Emerson Liu

Jielin Qiu, William Han, Jiacheng Zhu et al. · cmu

Recent advancements in Large Language Models (LLMs) have drawn increasing attention since the learned embeddings pretrained on large-scale datasets have shown powerful ability in various downstream applications. However, whether the learned knowledge by LLMs can be transferred to clinical cardiology remains unknown. In this work, we aim to bridge this gap by transferring the knowledge of LLMs to clinical Electrocardiography (ECG). We propose an approach for cardiovascular disease diagnosis and automatic ECG diagnosis report generation. We also introduce an additional loss function by Optimal Transport (OT) to align the distribution between ECG and language embedding. The learned embeddings are evaluated on two downstream tasks: (1) automatic ECG diagnosis report generation, and (2) zero-shot cardiovascular disease detection. Our approach is able to generate high-quality cardiac diagnosis reports and also achieves competitive zero-shot classification performance even compared with supervised baselines, which proves the feasibility of transferring knowledge from LLMs to the cardiac domain.

Jielin Qiu, Jiacheng Zhu, Shiqi Liu et al. · cmu

Automated interpretation of electrocardiograms (ECG) has garnered significant attention with the advancements in machine learning methodologies. Despite the growing interest, most current studies focus solely on classification or regression tasks, which overlook a crucial aspect of clinical cardio-disease diagnosis: the diagnostic report generated by experienced human clinicians. In this paper, we introduce a novel approach to ECG interpretation, leveraging recent breakthroughs in Large Language Models (LLMs) and Vision-Transformer (ViT) models. Rather than treating ECG diagnosis as a classification or regression task, we propose an alternative method of automatically identifying the most similar clinical cases based on the input ECG data. Also, since interpreting ECG as images is more affordable and accessible, we process ECG as encoded images and adopt a vision-language learning paradigm to jointly learn vision-language alignment between encoded ECG images and ECG diagnosis reports. Encoding ECG into images can result in an efficient ECG retrieval system, which will be highly practical and useful in clinical applications. More importantly, our findings could serve as a crucial resource for providing diagnostic services in underdeveloped regions.

William Jongwon Han, Diana Gomez, Avi Alok et al. · cmu

Understanding the irregular electrical activity of atrial fibrillation (AFib) has been a key challenge in electrocardiography. For serious cases of AFib, catheter ablations are performed to collect intracardiac electrograms (EGMs). EGMs offer intricately detailed and localized electrical activity of the heart and are an ideal modality for interpretable cardiac studies. Recent advancements in artificial intelligence (AI) has allowed some works to utilize deep learning frameworks to interpret EGMs during AFib. Additionally, language models (LMs) have shown exceptional performance in being able to generalize to unseen domains, especially in healthcare. In this study, we are the first to leverage pretrained LMs for finetuning of EGM interpolation and AFib classification via masked language modeling. We formulate the EGM as a textual sequence and present competitive performances on AFib classification compared against other representations. Lastly, we provide a comprehensive interpretability study to provide a multi-perspective intuition of the model's behavior, which could greatly benefit the clinical use.

William Han, Chaojing Duan, Zhepeng Cen et al. · cmu

Recent advances have increasingly applied large language models (LLMs) to electrocardiogram (ECG) interpretation, giving rise to Electrocardiogram-Language Models (ELMs). Conditioned on an ECG and a textual query, an ELM autoregressively generates a free-form textual response. Unlike traditional classification-based systems, ELMs emulate expert cardiac electrophysiologists by issuing diagnoses, analyzing waveform morphology, identifying contributing factors, and proposing patient-specific action plans. To realize this potential, researchers are curating instruction-tuning datasets that pair ECGs with textual dialogues and are training ELMs on these resources. Yet before scaling ELMs further, there is a fundamental question yet to be explored: What is the most effective ECG input representation? In recent works, three candidate representations have emerged-raw time-series signals, rendered images, and discretized symbolic sequences. We present the first comprehensive benchmark of these modalities across 6 public datasets and 5 evaluation metrics. We find symbolic representations achieve the greatest number of statistically significant wins over both signal and image inputs. We further ablate the LLM backbone, ECG duration, and token budget, and we evaluate robustness to signal perturbations. We hope that our findings offer clear guidance for selecting input representations when developing the next generation of ELMs.

Yihang Yao, Zhepeng Cen, Miao Li et al. · cmu

Large Language Models (LLMs) have demonstrated strong reasoning capabilities across various tasks. However, even minor variations in query phrasing, despite preserving the underlying semantic meaning, can significantly affect their performance. To address this, we focus on enhancing LLMs' awareness of symmetry in query variations and propose syMmetry-ENhanceD (MEND) Data Augmentation, a data-centric approach that improves the model's ability to extract useful information from context. Unlike existing methods that emphasize reasoning chain augmentation, our approach improves model robustness at the knowledge extraction stage through query augmentations, enabling more data-efficient training and stronger generalization to Out-of-Distribution (OOD) settings. Extensive experiments on both logical and arithmetic reasoning tasks show that MEND enhances reasoning performance across diverse query variations, providing new insight into improving LLM robustness through structured dataset curation.