arXiv:2607.09749eess.SPcs.AI2026-07

用心电图和血氧波形的形态特征训练通用医疗基础模型

MorphologyFM: A Foundation Model for Morphology-Aware Representation Learning from ECG and Pulse Oximetry Waveforms

  • 基于波形形态设计自监督学习目标,无需人工标注
  • 在心律失常、低氧血症等任务上显著优于现有方法
  • 适合做连续生理监测的通用基础模型,临床意义强

基础模型近年来成为从大规模生物医学数据中学习可迁移表示的强大范式,但现有生理波形方法主要优化重建或预测目标,未显式保留具有临床意义的波形形态。心电图(ECG)和脉搏血氧(SpO2)波形通过其形态结构编码丰富的心血管与血流动力学信息。本文提出MorphologyFM,一个在MIMIC重症数据库的配对ECG与SpO2波形上预训练的多模态基础模型,采用形态感知的自监督学习目标。MorphologyFM结合形态引导掩码、跨模态表示学习和对比潜在对齐,学习捕捉临床相关生理结构的表示,无需人工标注。我们在多个下游预测任务上评估该模型,包括心律失常分类、低氧血症预测、死亡率预测和住院时长估计,结果表明其一致优于代表性自监督方法,如掩码自编码器(MAE)、对比学习、Barlow Twins和联合嵌入预测架构(JEPA)。此外,联合建模ECG与SpO2波形比单模态预训练产生更可迁移的表示。结果表明波形形态是自监督生理表示学习的强大归纳偏置,并引入MorphologyFM作为连续生理监测的通用基础模型。

原文摘要 · Abstract (English)

Foundation models have recently emerged as a powerful paradigm for learning transferable representations from large scale biomedical data, yet existing approaches for physiological waveforms primarily optimize reconstruction or forecasting objectives that do not explicitly preserve clinically meaningful waveform morphology. Electrocardiograms (ECGs) and pulse oximetry (SpO2) waveforms encode rich cardiovascular and hemodynamic information through their morphological structure. In this work, we introduce MorphologyFM, a multimodal foundation model pretrained on paired ECG and SpO2 waveforms from the MIMIC critical care database using a morphology aware self supervised learning objective. MorphologyFM combines morphology guided masking, cross modal representation learning, and contrastive latent alignment to learn representations that capture clinically relevant physiological structure without requiring manual annotations. We evaluate MorphologyFM across multiple downstream prediction tasks, including arrhythmia classification, hypoxemia prediction, mortality prediction, and length of stay estimation, demonstrating consistent improvements over representative self supervised learning methods, including Masked Autoencoders (MAE), contrastive learning, Barlow Twins, and Joint Embedding Predictive Architectures (JEPA). Furthermore, we show that jointly modeling ECG and SpO2 waveforms produces more transferable representations than single modality pretraining. Our results establish waveform morphology as a powerful inductive bias for self supervised physiological representation learning and introduce MorphologyFM as a general purpose foundation model for continuous physiological monitoring.

基础模型心电图分析自监督学习多模态

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