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Pretraining EHR Foundation Models with Patient-Aware Sampling

Research Medical/Healthcare AI

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TL;DR - This paper proposes patient-aware sampling for pretraining autoregressive EHR foundation models, avoiding mixed-patient windows and controlling each patient’s training contribution. It improves downstream clinical performance over conventional global-stream sampling.

  • Standard token-stream sampling can overrepresent patients with longer records.
  • Stochastic Patient Sampling supports controllable weighting of training signals across patients.
  • It improves Macro AUROC and AUPRC on clinical tasks using MIMIC-IV v2.2 and v3.1.
  • Sequence construction is identified as an important, underexplored EHR pretraining design choice.

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Pretraining EHR Foundation Models with Patient-Aware Sampling

arXiv cs.LG Joshua Placidi, Yuxuan Liu, Jinpei Han, Marek Rei, A. Aldo Faisal 2026-07-24 arXiv:2607.22114
Public signals Semantic Scholar citations 0 · Semantic Scholar influential citations 0
Providers: Hugging Face · N/A OpenAlex · N/A Publisher · N/A Semantic Scholar · Citations 0 · Influential citations 0 X · N/A Fetched 2026-08-26 14:45:47.385283 UTC

TL;DR - This paper proposes patient-aware sampling for pretraining autoregressive EHR foundation models, avoiding mixed-patient windows and controlling each patient’s training contribution. It improves downstream clinical performance over conventional global-stream sampling.

  • Standard token-stream sampling can overrepresent patients with longer records.
  • Stochastic Patient Sampling supports controllable weighting of training signals across patients.
  • It improves Macro AUROC and AUPRC on clinical tasks using MIMIC-IV v2.2 and v3.1.
  • Sequence construction is identified as an important, underexplored EHR pretraining design choice.
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