Integrating multimodal datasets in clinical oncology is frequently hindered by high dimensionality and blockwise missingness, where entire data sources are unavailable for specific patient subsets. Standard survival models often struggle with these gaps, leading to biased results or patient exclusion. We introduce Multimodality Stacking with Blockwise missing values (MSB), a late-fusion framework for survival analysis that independently models modality-specific features before aggregating predictions via a cross-validated stacking meta-learner. MSB was validated on the PIONeeR study (n=443 patients, 378 biomarkers across eight heterogeneous sources) to predict progression-free survival in advanced non-small cell lung cancer patients receiving immunotherapy. MSB yielded higher predictive performance (C-index) than baseline algorithms. Improvements varied by baseline strength: linear models showed a 15.9% increase (p<0.001 for the Wilcoxon signed-rank test), random survival forests gained 5.4% (p=0.002), and gradient boosting methods improved by 2.1% (p=0.030). Beyond discrimination, MSB reduced the generalization gap (train-test difference in 5 folds cross-validation repeated 3 times: 0.055 vs 0.380 for linear models). Permutation importance analysis identified routine laboratory markers, clinical features, and PD-L1 expression as primary predictive drivers. Missing block indicators showed negligible importance, suggesting the model learned from biomarker values rather than data availability patterns. MSB provides a statistically validated framework for multimodal survival prediction with blockwise missingness. By enabling systematic biomarker evaluation without requiring complete data, MSB offers a practical tool for predictive modeling in biomedical research, pending external validation. Implementation is available at https://github.com/MohamedBoussena/MSB under Inria license.

Many clinical risk scores are deployed as additive rules with nonnegative integer points assigned to relevant binary predictive features. These integer weights not only make the score easier to use in practice but also promote sparsity in the resulting prediction model. Such risk scores are often derived by first fitting a regression model and then rounding the estimated coefficients to the nearest integer after appropriate scaling. This approach is computationally fast but does not guarantee optimality of the resulting score. Alternatively, one may search over all possible integer weights to directly optimize a value function by posing the problem as an integer programming task. However, the associated computational burden can be substantial, especially when the value function is nonconcave or even discontinuous. In this paper, we develop new machine learning algorithms that employ a flexible greedy optimization strategy to learn such additive scoring directly under explicit and sensible optimality objectives. We apply the proposed method to a large electronic health record (EHR) cohort in Epic Cosmos to construct an integer-weighted comorbidity score for measuring the risk of post-discharge mortality. We also conduct a simulation study to examine the finite-sample operating characteristics.

Current question-answering benchmarks predominantly focus on accuracy in realizable prediction tasks.Conditioned on a question and answer-key, does the most likely token match the ground truth?Such benchmarks necessarily fail to evaluate LLMs' ability to quantify ground-truth outcome uncertainty.In this work, we focus on the use of LLMs as risk scores for unrealizable prediction tasks.We introduce folktexts, a software package to systematically generate risk scores using LLMs, and evaluate them against US Census data products.A flexible API enables the use of different prompting schemes, local or web-hosted models, and diverse census columns that can be used to compose custom prediction tasks.We evaluate 17 recent LLMs across five proposed benchmark tasks.We find that zero-shot risk scores produced by multiple-choice question-answering have high predictive signal but are widely miscalibrated.Base models consistently overestimate outcome uncertainty, while instruction-tuned models underestimate uncertainty and produce over-confident risk scores.In fact, instruction-tuning polarizes answer distribution regardless of true underlying data uncertainty.This reveals a general inability of instruction-tuned models to express data uncertainty using multiple-choice answers.A separate experiment using verbalized chat-style risk queries yields substantially improved calibration across instruction-tuned models.These differences in ability to quantify data uncertainty cannot be revealed in realizable settings, and highlight a blind-spot in the current evaluation ecosystem that folktexts covers.

High-stakes prediction tasks (e.g., patient diagnosis) are often handled by trained

Section A.2 shows results using a chat-style verbalized numeric Section A.3 shows results on four extra benchmark tasks made available with Finally, Section A.5 presents and discusses results on feature In this section, we evaluate risk score calibration on the income prediction task across different subpopulations, such as typically done as part of a fairness audit. Figures A1-A2 show group-conditional calibration curves for all models on the ACSIncome task, evaluated on three subgroups specified by the race attribute in the ACS data. We show the three race categories with largest representation. The'Mixtral 8x22B' and'Yi 34B' models shown are the worst offenders, where samples belonging to the'Black' population see consistently lower scores for the same positive label probability when compared to the'Asian' or'White' populations. On average, the'Mixtral 8x22B (it)' model classifies a Black individual with a In fact, this score bias can be reversed for some base models, overestimating scores from Black individuals compared with other subgroups.

Over the last century, risk scores have been the most popular form of predictive model used in healthcare and criminal justice. Risk scores are sparse linear models with integer coefficients; often these models can be memorized or placed on an index card. Typically, risk scores have been created either without data or by rounding logistic regression coefficients, but these methods do not reliably produce high-quality risk scores. Recent work used mathematical programming, which is computationally slow. We introduce an approach for efficiently producing a collection of high-quality risk scores learned from data. Specifically, our approach produces a pool of almost-optimal sparse continuous solutions, each with a different support set, using a beam-search algorithm. Each of these continuous solutions is transformed into a separate risk score through a star ray search, where a range of multipliers are considered before rounding the coefficients sequentially to maintain low logistic loss. Our algorithm returns all of these high-quality risk scores for the user to consider. This method completes within minutes and can be valuable in a broad variety of applications.