Interpretable Multimodal Zero-Shot ECG Diagnosis via Structured Clinical Knowledge Alignment

Fuente: arXiv
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Auteurs principaux: Tang, Jialu, Pham, Hung Manh, De Lathauwer, Ignace, Schipper, Henk S., Lu, Yuan, Ma, Dong, Saeed, Aaqib
Format: Preprint
Publié: 2025
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author Tang, Jialu
Pham, Hung Manh
De Lathauwer, Ignace
Schipper, Henk S.
Lu, Yuan
Ma, Dong
Saeed, Aaqib
author_facet Tang, Jialu
Pham, Hung Manh
De Lathauwer, Ignace
Schipper, Henk S.
Lu, Yuan
Ma, Dong
Saeed, Aaqib
contents Electrocardiogram (ECG) interpretation is essential for cardiovascular disease diagnosis, but current automated systems often struggle with transparency and generalization to unseen conditions. To address this, we introduce ZETA, a zero-shot multimodal framework designed for interpretable ECG diagnosis aligned with clinical workflows. ZETA uniquely compares ECG signals against structured positive and negative clinical observations, which are curated through an LLM-assisted, expert-validated process, thereby mimicking differential diagnosis. Our approach leverages a pre-trained multimodal model to align ECG and text embeddings without disease-specific fine-tuning. Empirical evaluations demonstrate ZETA's competitive zero-shot classification performance and, importantly, provide qualitative and quantitative evidence of enhanced interpretability, grounding predictions in specific, clinically relevant positive and negative diagnostic features. ZETA underscores the potential of aligning ECG analysis with structured clinical knowledge for building more transparent, generalizable, and trustworthy AI diagnostic systems. We will release the curated observation dataset and code to facilitate future research.
format Preprint
id arxiv_https___arxiv_org_abs_2510_21551
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Interpretable Multimodal Zero-Shot ECG Diagnosis via Structured Clinical Knowledge Alignment
Tang, Jialu
Pham, Hung Manh
De Lathauwer, Ignace
Schipper, Henk S.
Lu, Yuan
Ma, Dong
Saeed, Aaqib
Machine Learning
Electrocardiogram (ECG) interpretation is essential for cardiovascular disease diagnosis, but current automated systems often struggle with transparency and generalization to unseen conditions. To address this, we introduce ZETA, a zero-shot multimodal framework designed for interpretable ECG diagnosis aligned with clinical workflows. ZETA uniquely compares ECG signals against structured positive and negative clinical observations, which are curated through an LLM-assisted, expert-validated process, thereby mimicking differential diagnosis. Our approach leverages a pre-trained multimodal model to align ECG and text embeddings without disease-specific fine-tuning. Empirical evaluations demonstrate ZETA's competitive zero-shot classification performance and, importantly, provide qualitative and quantitative evidence of enhanced interpretability, grounding predictions in specific, clinically relevant positive and negative diagnostic features. ZETA underscores the potential of aligning ECG analysis with structured clinical knowledge for building more transparent, generalizable, and trustworthy AI diagnostic systems. We will release the curated observation dataset and code to facilitate future research.
title Interpretable Multimodal Zero-Shot ECG Diagnosis via Structured Clinical Knowledge Alignment
topic Machine Learning
url https://arxiv.org/abs/2510.21551