DiffuSETS: 12-lead ECG Generation Conditioned on Clinical Text Reports and Patient-Specific Information

Heart disease remains a significant threat to human health. As a non-invasive diagnostic tool, the electrocardiogram (ECG) is one of the most widely used methods for cardiac screening. However, the scarcity of high-quality ECG data, driven by privacy concerns and limited medical resources, creates a pressing need for effective ECG signal generation. Existing approaches for generating ECG signals typically rely on small training datasets, lack comprehensive evaluation frameworks, and overlook potential applications beyond data augmentation. To address these challenges, we propose DiffuSETS, a novel framework capable of generating ECG signals with high semantic alignment and fidelity. DiffuSETS accepts various modalities of clinical text reports and patient-specific information as inputs, enabling the creation of clinically meaningful ECG signals. Additionally, to address the lack of standardized evaluation in ECG generation, we introduce a comprehensive benchmarking methodology to assess the effectiveness of generative models in this domain. Our model achieve excellent results in tests, proving its superiority in the task of ECG generation. Furthermore, we showcase its potential to mitigate data scarcity while exploring novel applications in cardiology education and medical knowledge discovery, highlighting the broader impact of our work.

Dist Loss: Enhancing Regression in Few-Shot Region through Distribution Distance Constraint

Imbalanced data distributions are prevalent in real-world scenarios, posing significant challenges in both imbalanced classification and imbalanced regression tasks. They often cause deep learning models to overfit in areas of high sample density (many-shot regions) while underperforming in areas of low sample density (few-shot regions). This characteristic restricts the utility of deep learning models in various sectors, notably healthcare, where areas with few-shot data hold greater clinical relevance. While recent studies have shown the benefits of incorporating distribution information in imbalanced classification tasks, such strategies are rarely explored in imbalanced regression. In this paper, we address this issue by introducing a novel loss function, termed Dist Loss, designed to minimize the distribution distance between the model's predictions and the target labels in a differentiable manner, effectively integrating distribution information into model training. Dist Loss enables deep learning models to regularize their output distribution during training, effectively enhancing their focus on few-shot regions. We have conducted extensive experiments across three datasets spanning computer vision and healthcare: IMDB-WIKI-DIR, AgeDB-DIR, and ECG-Ka-DIR. The results demonstrate that Dist Loss effectively mitigates the negative impact of imbalanced data distribution on model performance, achieving state-of-the-art results in sparse data regions. Furthermore, Dist Loss is easy to integrate, complementing existing methods.

Retrieval-Augmented Diffusion Models for Time Series Forecasting

While time series diffusion models have received considerable focus from many recent works, the performance of existing models remains highly unstable. Factors limiting time series diffusion models include insufficient time series datasets and the absence of guidance. To address these limitations, we propose a Retrieval- Augmented Time series Diffusion model (RATD). The framework of RATD consists of two parts: an embedding-based retrieval process and a reference-guided diffusion model. In the first part, RATD retrieves the time series that are most relevant to historical time series from the database as references. The references are utilized to guide the denoising process in the second part. Our approach allows leveraging meaningful samples within the database to aid in sampling, thus maximizing the utilization of datasets. Meanwhile, this reference-guided mechanism also compensates for the deficiencies of existing time series diffusion models in terms of guidance. Experiments and visualizations on multiple datasets demonstrate the effectiveness of our approach, particularly in complicated prediction tasks.

From Hospital to Portables: A Universal ECG Foundation Model Built on 10+ Million Diverse Recordings

Artificial Intelligence (AI) has shown great promise in electrocardiogram (ECG) analysis and cardiovascular disease detection. However, developing a general AI-ECG model has been challenging due to inter-individual variability and the diversity of ECG diagnoses, limiting existing models to specific diagnostic tasks and datasets. Moreover, current AI-ECG models struggle to achieve comparable performance between single-lead and 12-lead ECGs, limiting the application of AI-ECG to portable and wearable ECG devices. To address these limitations, we introduce an ECG Foundation Model (ECGFounder), a general-purpose model that leverages real-world ECG annotations from cardiology experts to broaden the diagnostic capabilities of ECG analysis. ECGFounder is trained on over 10 million ECGs with 150 label categories from the Harvard-Emory ECG Database, enabling comprehensive cardiovascular disease diagnosis through ECG analysis. The model is designed to be both effective out-of-the-box and fine-tunable for downstream tasks, maximizing usability. More importantly, we extend its application to single-lead ECGs, enabling complex condition diagnoses and supporting various downstream tasks in mobile and remote monitoring scenarios. Experimental results demonstrate that ECGFounder achieves expert-level performance on internal validation sets for both 12-lead and single-lead ECGs, while also exhibiting strong classification performance and generalization across various diagnoses on external validation sets. When fine-tuned, ECGFounder outperforms baseline models in demographics detection, clinical event detection, and cross-modality cardiac rhythm diagnosis. The trained model and data will be publicly released upon publication through the bdsp.io. Our code is available at https://github.com/bdsp-core/ECGFounder.

