让睡眠分期模型像医生一样讲道理,输出可审计的判断依据。
SleepVLM: A Rule-Grounded Vision-Language Model for Auditable Sleep Staging
- 用视觉语言模型分析脑电波图像,结合AASM规则推理分期。
- 在4个数据集上准确率超越现有方法,且理由覆盖关键特征。
- 适合需要可解释性、临床可信度的研究者和医疗开发者。
睡眠分期对睡眠评估和疾病诊断至关重要。近年来,自动睡眠分期系统已达到接近人类专家的准确率,但其黑箱特性阻碍了临床应用。现有可解释性方法仅提供部分洞察,仍需专家解读,无法直接支持个体预测审计。为此,我们提出可审计睡眠分期任务。本文提出SleepVLM,一种基于规则的视觉语言模型,将睡眠分期建模为对生成的多导睡眠图(PSG)波形图像的视觉推理。每个时间窗内,SleepVLM输出分期结果、适用的美国睡眠医学会(AASM)规则及可审计的理由。模型采用两阶段训练:先进行波形感知预训练,再在细粒度与粗粒度标注混合数据上进行规则引导的监督微调。在四个数据集上的实验表明,SleepVLM平均性能优于当前最优方法。自动化AASM特征审计显示,理由中广泛覆盖了定义分期的关键证据,独立专家也验证了其推理质量。为促进后续研究,我们构建并发布了MASS-EX——一个由专家标注的规则导向睡眠分期数据集,包含AASM规则标注和专家撰写的理由。
原文摘要 · Abstract (English)
Sleep staging is essential for sleep assessment and disorder diagnosis. In recent years, automatic sleep staging systems have achieved accuracy approaching that of human experts, but the black-box nature of their predictions hinders clinical adoption. Existing interpretability methods offer partial insight into model behavior, but their outputs still require expert reinterpretation and do not provide a direct basis for auditing individual predictions. To improve trustworthiness, we propose the task of auditable sleep staging. To solve this task, we present SleepVLM, a vision-language model that casts sleep staging as visual reasoning over rendered polysomnography (PSG) waveform images. For each epoch, SleepVLM outputs a stage together with the applicable American Academy of Sleep Medicine (AASM) rules and an auditable rationale. The model is trained using a two-stage framework: Waveform-Perceptual Pre-training followed by Rule-Grounded Supervised Fine-tuning over a mixture of fine-grained and coarse annotations. Experiments on four datasets show that SleepVLM outperforms state-of-the-art methods on average. An automated AASM-feature audit shows broad coverage of stage-defining evidence in the rationales, and independent experts validate their reasoning quality. To facilitate further research, we construct and release MASS-EX, an expert-annotated dataset for rule-grounded sleep staging with AASM rule annotations and expert-written rationales.
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