Established Machine Learning Matches Tabular Foundation Models in Clinical Predictions
Shaktah, L. A.; Gustav, M.; Lenz, T.; Liang, J.; Hilgers, L.; Carrero, Z. I.; Kather, J. N.
Show abstract
Foundation models (FMs) promise to standardise predictive modeling across domains, yet their clinical value for tabular data remains unproven. To test this, we performed a large, fully reproducible benchmark of TabPFN, a leading FM for tabular prediction, against twelve established machine learning (ML) methods across twelve binary clinical tasks. Cohorts spanned 788 - 139,528 patients across diverse outcomes, including survival, metastasis, and disease status. Using standardized preprocessing, bootstrapping, and multiple performance metrics, TabPFN was generally competitive but did not consistently outperform strong ML baselines. It exceeded the best ML model in only 16.7% of tasks, with most area under the receiver operating characteristic (AUROC) differences within {+/-}0.01. TabPFN also incurred higher computational cost, with median runtimes 5.5x longer and practical reliance on GPU acceleration. These findings indicate that, for routine clinical tabular prediction, TabPFN offers limited performance gains relative to optimized ML methods, while introducing significant efficiency trade-offs.
Matching journals
The top 5 journals account for 50% of the predicted probability mass.
Similar papers in this journal
Similar papers in this journal
- Clinical Knowledge Extraction via Sparse Embedding Regression (KESER) with Multi-Center Large Scale Electronic Health Record Data 94%
- Federated Target Trial Emulation using Distributed Observational Data for Treatment Effect Estimation 94%
- Zero Shot Health Trajectory Prediction Using Transformer 94%
Similar papers in this journal
"Similar papers" are the closest papers from that journal in the model's embedding space. They show what the match is built on, but the ranking comes mostly from a classifier over the whole training set, not from these examples alone.