针对心电图个体差异,提出患者感知对比学习,保留每位患者的基线特征。
Patient-Aware Contrastive Learning Preserves Per-Patient Structure in RR-Interval Representations

- 只将同患者、同类别片段配对,保留个体基线结构
- 患者内结构一致性达0.850,优于对比基线0.800
- 适合需要跨患者泛化的医疗信号建模任务
对比表示学习在生理信号上面临挑战:每位受试者有独特的基线模式。若类间差异与个体差异重叠,传统类级目标(如监督对比学习)会将个体结构融合为单一类别簇,损失关键的个体差异。本文在阵发性房颤(PAF)检测任务中,基于RR间隔(RRI)序列,提出患者感知对比目标:仅将同患者、同类别片段构成正样本对,保留每位患者的窦性心律(SR)基线,同时分离两类。直接分析嵌入结果表明,该方法在患者内结构一致性上表现最优(凝聚度0.850,优于监督对比损失的0.800和二元交叉熵的0.772)。同时发现,二元交叉熵虽实现最清晰的全局类别分离,但患者内结构最混乱,导致在线性探测中对未见患者失效。在IRIDIA-AF数据集上,该表示方法达到0.989±0.003的患者无关AUROC,种子方差降低2.6倍。结果表明,患者内几何一致性比全局类别可分性更关键于跨患者泛化。
原文摘要 · Abstract (English)
Contrastive representation learning struggles on physiological signals when each subject contributes a distinct baseline pattern. If class differences overlap with subject differences,class-level objectives such as supervised contrastive learning tend to merge per-subject structure into a single per-class cluster,removing the individual variation that a model needs to generalize to unseen patients. We study this problem in the setting of Paroxysmal Atrial Fibrillation(PAF) detection from RR-interval(RRI) sequences and propose a patient-aware contrastive objective that forms positive pairs only from same-patient, same-class segments, preserving each patient's own sinus rhythm(SR) baseline while still pushing the two classes apart. Examining the learned embeddings directly, our objective achieves the most consistent per-patient SR structure (cohesion $0.850$ vs. $0.800$ for supervised contrastive loss (SupCon) and $0.772$ for binary cross-entropy (BCE)). We also identify that BCE produces the cleanest global class separation yet the most disordered per-patient structure. This is precisely why a linear probe trained on its features breaks down on unseen patients. On the IRIDIA-AF dataset, the resulting representation reaches a patient-independent Area Under the Receiver Operating Characteristic Curve (AUROC) of $0.989 \pm 0.003$ with $2.6\times$ lower seed variance than supervised contrastive baselines.These results highlight that per-subject geometric consistency, rather than global class separability, is key to robust cross-patient generalization.
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