Multi-Channel Masked Autoencoder and Comprehensive Evaluations for Reconstructing 12-Lead ECG from Arbitrary Single-Lead ECG

In the context of cardiovascular diseases (CVD) that exhibit an elevated prevalence and mortality, the electrocardiogram (ECG) is a popular and standard diagnostic tool for doctors, commonly utilizing a 12-lead configuration in clinical practice. However, the 10 electrodes placed on the surface would cause a lot of inconvenience and discomfort, while the rapidly advancing wearable devices adopt the reduced-lead or single-lead ECG to reduce discomfort as a solution in long-term monitoring. Since the single-lead ECG is a subset of 12-lead ECG, it provides insufficient cardiac health information and plays a substandard role in real-world healthcare applications. Hence, it is necessary to utilize signal generation technologies to reduce their clinical importance gap by reconstructing 12-lead ECG from the real single-lead ECG. Specifically, this study proposes a multi-channel masked autoencoder (MCMA) for this goal. In the experimental results, the visualized results between the generated and real signals can demonstrate the effectiveness of the proposed framework. At the same time, this study introduces a comprehensive evaluation benchmark named ECGGenEval, encompassing the signal-level, feature-level, and diagnostic-level evaluations, providing a holistic assessment of 12-lead ECG signals and generative model. Further, the quantitative experimental results are as follows, the mean square errors of 0.0178 and 0.0658, correlation coefficients of 0.7698 and 0.7237 in the signal-level evaluation, the average F1-score with two generated 12-lead ECG is 0.8319 and 0.7824 in the diagnostic-level evaluation, achieving the state-of-the-art performance. The open-source code is publicly available at \url{https://github.com/CHENJIAR3/MCMA}.

Annotation of Sleep Depth Index with Scalable Deep Learning Yields Novel Digital Biomarkers for Sleep Health

Traditional sleep staging categorizes sleep and wakefulness into five coarse-grained classes, overlooking subtle variations within each stage. It provides limited information about the probability of arousal and may hinder the diagnosis of sleep disorders, such as insomnia. To address this issue, we propose a deep-learning method for automatic and scalable annotation of sleep depth index using existing sleep staging labels. Our approach is validated using polysomnography from over ten thousand recordings across four large-scale cohorts. The results show a strong correlation between the decrease in sleep depth index and the increase in arousal likelihood. Several case studies indicate that the sleep depth index captures more nuanced sleep structures than conventional sleep staging. Sleep biomarkers extracted from the whole-night sleep depth index exhibit statistically significant differences with medium-to-large effect sizes across groups of varied subjective sleep quality and insomnia symptoms. These sleep biomarkers also promise utility in predicting the severity of obstructive sleep apnea, particularly in severe cases. Our study underscores the utility of the proposed method for continuous sleep depth annotation, which could reveal more detailed structures and dynamics within whole-night sleep and yield novel digital biomarkers beneficial for sleep health.

Deep Imbalanced Regression to Estimate Vascular Age from PPG Data: a Novel Digital Biomarker for Cardiovascular Health

Photoplethysmography (PPG) is emerging as a crucial tool for monitoring human hemodynamics, with recent studies highlighting its potential in assessing vascular aging through deep learning. However, real-world age distributions are often imbalanced, posing significant challenges for deep learning models. In this paper, we introduce a novel, simple, and effective loss function named the Dist Loss to address deep imbalanced regression tasks. We trained a one-dimensional convolutional neural network (Net1D) incorporating the Dist Loss on the extensive UK Biobank dataset (n=502,389) to estimate vascular age from PPG signals and validate its efficacy in characterizing cardiovascular health. The model's performance was validated on a 40% held-out test set, achieving state-of-the-art results, especially in regions with small sample sizes. Furthermore, we divided the population into three subgroups based on the difference between predicted vascular age and chronological age: less than -10 years, between -10 and 10 years, and greater than 10 years. We analyzed the relationship between predicted vascular age and several cardiovascular events over a follow-up period of up to 10 years, including death, coronary heart disease, and heart failure. Our results indicate that the predicted vascular age has significant potential to reflect an individual's cardiovascular health status. Our code will be available at https://github.com/Ngk03/AI-vascular-age.

