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原文摘要

Clinical data are split across incomplete cohorts with partially overlapping variables. Causal discovery under missing data and multi-source integration have developed separately, and tabular foundation models cannot take a causal graph without retraining. We make two contributions. First, causal graph fusion learns a partial ancestral graph on the shared variables, fuses it into each cohort's graph under temporal background knowledge and lets Markov blankets guide re-imputation, so missing data are handled inside discovery. Second, causal attention steering compiles the learned graph into the attention of a frozen tabular foundation model at inference. Against known ground truth, fusion dominates pooled and per-cohort baselines in every missingness and heterogeneity condition tested (p<0.001), and steering improves discrimination under distribution shift (p<10^{-5}), a gain that a random graph does not produce. In two spinal cord injury cohorts, fusion orients age, albumin and hemoglobin as ancestors of length of stay, a set no single cohort orients in full, and yields compact, temporally ordered predictor sets that match or exceed automatic feature selection on four of five outcomes.