The increase in imaging orders and the availability of high-resolution scanners have led to large workloads for radiologists.^1,2 With advances in artificial intelligence (AI), there is now potential for radiologists to be aided in clinical workflows by machine assistants in a manner similar to the duties performed by radiology residents,³ through preliminary interpretations that can be later corrected or approved by attending radiologists. This can help expedite workflows, improve accuracy, and ultimately reduce overall costs.³

Machine learning (ML) applications in medical artificial intelligence (AI) systems have shifted from traditional and statistical methods to increasing application of deep learning models. This survey navigates the current landscape of multimodal ML, focusing on its profound impact on medical image analysis and clinical decision support systems. Emphasizing challenges and innovations in addressing multimodal representation, fusion, translation, alignment, and co-learning, the paper explores the transformative potential of multimodal models for clinical predictions. It also highlights the need for principled assessments and practical implementation of such models, bringing attention to the dynamics between decision support systems and healthcare providers and personnel. Despite advancements, challenges such as data biases and the scarcity of “big data” in many biomedical domains persist. We conclude with a discussion on principled innovation and collaborative efforts to further the mission of seamless integration of multimodal ML models into biomedical practice.

In this paper we present a new method of uncovering patients with aortic valve diseases in large electronic health record systems through learning with multimodal data. The method automatically extracts clinically-relevant valvular disease features from five multimodal sources of information including structured diagnosis, echocardiogram reports, and echocardiogram imaging studies. It combines these partial evidence features in a random forests learning framework to predict patients likely to have the disease. Results of a retrospective clinical study from a 1000 patient dataset are presented that indicate that over 25 % new patients with moderate to severe aortic stenosis can be automatically discovered by our method that were previously missed from the records.