Artificial Intelligence-Based Methods for Fusion of Electronic Health Records and Imaging Data

Healthcare data are inherently multimodal, including electronic health records (EHR), medical images, and multi-omics data. Combining these multimodal data sources contributes to a better understanding of human health and provides optimal personalized healthcare. Advances in AI technologies, particularly ML, enable the fusion of these different data modalities to provide multimodal insights. To this end, in this scoping review, we focus on synthesizing and analyzing the literature that uses AI techniques to fuse multimodal medical data for different clinical applications. More specifically, we focus on studies that only fused EHR with medical imaging data to develop various AI methods for clinical applications. We present a comprehensive analysis of the various fusion strategies, the diseases and clinical outcomes for which multimodal fusion was used, the ML algorithms used to perform multimodal fusion for each clinical application, and the available multimodal medical datasets. We followed the PRISMA-ScR guidelines. We searched Embase, PubMed, Scopus, and Google Scholar to retrieve relevant studies. We extracted data from 34 studies that fulfilled the inclusion criteria. In our analysis, a typical workflow was observed: feeding raw data, fusing different data modalities by applying conventional ML or deep learning (DL) algorithms, and finally, evaluating the multimodal fusion through clinical outcome predictions. Specifically, early fusion was the most used technique in most applications for multimodal learning (22 out of 34 studies). We found that multimodality fusion models outperformed traditional single-modality models for the same task. Disease diagnosis and prediction were the most common clinical outcomes (reported in 20 and 10 studies, respectively) from a clinical outcome perspective.