Zhangdaihong Liu

Fenglin Liu, Bang Yang, Chenyu You et al. · oxford

Language models (LMs), including large language models (such as ChatGPT), have the potential to assist clinicians in generating various clinical notes. However, LMs are prone to produce ``hallucinations'', i.e., generated content that is not aligned with facts and knowledge. In this paper, we propose the Re$^3$Writer method with retrieval-augmented generation and knowledge-grounded reasoning to enable LMs to generate faithful clinical texts. We demonstrate the effectiveness of our method in generating patient discharge instructions. It requires the LMs not to only understand the patients' long clinical documents, i.e., the health records during hospitalization, but also to generate critical instructional information provided both to carers and to the patient at the time of discharge. The proposed Re$^3$Writer imitates the working patterns of physicians to first \textbf{re}trieve related working experience from historical instructions written by physicians, then \textbf{re}ason related medical knowledge. Finally, it \textbf{re}fines the retrieved working experience and reasoned medical knowledge to extract useful information, which is used to generate the discharge instructions for previously-unseen patients. Our experiments show that, using our method, the performance of five representative LMs can be substantially boosted across all metrics. Meanwhile, we show results from human evaluations to measure the effectiveness in terms of fluency, faithfulness, and comprehensiveness.

Zhangdaihong Liu, Chang Liu, Fenglin Liu et al.

Cardiovascular disease remains the leading cause of global mortality, yet scalable cardiac monitoring is hindered by the gap between diagnostic-rich ECG and ubiquitous wearable PPG. Bridging this gap requires representations that are compact, transferable across modalities and devices, and deployable without task-specific retraining. Here we introduce biosignal fingerprints: compact latent representations of cardiovascular state derived from a cross-modal foundation model, the Multi-modal Masked Autoencoder (M2AE), trained on over 3.4 million paired ECG and PPG signals. M2AE integrates modality-specific encoders with a shared bottleneck and dual decoders, jointly optimized using reconstruction and cross-modal contrastive objectives, yielding generalizable fingerprints that retain intra- and inter-modality features. Like a biometric fingerprint, these representations uniquely encode an individual's cardiovascular state in a modality-agnostic, privacy-preserving form reusable across clinical tasks without exposing raw waveform data or requiring model retraining. Across 7 downstream tasks, spanning cross-modal reconstruction, cardiovascular disease classification, hypertension detection, mortality prediction, and demographic inference, biosignal fingerprints achieve competitive or superior performance compared to leading domain-specialist foundation models in frozen settings, including an AUROC of 0.974 for five-class CVD classification and 0.877 for hypertension detection, with a maximum improvement of 27.7% in AUROC across 5 classification tasks. Critically, strong performance is maintained with only a single modality, enabling deployment in resource-constrained, single-sensor environments typical of real-world wearable monitoring, with direct implications for continuous cardiovascular monitoring across clinical and consumer health settings.

Xiao Gu, Wei Tang, Jinpei Han et al. · oxford

Cardiac biosignals, such as electrocardiograms (ECG) and photoplethysmograms (PPG), are of paramount importance for the diagnosis, prevention, and management of cardiovascular diseases, and have been extensively used in a variety of clinical tasks. Conventional deep learning approaches for analyzing these signals typically rely on homogeneous datasets and static bespoke models, limiting their robustness and generalizability across diverse clinical settings and acquisition protocols. In this study, we present a cardiac sensing foundation model (CSFM) that leverages advanced transformer architectures and a generative, masked pretraining strategy to learn unified representations from vast, heterogeneous health records. Our model is pretrained on an innovative multi-modal integration of data from multiple large-scale datasets (including MIMIC-III-WDB, MIMIC-IV-ECG, and CODE), comprising cardiac signals and the corresponding clinical or machine-generated text reports from approximately 1.7 million individuals. We demonstrate that the embeddings derived from our CSFM not only serve as effective feature extractors across diverse cardiac sensing scenarios, but also enable seamless transfer learning across varying input configurations and sensor modalities. Extensive evaluations across diagnostic tasks, demographic information recognition, vital sign measurement, clinical outcome prediction, and ECG question answering reveal that CSFM consistently outperforms traditional one-modal-one-task approaches. Notably, CSFM exhibits robust performance across multiple ECG lead configurations from standard 12-lead systems to single-lead setups, and in scenarios where only ECG, only PPG, or a combination thereof is available. These findings highlight the potential of CSFM as a versatile and scalable solution, for comprehensive cardiac monitoring.