arXiv:2605.22859eess.SPcs.AI2026-05被引 1

用可执行规则实现符合临床标准的自动睡眠分期,透明可解释。

Staging by the Book: Automatic Sleep Stage Classification Using Scoring Rules

论文配图:Staging by the Book: Automatic Sleep Stage Classification Using Scoring Rules
图 1 · 摘自论文原文
  • 将AASM评分规则转为可执行代码,实现确定性分期决策。
  • 在50个记录上达成60.5%的分段一致率(κ=0.42),N2阶段召回率达83.5%。
  • 输出自然语言解释,适合用于调试和监管深度学习模型。

自动化睡眠分期通常作为监督学习问题处理,深度学习方法主导了近期研究。尽管机器学习模型与人工标注参考达到近人类水平的一致性,但其决策过程通常不透明,且未遵循临床评分规则。本文提出一种透明替代方案:一种确定性的、基于规则的睡眠分期方法,将美国睡眠医学学会(AASM)的评分逻辑明确转化为可执行代码,并生成基于解释追踪的逐段自然语言说明。我们在50份多导睡眠图记录上评估该方法,以10名评分者多数投票共识作为参考。整体上,该方法与多数投票参考在60.5%的时段中一致(κ=0.42),在开发数据集上一致性更高(77.1%,κ=0.61)。对睡眠阶段N2的召回率最高(83.5%),对快速眼动期(R)为中等(68.7%),而清醒(Wake)和轻度睡眠(N1)的召回率较低。尽管该方法与当前深度学习模型相比一致性较低,但其提供确定性决策和与AASM规则一致的自然语言解释,可作为审计、调试和管理深度学习睡眠分期的补充工具。

原文摘要 · Abstract (English)

Automated sleep staging is commonly approached as a supervised machine learning problem, with deep learning methods dominating recent research. While machine learning models achieve near-human level agreement with human-scored reference sleep stages, their decisions are typically opaque and not designed to follow clinical scoring rules. We propose a transparent alternative: a deterministic, rule-based sleep staging method that explicitly operationalizes the American Academy of Sleep Medicine's (AASM) scoring logic as executable code, coupled with epoch-level natural-language justifications derived from an explanation trace. We evaluate the approach on 50 polysomnography recordings with a 10-scorer majority-vote consensus as reference. Across all recordings, the method agreed with the majority-vote reference in 60.5% of epochs ($κ=0.42$), with substantially higher agreement on a dataset used during development (77.1%, $κ=0.61$). Agreement with the reference was highest for sleep stage N2 (recall 83.5%) and moderate for sleep stage R (recall 68.7%), while Wake and N1 recall were low. Despite lower agreement with the reference than contemporary deep learning models, the method provides deterministic decisions and natural language explanations aligned with AASM scoring rules, making it a complementary tool for auditing, debugging, and governing deep learning-based sleep staging.

睡眠分期规则系统可解释性AASM

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