用大模型实现可解释的心电等生理信号波峰检测,兼顾跨模态准确与医生可理解性。
Peak-Detector: Explainable Peak Detection via Instruction-Tuned Large Language Models in Physiological Sign

- 将生理信号转为浓缩事件表示,引导大模型关注关键生理事件而非原始噪声。
- 在七大数据集上跨模态检测表现最优,满足临床容错要求。
- 生成可读的推理过程,帮助医生发现错误模式并验证结果。
在心电图(ECG)、光电容积脉搏波(PPG)、ballistocardiogram(BCG)和体震图(BSG)等多类生理信号中实现精确波峰检测,对心血管监测至关重要,但常受伪影和信号差异影响。传统方法依赖专家知识针对单一模态设计,泛化能力差;深度学习方法虽性能强,却缺乏可解释性,阻碍专家验证与人机协作。为此,我们提出Peak-Detector框架,利用指令微调的大语言模型实现鲁棒、跨模态且可解释的波峰检测。核心创新在于一种“波峰表征”技术,将时序数据压缩为保留关键事件信息的紧凑格式,显著降低信号长度,提供关键归纳偏置,引导模型聚焦于生理有意义事件而非原始噪声。模型通过两阶段优化:监督微调(SFT)后接基于多目标奖励函数的强化学习(RL)。自解释能力通过在自建的Peak-Explanation数据集上微调获得。在涵盖七大数据集(六项公开基准加一项真实人群队列)的四个模态上,峰值检测表现达到最佳或并列最佳,符合临床容错标准。除准确性外,生成的推理理由能揭示失败模式,支持结果验证与误差分析。
原文摘要 · Abstract (English)
Accurate peak detection across diverse cardiac physiological signals, including the Electrocardiogram (ECG), Photoplethysmogram (PPG), Ballistocardiogram (BCG), and Bodyseismography (BSG), is fundamental for cardiovascular monitoring but is often hindered by artifacts and signal variability. Conventional algorithms are typically engineered with expert knowledge for a single signal modality, limiting their generalizability. Conversely, deep learning-based methods often lack interpretability, limiting transparency for expert verification and hindering expert-computer interaction. To address these limitations, we introduce Peak-Detector, a novel framework that leverages instruction-tuned Large Language Models (LLMs) for robust, cross-modal, and explainable peak detection. A core innovation of our framework is a "peak-representation" technique that transforms time-series data into a condensed format, preserving critical event information while significantly reducing signal length. This representation provides a crucial inductive bias, guiding the LLM to reason over physiologically meaningful events rather than raw, noisy data. The model is optimized through a two-stage process: supervised fine-tuning (SFT) followed by reinforcement learning (RL) with a multi-objective reward function. The model's self-explanation capabilities are cultivated by fine-tuning on a custom-built Peak-Explanation dataset. Across four modalities-ECG, PPG, BCG, and BSG-spanning seven datasets (six public benchmarks plus one real-world cohort), Peak-Detector demonstrates strong cross-modal performance, achieving best or tied-best detection under clinically relevant temporal tolerance. Beyond accuracy, the generated rationales surface failure modes and support verification and error analysis.
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