We propose an early-fusion framework that combines deep features from chest X-rays (CXR) with bag-of-words (BoW) representations of pre-imaging clinical notes. Using eight CNN backbones to extract image features and BoW vectors from notes, our model learns adaptive modality weights via a single-layer attention module and feeds the fused embedding into XGBoost classifiers. On a real-world Vietnamese hospital dataset of 15416 paired CXRs and notes spanning seven pulmonary diseases, fusion improves accuracy and F1 score over image-only baselines across all backbones. Results indicate that even simple clinical text cues, when fused early with radiographic features, enhance robustness on minority classes and better reflect clinical reasoning.

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Adaptive Early Fusion of Clinical Bag-of-Words and Chest X-Ray Deep Features for Pulmonary Disease Diagnosis

  • Phuoc-Hai Huynh,
  • Thi-Diem Truong

摘要

We propose an early-fusion framework that combines deep features from chest X-rays (CXR) with bag-of-words (BoW) representations of pre-imaging clinical notes. Using eight CNN backbones to extract image features and BoW vectors from notes, our model learns adaptive modality weights via a single-layer attention module and feeds the fused embedding into XGBoost classifiers. On a real-world Vietnamese hospital dataset of 15416 paired CXRs and notes spanning seven pulmonary diseases, fusion improves accuracy and F1 score over image-only baselines across all backbones. Results indicate that even simple clinical text cues, when fused early with radiographic features, enhance robustness on minority classes and better reflect clinical reasoning.