CLEAR: Addressing Representation Contamination in Multimodal Healthcare Analytics

Electronic health records (EHRs) are the de facto standard for analyzing comprehensive patient conditions. Existing methods mainly employ specialized neural networks to extract modality-specific information, followed by modality correlation modeling to support clinical decision-making. However, these methods generally overlook the issue of ''contaminated'' representations inherent in routine EHR data, which can undermine the model's discriminative ability, as less relevant representations associated with false positive correlations may impede the recognition of truly effective representations. To address the issue of representation contamination, we propose CLEAR, a counterfactual disparity learning model for explicit multimodal EHR analytics. The core idea is to first model the contamination in representations, and subsequently perform calibration and enhancement to construct highly discriminative representations. Specifically, CLEAR first proposes the Counterfactual Prompt Learning Module to capture the representation discrepancy to model representation contamination. Subsequently, an Adaptive Dynamic Imputation Module is devised to decouple the elementwise representations for representation calibration, while a gating mechanism is further proposed to incorporate discriminative discrepancy information for representation enhancement. Finally, the Multimodal Representation Fusion Module establishes intra- and inter-modality correlations, thereby creating a seamless integration towards downstream analytic tasks. To our knowledge, CLEAR is the first to model and resolve representation contamination in multimodal EHR analytics. Experimental results on two real-world datasets demonstrate that CLEAR consistently outperforms state-of-the-art baselines in facilitating multimodal healthcare analytics.