用语言模型融合生理与临床信息,精准预测手术中稀疏的低血压事件。
Multimodal Forecasting of Sparse Intraoperative Hypotension Events Powered by Language Model
- 构建双阶段训练框架,先用扩散增强生理信号,再微调识别低血压状态。
- 在两个手术数据集上表现优于基线,准确识别稀疏低血压事件。
- 适合临床决策支持系统开发,尤其关注麻醉期间风险预警的研究者。
术中低血压(IOH)在全身麻醉下频繁发生,与心肌损伤和死亡率升高密切相关。然而,由于事件稀疏性以及静态与动态数据跨患者整合困难,其预测面临挑战。本文提出一种多模态语言模型框架——IOHFuseLM。为精准识别和区分稀疏低血压事件,采用两阶段训练策略:第一阶段在通过扩散方法增强的生理时间序列上进行领域自适应预训练,提升模型对低血压相关模式的敏感性;第二阶段在原始临床数据集上进行任务微调,进一步强化区分正常与低血压状态的能力。为实现每位患者的多模态融合,将结构化临床描述与对应生理时间序列在令牌层面对齐,使模型能捕捉个体化时间模式及其临床语义关联。同时,将静态患者特征转换为结构化文本以丰富个性化信息。在两个术中数据集上的实验表明,IOHFuseLM 在准确识别 IOH 事件方面优于现有基线,展现出在临床决策支持中的应用潜力。代码已公开,促进可复现性:https://github.com/zjt-gpu/IOHFuseLM。
原文摘要 · Abstract (English)
Intraoperative hypotension (IOH) frequently occurs under general anesthesia and is strongly linked to adverse outcomes such as myocardial injury and increased mortality. Despite its significance, IOH prediction is hindered by event sparsity and the challenge of integrating static and dynamic data across diverse patients. In this paper, we propose \textbf{IOHFuseLM}, a multimodal language model framework. To accurately identify and differentiate sparse hypotensive events, we leverage a two-stage training strategy. The first stage involves domain adaptive pretraining on IOH physiological time series augmented through diffusion methods, thereby enhancing the model sensitivity to patterns associated with hypotension. Subsequently, task fine-tuning is performed on the original clinical dataset to further enhance the ability to distinguish normotensive from hypotensive states. To enable multimodal fusion for each patient, we align structured clinical descriptions with the corresponding physiological time series at the token level. Such alignment enables the model to capture individualized temporal patterns alongside their corresponding clinical semantics. In addition, we convert static patient attributes into structured text to enrich personalized information. Experimental evaluations on two intraoperative datasets demonstrate that IOHFuseLM outperforms established baselines in accurately identifying IOH events, highlighting its applicability in clinical decision support scenarios. Our code is publicly available to promote reproducibility at https://github.com/zjt-gpu/IOHFuseLM.
Thank you to arXiv for use of its open access interoperability. PaperDance 不是 arXiv 官方产品;中文卡片由大模型生成,请以原文为准。