用可解释的生成模型预测胎儿结局,准确率超75%。
Predicting Fetal Outcomes from Cardiotocography Signals Using a Supervised Variational Autoencoder
- 用带监督的变分自编码器学习胎心信号,约束潜在空间结构
- 片段级和整体级预测的AUROC分别达0.752和0.779
- 能部分识别基线特征,适合临床辅助决策场景
目的:开发并解释一种基于妊娠结局分类胎心监护(CTG)信号的有监督变分自编码器(VAE),以解决当前深度学习方法可解释性不足的问题。方法:使用牛津产科胎心监测数据集(OxMat CTG)训练VAE模型,对五分钟胎心率(FHR)段进行建模,并标注出生后结局。模型优化信号重建与结局预测性能,引入Kullback-Leibler散度和总相关性(TC)约束以结构化潜在空间。评估指标包括受试者工作特征曲线下面积(AUROC)和均方误差(MSE)。通过决定系数、潜在变量遍历及无监督成分分析评估可解释性。结果:模型在片段级达到0.752的AUROC,CTG级达0.779(预测得分聚合)。放松TC约束可同时提升重建与分类效果。潜变量分析显示基线相关特征(如胎心基线、基线漂移)被良好编码且与预测得分一致,而短/长期变异等指标编码较弱。遍历结果显示基线特征变化明显,其他特性则存在纠缠或不显著。无监督分解结果支持上述模式。结论:该研究证明有监督VAE可在保持竞争性预测能力的同时,部分编码临床有意义的CTG特征。胎心信号非平稳、多时标特性导致生理成分难以解耦,区别于心电图等周期性信号。虽未实现完全可解释,但模型支持临床有用的结果预测,并为未来可解释生成模型奠定基础。
原文摘要 · Abstract (English)
Objective: To develop and interpret a supervised variational autoencoder (VAE) model for classifying cardiotocography (CTG) signals based on pregnancy outcomes, addressing interpretability limits of current deep learning approaches. Methods: The OxMat CTG dataset was used to train a VAE on five-minute fetal heart rate (FHR) segments, labeled with postnatal outcomes. The model was optimised for signal reconstruction and outcome prediction, incorporating Kullback-Leibler divergence and total correlation (TC) constraints to structure the latent space. Performance was evaluated using area under the receiver operating characteristic curve (AUROC) and mean squared error (MSE). Interpretability was assessed using coefficient of determination, latent traversals and unsupervised component analyses. Results: The model achieved an AUROC of 0.752 at the segment level and 0.779 at the CTG level, where predicted scores were aggregated. Relaxing TC constraints improved both reconstruction and classification. Latent analysis showed that baseline-related features (e.g., FHR baseline, baseline shift) were well represented and aligned with model scores, while metrics like short- and long-term variability were less strongly encoded. Traversals revealed clear signal changes for baseline features, while other properties were entangled or subtle. Unsupervised decompositions corroborated these patterns. Findings: This work demonstrates that supervised VAEs can achieve competitive fetal outcome prediction while partially encoding clinically meaningful CTG features. The irregular, multi-timescale nature of FHR signals poses challenges for disentangling physiological components, distinguishing CTG from more periodic signals such as ECG. Although full interpretability was not achieved, the model supports clinically useful outcome prediction and provides a basis for future interpretable, generative models.
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