# MedGate-Fusion: Integrating First-Encounter Semantic Narratives and Physiological Biomarkers for Prospective Stroke Risk Stratification

arXiv: https://arxiv.org/abs/2609.25272 · HTML: https://mlsanity.com/paper/2609.25272/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 17 of its 43 references that are in the map.
- First posted on arXiv 21 Sep 2026.

## Builds on (most cited first, 17 of 17)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [MiniLM: Deep Self-Attention Distillation for Task-Agnostic Compression of Pre-Trained Transformers](https://mlsanity.com/paper/2002.10957/) (2020)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [ClinicalBERT: Modeling Clinical Notes and Predicting Hospital Readmission](https://mlsanity.com/paper/1904.05342/) (2019)
- [Med-BERT: pre-trained contextualized embeddings on large-scale structured electronic health records for disease prediction](https://mlsanity.com/paper/2005.12833/) (2020)
- [Scalable and accurate deep learning for electronic health records](https://mlsanity.com/paper/1801.07860/) (2018)
- [BEHRT: Transformer for Electronic Health Records](https://mlsanity.com/paper/1907.09538/) (2019)
- [GatorTron: A Large Clinical Language Model to Unlock Patient Information from Unstructured Electronic Health Records](https://mlsanity.com/paper/2203.03540/) (2022)
- [FuseMoE: Mixture-of-Experts Transformers for Fleximodal Fusion](https://mlsanity.com/paper/2402.03226/) (2024)
- [Hi-BEHRT: Hierarchical Transformer-based model for accurate prediction of clinical events using multimodal longitudinal electronic health records](https://mlsanity.com/paper/2106.11360/) (2021)
- [A Multimodal Transformer: Fusing Clinical Notes with Structured EHR Data for Interpretable In-Hospital Mortality Prediction](https://mlsanity.com/paper/2208.10240/) (2022)
- [Natural Language Processing of Clinical Notes on Chronic Diseases: Systematic Review](https://mlsanity.com/paper/1908.05780/) (2019)
- [Transformers in Healthcare: A Survey](https://mlsanity.com/paper/2307.00067/) (2023)
- [On Leakage in Machine Learning Pipelines](https://mlsanity.com/paper/2311.04179/) (2023)
- [MoE-Health: A Mixture of Experts Framework for Robust Multimodal Healthcare Prediction](https://mlsanity.com/paper/2508.21793/) (2025)

## Abstract (arXiv)

Prospective stroke risk stratification in primary care is challenging because early risk signals are distributed across routine biomarkers and unstructured clinical narratives. We propose MedGate-Fusion, a multi-modal gated architecture that integrates transformer-based embeddings of first-encounter narratives with ten routinely recorded risk markers. We used electronic medical record data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). Starting from 808,921 encounter-level observations, we constructed a first-encounter cohort and retained 102,736 unique patient records with non-empty narratives and sufficient data to evaluate a five-year stroke outcome. To reduce explicit target leakage from diagnostic mentions in notes, we applied dictionary-based redaction of stroke-related terms prior to semantic encoding.