Deep Learning for Detecting and Early Predicting Chronic Obstructive Pulmonary Disease from Spirogram Time Series: A UK Biobank Study

Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung condition that causes airflow obstruction. The existing methods can only detect patients who already have COPD based on obvious features shown in the spirogram (In this article, the spirogram specifically involves measuring Volume-Flow curve time series). Early prediction of COPD risk is vital for monitoring COPD disease progression, slowing it down, or even preventing its onset. However, these methods fail to early predict an individual's probability of COPD in the future based on subtle features in the spirogram. To address this gap, for the first time, we propose DeepSpiro, a method based on deep learning for early prediction of future COPD risk. DeepSpiro consists of four parts. First, we construct Volume-Flow curves guided by Time-Volume instability smoothing (SpiroSmoother) to enhance the stability of the original Volume-Flow curves precisely. Second, we extract critical features from the evolution of varied-length key patches (SpiroEncoder) to capture the key temporal evolution from original high-dimensional dynamic sequences to a unified low-dimensional temporal representation. Third, we explain the model based on temporal attention and heterogeneous feature fusion (SpiroExplainer), which integrates information from heterogeneous data such as spirogram and demographic information. Fourth, we predict the risk of COPD based on the evolution of key patch concavity (SpiroPredictor), enabling accurate prediction of the risk of disease in high-risk patients who are not yet diagnosed, for up to 1, 2, 3, 4, 5 years, and beyond. We conduct experiments on the UK Biobank dataset. Results show that DeepSpiro achieves an AUC value of 0.8328 in the task of detecting COPD. In early prediction tasks, high-risk and low-risk groups show significant differences in the future, with a p-value of <0.001.

Review of Data-centric Time Series Analysis from Sample, Feature, and Period

Data is essential to performing time series analysis utilizing machine learning approaches, whether for classic models or today's large language models. A good time-series dataset is advantageous for the model's accuracy, robustness, and convergence, as well as task outcomes and costs. The emergence of data-centric AI represents a shift in the landscape from model refinement to prioritizing data quality. Even though time-series data processing methods frequently come up in a wide range of research fields, it hasn't been well investigated as a specific topic. To fill the gap, in this paper, we systematically review different data-centric methods in time series analysis, covering a wide range of research topics. Based on the time-series data characteristics at sample, feature, and period, we propose a taxonomy for the reviewed data selection methods. In addition to discussing and summarizing their characteristics, benefits, and drawbacks targeting time-series data, we also introduce the challenges and opportunities by proposing recommendations, open problems, and possible research topics.

A Deep Learning Method for Beat-Level Risk Analysis and Interpretation of Atrial Fibrillation Patients during Sinus Rhythm

Atrial Fibrillation (AF) is a common cardiac arrhythmia. Many AF patients experience complications such as stroke and other cardiovascular issues. Early detection of AF is crucial. Existing algorithms can only distinguish ``AF rhythm in AF patients'' from ``sinus rhythm in normal individuals'' . However, AF patients do not always exhibit AF rhythm, posing a challenge for diagnosis when the AF rhythm is absent. To address this, this paper proposes a novel artificial intelligence (AI) algorithm to distinguish ``sinus rhythm in AF patients'' and ``sinus rhythm in normal individuals'' in beat-level. We introduce beat-level risk interpreters, trend risk interpreters, addressing the interpretability issues of deep learning models and the difficulty in explaining AF risk trends. Additionally, the beat-level information fusion decision is presented to enhance model accuracy. The experimental results demonstrate that the average AUC for single beats used as testing data from CPSC 2021 dataset is 0.7314. By employing 150 beats for information fusion decision algorithm, the average AUC can reach 0.7591. Compared to previous segment-level algorithms, we utilized beats as input, reducing data dimensionality and making the model more lightweight, facilitating deployment on portable medical devices. Furthermore, we draw new and interesting findings through average beat analysis and subgroup analysis, considering varying risk levels.