Sheng Wong

Sheng Wong, Ravi Shankar, Beth Albert et al.

Foundation models (FMs) and large language models (LLMs) have demonstrated promising generalization across diverse domains for time-series analysis, yet their potential for electronic fetal monitoring (EFM) and cardiotocography (CTG) analysis remains underexplored. Most existing CTG studies relied on domain-specific models and lack systematic comparisons with modern foundation or language models, limiting our understanding of whether these models can outperform specialized systems in fetal health assessment. In this study, we present the first comprehensive benchmark of state-of-the-art architectures for automated antepartum CTG classification. Over 2,500 20-minutes recordings were used to evaluate over 15 models spanning domain-specific, time-series, foundation, and language-model categories under a unified framework. Fine-tuned LLMs consistently outperformed both foundation and domain-specific models across data-availability scenarios, except when uterine-activity signals were absent, where domain-specific models showed greater robustness. These performance gains, however, required substantially higher computational resources. Our results highlight that while fine-tuned LLMs achieved state-of-the-art performance for CTG classification, practical deployment must balance performance with computational efficiency.

Scott Barnett, Zac Brannelly, Stefanus Kurniawan et al.

Large Language Models (LLMs) have the unique capability to understand and generate human-like text from input queries. When fine-tuned, these models show enhanced performance on domain-specific queries. OpenAI highlights the process of fine-tuning, stating: "To fine-tune a model, you are required to provide at least 10 examples. We typically see clear improvements from fine-tuning on 50 to 100 training examples, but the right number varies greatly based on the exact use case." This study extends this concept to the integration of LLMs within Retrieval-Augmented Generation (RAG) pipelines, which aim to improve accuracy and relevance by leveraging external corpus data for information retrieval. However, RAG's promise of delivering optimal responses often falls short in complex query scenarios. This study aims to specifically examine the effects of fine-tuning LLMs on their ability to extract and integrate contextual data to enhance the performance of RAG systems across multiple domains. We evaluate the impact of fine-tuning on the LLMs' capacity for data extraction and contextual understanding by comparing the accuracy and completeness of fine-tuned models against baseline performances across datasets from multiple domains. Our findings indicate that fine-tuning resulted in a decline in performance compared to the baseline models, contrary to the improvements observed in standalone LLM applications as suggested by OpenAI. This study highlights the need for vigorous investigation and validation of fine-tuned models for domain-specific tasks.