用真实心电图证据自动改进分类器,让失败案例变优化线索
Failures Reveal What Metrics Miss: An Evidence-Driven Agent for Recursive Refinement of ECG Classifiers

- 基于具体失败案例和可复现的心电测量数据,驱动大模型精准诊断
- 在三个数据集上平均提升10.0%,优于现有强基线方法
- 适合医疗AI研发者,尤其关注模型可解释性与可靠性提升
深度模型显著推进了12导联心电图分类,但其优化仍依赖人工专家分析失败案例并迭代修改设计。现有基于大语言模型(LLM)的自动化设计工具仅依赖整体性能指标,缺乏对个体病例失败原因及改进方向的洞察。本文提出RecursiveECG——一种证据驱动的LLM作为设计师框架,通过可执行的证据来指导心电图分类器的递归优化。为确保失败诊断基于可验证证据,我们设计了“准则转测量编译”机制,将预设心电标准转化为可复现、有参考依据的确定性函数,生成每个心电图的标准化测量值。在此基础上,证据锚定的失败审查模块联合分析原始波形、测量结果与模型输出,使LLM能准确识别分类器局限并提出针对性修正方案。所有候选修正均在固定问题契约下执行与再评估,仅保留有证据支持的更新。最终预测器冻结后部署,无需运行LLM推理,且每项采纳的修订均有可追溯的证据链。在PTB-XL、Georgia、CPSC2018三个数据集上,RecursiveECG持续超越强基线,实现平均10.0%的相对性能提升。大量消融实验与迁移研究进一步验证了其证据驱动优化流程的有效性。
原文摘要 · Abstract (English)
Deep models have substantially advanced 12-lead ECG classification, yet their refinement still relies heavily on human experts to inspect failures and iteratively revise classifier designs. Recent LLM-based agents have demonstrated the potential for automated model design, but when guided only by aggregate performance metrics, they lack insight into why individual cases fail and how the classifier should be revised. We present RecursiveECG, an evidence-driven LLM-as-Designer framework in which an LLM serves as an offline model designer that refines ECG classifiers based on concrete failures and objective ECG evidence. To ground failure diagnosis in executable evidence, Criteria-to-Measurement Compilation converts curated ECG criteria into validated deterministic functions that produce reproducible, reference-backed measurements for individual ECGs. Building on these measurements, Evidence-Grounded Failure Review analyzes failed and comparator cases by jointly considering raw waveforms, measurements, and model outputs, enabling the LLM to diagnose classifier limitations and formulate targeted revisions. Candidate revisions are executed and re-evaluated under a fixed problem contract, and only evidence-supported updates are retained. The resulting predictor is frozen after refinement and requires no LLM inference during deployment, while an audit trail links each accepted revision to its supporting evidence. Across PTB-XL, Georgia, and CPSC2018, RecursiveECG consistently outperforms strong baselines, achieving an average relative improvement of 10.0%. Extensive ablation and transfer studies further validate the effectiveness of its evidence-grounded refinement process.
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