CDMT-EHR: A Continuous-Time Diffusion Framework for Generating Mixed-Type Time-Series Electronic Health Records

Abstract

Electronic health records (EHRs) are invaluable for clinical research, yet privacy concerns severely restrict data sharing. Synthetic data generation offers a promising solution, but EHRs present unique challenges: they contain both numerical and categorical features that evolve over time. While diffusion models have demonstrated strong performance in EHR synthesis, existing approaches predominantly rely on discrete-time formulations, which suffer from finite-step approximation errors and coupled training-sampling step counts. We propose a continuous-time diffusion framework for generating mixed-type time-series EHRs with three contributions: (1) continuous-time diffusion with a bidirectional gated recurrent unit backbone for capturing temporal dependencies, (2) unified Gaussian diffusion via learnable continuous embeddings for categorical variables, enabling joint cross-feature modeling, and (3) a factorized learnable noise schedule that adapts to per-feature-per-timestep learning difficulties. Experiments on two large-scale intensive care unit datasets demonstrate that our method outperforms existing approaches in downstream task performance, distribution fidelity, and discriminability, while requiring only 50 sampling steps compared to 1,000 for baseline methods. Classifier-free guidance further enables effective conditional generation for class-imbalanced clinical scenarios.