Journal Article DKFZ-2026-01660

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Established machine learning matches tabular foundation models in clinical predictions.

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2026
BioMed Central London

BMC medical informatics and decision making nn, nn () [10.1186/s12911-026-03654-3]
 GO

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 ± 0.02. TabPFN also incurred higher computational cost, with median runtimes 5.5× longer and practical reliance on GPU acceleration. These findings indicate that, for routine binary clinical prediction, TabPFN offers limited performance gains relative to optimized ML methods, while introducing significant efficiency trade-offs.

Keyword(s): Benchmarking ; Deep learning ; Machine learning ; TabPFN ; Tabular data

Classification:

Note: #NCTZFB9# / epub

Contributing Institute(s):
  1. Koordinierungsstelle NCT Heidelberg (HD02)
Research Program(s):
  1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2026
Database coverage:
Medline ; DOAJ ; Article Processing Charges ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DOAJ Seal ; Ebsco Academic Search ; Essential Science Indicators ; Fees ; IF < 5 ; JCR ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection
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 Record created 2026-07-07, last modified 2026-07-07



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