistency](https://mlsanity.com/paper/2403.06197/) (2024)
- [Improving Performance, Robustness, and Fairness of Radiographic AI Models with Finely-Controllable Synthetic Data](https://mlsanity.com/paper/2508.16783/) (2025)
- [PyHealth 2.0: A Comprehensive Open-Source Toolkit for Accessible and Reproducible Clinical Deep Learning](https://mlsanity.com/paper/2601.16414/) (2026)
- [GRASP: group-Shapley feature selection for patients](https://mlsanity.com/paper/2602.11084/) (2026)
- [Guideline-grounded retrieval-augmented generation for ophthalmic clinical decision support](https://mlsanity.com/paper/2603.21925/) (2026)

## Abstract (arXiv)

Early identification of lung cancer risk is critical for timely intervention, yet existing prediction models are limited by their reliance on single data modalities and their inability to leverage structured clinical knowledge. We propose LUNG-KGMM, a knowledge-guided multimodal framework that integrates longitudinal electronic health records, radiology reports, chest radiograph representations, and guideline-derived knowledge for 1-to-6-year incident lung cancer prediction. To address modality heterogeneity and potential data leakage, we develop a leakage-sanitized report processing pipeline and a horizon-masked cumulative training objective that handles incomplete follow-up. We further introduce a knowledge-graph representation of clinical guidance that encodes report-triggered finding-attribute-action relations as an auditable knowledge stream. We build a multimodal development cohort from the publicly available MIMIC databases and construct a real-world validation cohort from the Xiamen Medical Big Data Platform. Extensive experiments on the MIMIC cohort demonstrate that LUNG-KGMM achieves superior performance over state-of-the-art methods, and validation on the Xiamen cohort further characterizes its cross-cohort portability and the need for local adaptation. The MIMIC development cohort is publicly accessible; the Xiamen cohort is governed by local data privacy regulations.