Yingchen Wei

Chen Zhan, Yingchen Wei, Xiaoyu Tan et al.

Effective pre-polysomnography screening for obstructive sleep apnea-hypopnea syndrome (OSAHS) requires combining clinical risk factors with visible craniofacial and neck cues. Directly prompting general-purpose multimodal foundation models for medical yes/no decisions can yield unstable, poorly calibrated outputs. We propose EviOSAHS, an evidence-grounded multimodal reasoning framework that separates image-only anatomical evidence acquisition from final clinical adjudication. Each frontal facial image is decomposed into seven fixed anatomical queries covering the neck, chin, mouth, face/neck fat, lower jaw, midface, and nose. Visual responses are converted into structured evidence cards recording target anatomy, visibility, risk direction, evidence strength, confidence, and a concise summary. These cards are combined with a cleaned clinical profile only in the final stage, where a large language model performs balanced binary screening adjudication. We evaluated EviOSAHS on a 642-subject cohort, mapping normal subjects to screening-negative and mild, moderate, or severe OSAHS subjects to screening-positive. EviOSAHS achieved 88.47% accuracy, 94.86% sensitivity, 93.74% F1-score, and a 5.14% false-negative rate, outperforming clinical-only prompting, direct multimodal prompting, and naive two-stage pipelines under a unified protocol. Ablations showed that seven-question visual decomposition and balanced final adjudication were critical to the high-sensitivity operating point. A question-level audit of 4,494 visual outputs showed a 100% structured parse rate and 93.88% high-visibility rate. EviOSAHS provides an auditable, high-sensitivity workflow for binary pre-polysomnography OSAHS screening, but should be viewed as a triage assistant rather than a diagnostic system. Prospective validation, external testing, and calibrated operating-point control are needed before clinical deployment.

Yingchen Wei, Xihe Qiu, Xiaoyu Tan et al.

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common sleep disorder caused by upper airway blockage, leading to oxygen deprivation and disrupted sleep. Traditional diagnosis using polysomnography (PSG) is expensive, time-consuming, and uncomfortable. Existing deep learning methods using facial image analysis lack accuracy due to poor facial feature capture and limited sample sizes. To address this, we propose a multimodal dual encoder model that integrates visual and language inputs for automated OSAHS diagnosis. The model balances data using randomOverSampler, extracts key facial features with attention grids, and converts physiological data into meaningful text. Cross-attention combines image and text data for better feature extraction, and ordered regression loss ensures stable learning. Our approach improves diagnostic efficiency and accuracy, achieving 91.3% top-1 accuracy in a four-class severity classification task, demonstrating state-of-the-art performance. Code will be released upon acceptance.