Barry Rubin

Kaden McKeen, Sameer Masood, Augustin Toma et al.

Conventional task-specific electrocardiogram (ECG) analysis models require large annotated datasets to train. Foundation models mitigate this burden by leveraging self-supervised pretraining; however, the scarcity of open-weight ECG foundation models hinders adoption and cross-study comparability. We present ECG-FM, an open foundation model for ECG analysis, and conduct a study using a dataset of 1.5 million ECGs. ECG-FM is a transformer-based model pretrained using a hybrid contrastive and generative self-supervised learning approach. Our downstream tasks include predicting reduced left ventricular ejection fraction (LVEF) and ECG interpretation labels, where we release a benchmark task on the MIMIC-IV-ECG dataset. We affirm that ECG-FM is robust, label-efficient, and functionally discriminative by showcasing data scaling experiments, performing a latent space analysis, and generating saliency maps. ECG-FM markedly outperforms task-specific models in the small-to-medium-scale data regime and demonstrates cross-dataset generalizability, achieving high AUROC on many clinically salient labels such as atrial fibrillation (0.996) and LVEF<=40% (0.929). We release our code, model weights, and benchmark task at https://github.com/bowang-lab/ECG-FM/.

Senthujan Senkaiahliyan, Augustin Toma, Jun Ma et al.

OpenAI's large multimodal model, GPT-4V(ision), was recently developed for general image interpretation. However, less is known about its capabilities with medical image interpretation and diagnosis. Board-certified physicians and senior residents assessed GPT-4V's proficiency across a range of medical conditions using imaging modalities such as CT scans, MRIs, ECGs, and clinical photographs. Although GPT-4V is able to identify and explain medical images, its diagnostic accuracy and clinical decision-making abilities are poor, posing risks to patient safety. Despite the potential that large language models may have in enhancing medical education and delivery, the current limitations of GPT-4V in interpreting medical images reinforces the importance of appropriate caution when using it for clinical decision-making.

Alif Munim, Adibvafa Fallahpour, Teodora Szasz et al.

Foundation models for echocardiography promise to reduce annotation burden and improve diagnostic consistency by learning generalizable representations from large unlabeled video archives. However, current approaches fail to disentangle anatomical signal from the stochastic speckle and acquisition artifacts that dominate ultrasound imagery. We present EchoJEPA, a foundation model for echocardiography trained on 18 million echocardiograms across 300K patients, the largest pretraining corpus for this modality to date. We also introduce a novel multi-view probing framework with factorized stream embeddings that standardizes evaluation under frozen backbones. Compared to prior methods, EchoJEPA reduces left ventricular ejection fraction estimation error by 19% and achieves 87.4% view classification accuracy. EchoJEPA exhibits strong sample efficiency, reaching 78.6% accuracy with only 1% of labeled data versus 42.1% for the best baseline trained on 100%. Under acoustic perturbations, EchoJEPA degrades by only 2.3% compared to 16.8% for the next best model, and transfers zero-shot to pediatric patients with 15% lower error than the next best model, outperforming all fine-tuned baselines. These results establish latent prediction as a superior paradigm for ultrasound foundation models.