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Teach Multimodal LLMs to Comprehend Electrocardiographic Images (2410.19008v1)

Published 21 Oct 2024 in eess.IV, cs.AI, and cs.CV

Abstract: The electrocardiogram (ECG) is an essential non-invasive diagnostic tool for assessing cardiac conditions. Existing automatic interpretation methods suffer from limited generalizability, focusing on a narrow range of cardiac conditions, and typically depend on raw physiological signals, which may not be readily available in resource-limited settings where only printed or digital ECG images are accessible. Recent advancements in multimodal LLMs (MLLMs) present promising opportunities for addressing these challenges. However, the application of MLLMs to ECG image interpretation remains challenging due to the lack of instruction tuning datasets and well-established ECG image benchmarks for quantitative evaluation. To address these challenges, we introduce ECGInstruct, a comprehensive ECG image instruction tuning dataset of over one million samples, covering a wide range of ECG-related tasks from diverse data sources. Using ECGInstruct, we develop PULSE, an MLLM tailored for ECG image comprehension. In addition, we curate ECGBench, a new evaluation benchmark covering four key ECG image interpretation tasks across nine different datasets. Our experiments show that PULSE sets a new state-of-the-art, outperforming general MLLMs with an average accuracy improvement of 15% to 30%. This work highlights the potential of PULSE to enhance ECG interpretation in clinical practice.

Summary

  • The paper’s main contribution is the creation of ECGInstruct, a dataset with over one million ECG image-text pairs for advanced instruction tuning.
  • It presents PULSE, a specialized multimodal LLM that outperforms general models like GPT-4o by 15-30% in ECG abnormality detection and report generation.
  • The study establishes ECGBench as a new benchmark, setting a higher standard for scalable and accessible clinical ECG diagnostics.

Overview of "Teach Multimodal LLMs to Comprehend Electrocardiographic Images"

The paper "Teach Multimodal LLMs to Comprehend Electrocardiographic Images" presents a refined technique in ECG interpretation using Multimodal LLMs (MLLMs). This is a timely intervention in addressing the limitations of existing automatic ECG diagnostics, which typically hinge on raw physiological signals with narrow condition specifications, restricting their effectiveness especially in resource-limited settings.

Dataset Development and Model Composition

A pivotal contribution of this work is the creation of ECGInstruct, an extensive instruction-tuning dataset comprising over one million ECG image-text samples. These samples span various tasks sourced from diverse geographic regions and aim to augment the scope of ECG-related dataset instruction tuning. They reflect realistic scenarios, including image artifacts typical of paper-based ECG presentations.

The model PULSE is designed leveraging this robust dataset ECGInstruct. It exemplifies an MLLM tailored specifically for ECG images. The model's performance validation tool is ECGBench—a newly introduced benchmark covering critical ECG interpretation tasks through nine datasets.

Experimental Results

The empirical results underscore the efficacy of PULSE, highlighting its substantial improvements in accuracy over general MLLMs like GPT-4o, achieving an average accuracy improvement of 15\% to 30% superior performance in ECG tasks including abnormality detection and report generation. This accentuates its potential to redefine clinical ECG interpretations, driving better diagnostics in clinical practices—particularly notable given the proprietary models’ struggles in accurately interpreting ECG images.

Implications and Future Directions

The implications of adopting PULSE in clinical settings are manifold. It could revolutionize diagnostics by making ECG analysis more accessible across varied healthcare settings, offering scalability that can be particularly advantageous in developing regions where diagnostic resources are scant. Theoretically, this research shifts the paradigm of multimodal learning applications, integrating robust visual text comprehension tasks into cardiac diagnostics.

Looking forward, the trajectory for further research could involve enhancing the diversity of ECGInstruct by encompassing more intricate cardiac anomalies and perhaps expanding the model’s ability to simulate even more complex clinical settings. Enhancing the model's reasoning capabilities to better integrate and process multi-step diagnostic reasoning remains a frontier ripe for exploration. The research also opens avenues to incorporate advanced instruction-tuning methods across other domains of healthcare diagnostics, adhering closely to the foundational framework laid out by PULSE.

This paper provides not just a model but a comprehensive framework and benchmark for ECG interpretation, contributing significantly to the machine learning intersections within medical diagnostics. It sets a benchmark that can inspire additional work focusing on medical image comprehension using MLLMs, ultimately steering future developments in AI healthcare applications.

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