用单导联心电图预测血检指标,实现无创快速临床决策支持。
AnyECG-Lab: An Exploration Study of Fine-tuning an ECG Foundation Model to Estimate Laboratory Values from Single-Lead ECG Signals
- 基于预训练心电模型,通过迁移学习微调提升生物标志物识别能力。
- 对33项指标预测准确率超0.65,59项中等(0.55-0.65),16项有限(<0.55)。
- 为可穿戴设备实时无创检测血液指标提供可行性验证,适合临床辅助诊断场景。
及时获取实验室检测值对临床决策至关重要,但现有方法依赖侵入性静脉采样且存在固有延迟。心电图(ECG)作为非侵入且广泛应用的信号,为快速估算实验室指标提供了前景。深度学习进展使从心电图中提取潜在血液学特征成为可能。然而,现有模型受限于低信噪比、个体差异大、数据多样性不足及泛化能力差,尤其在适配低导联可穿戴设备时表现不佳。本研究探索性地利用迁移学习,在斯坦福大学的多模态急诊科监测数据集(MC-MED)上微调大型预训练心电基础模型ECGFounder。我们生成了超过2000万条标准化十秒心电片段,以增强对细微生化关联的敏感性。内部验证显示,模型对33项实验室指标的预测性能良好(曲线下面积高于0.65),59项中等(0.55至0.65之间),16项有限(低于0.55)。本研究提出一种高效的人工智能驱动方案,确立了实时无创实验室值估计的可行性范围。
原文摘要 · Abstract (English)
Timely access to laboratory values is critical for clinical decision-making, yet current approaches rely on invasive venous sampling and are intrinsically delayed. Electrocardiography (ECG), as a non-invasive and widely available signal, offers a promising modality for rapid laboratory estimation. Recent progress in deep learning has enabled the extraction of latent hematological signatures from ECGs. However, existing models are constrained by low signal-to-noise ratios, substantial inter-individual variability, limited data diversity, and suboptimal generalization, especially when adapted to low-lead wearable devices. In this work, we conduct an exploratory study leveraging transfer learning to fine-tune ECGFounder, a large-scale pre-trained ECG foundation model, on the Multimodal Clinical Monitoring in the Emergency Department (MC-MED) dataset from Stanford. We generated a corpus of more than 20 million standardized ten-second ECG segments to enhance sensitivity to subtle biochemical correlates. On internal validation, the model demonstrated strong predictive performance (area under the curve above 0.65) for thirty-three laboratory indicators, moderate performance (between 0.55 and 0.65) for fifty-nine indicators, and limited performance (below 0.55) for sixteen indicators. This study provides an efficient artificial-intelligence driven solution and establishes the feasibility scope for real-time, non-invasive estimation of laboratory values.
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