让机器学习更懂临床:多病种脑电图自动诊断准确率超80%。
Clinically Calibrated Machine Learning Benchmarks for Large-Scale Multi-Disorder EEG Classification
- 用多域特征+敏感度优先建模,处理罕见病数据不平衡问题。
- 多数病种识别召回率超80%,部分罕见病提升15%-30%。
- 结果贴近临床实际,适合真实医疗场景的筛查与分诊。
临床脑电图常用于评估多种重叠的神经疾病,但解读依赖人工,耗时且专家间差异大。尽管自动化分析已有研究,多数方法仅针对单一诊断任务(如癫痫发作检测),难以支持多病种筛查。本研究在包含十一类临床相关神经疾病的大规模异构脑电数据集上,采用标准双极导联记录,通过时间统计、谱结构、信号复杂度和通道间关系等多域特征进行表征,训练注重诊断敏感性的疾病感知机器学习模型,并在严重类别不平衡条件下校准决策阈值。在真实临床数据上的评估显示,敏感性优化模型对多数病种的召回率超过80%,部分低频病种在阈值校准后召回率提升15%-30%。特征重要性分析揭示了符合已知临床脑电标志物的生理学模式。该研究建立了多病种脑电分类的现实性能基准,证明以敏感性为导向的自动化分析可在真实临床环境中实现可扩展的筛查与分诊。
原文摘要 · Abstract (English)
Clinical electroencephalography is routinely used to evaluate patients with diverse and often overlapping neurological conditions, yet interpretation remains manual, time-intensive, and variable across experts. While automated EEG analysis has been widely studied, most existing methods target isolated diagnostic problems, particularly seizure detection, and provide limited support for multi-disorder clinical screening. This study examines automated EEG-based classification across eleven clinically relevant neurological disorder categories, encompassing acute time-critical conditions, chronic neurocognitive and developmental disorders, and disorders with indirect or weak electrophysiological signatures. EEG recordings are processed using a standard longitudinal bipolar montage and represented through a multi-domain feature set capturing temporal statistics, spectral structure, signal complexity, and inter-channel relationships. Disorder-aware machine learning models are trained under severe class imbalance, with decision thresholds explicitly calibrated to prioritize diagnostic sensitivity. Evaluation on a large, heterogeneous clinical EEG dataset demonstrates that sensitivity-oriented modeling achieves recall exceeding 80% for the majority of disorder categories, with several low-prevalence conditions showing absolute recall gains of 15-30% after threshold calibration compared to default operating points. Feature importance analysis reveals physiologically plausible patterns consistent with established clinical EEG markers. These results establish realistic performance baselines for multi-disorder EEG classification and provide quantitative evidence that sensitivity-prioritized automated analysis can support scalable EEG screening and triage in real-world clinical settings.
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