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Feb 16

Phase-shifted remote photoplethysmography for estimating heart rate and blood pressure from facial video

Human health can be critically affected by cardiovascular diseases, such as hypertension, arrhythmias, and stroke. Heart rate and blood pressure are important biometric information for the monitoring of cardiovascular system and early diagnosis of cardiovascular diseases. Existing methods for estimating the heart rate are based on electrocardiography and photoplethyomography, which require contacting the sensor to the skin surface. Moreover, catheter and cuff-based methods for measuring blood pressure cause inconvenience and have limited applicability. Therefore, in this thesis, we propose a vision-based method for estimating the heart rate and blood pressure. This thesis proposes a 2-stage deep learning framework consisting of a dual remote photoplethysmography network (DRP-Net) and bounded blood pressure network (BBP-Net). In the first stage, DRP-Net infers remote photoplethysmography (rPPG) signals for the acral and facial regions, and these phase-shifted rPPG signals are utilized to estimate the heart rate. In the second stage, BBP-Net integrates temporal features and analyzes phase discrepancy between the acral and facial rPPG signals to estimate SBP and DBP values. To improve the accuracy of estimating the heart rate, we employed a data augmentation method based on a frame interpolation model. Moreover, we designed BBP-Net to infer blood pressure within a predefined range by incorporating a scaled sigmoid function. Our method resulted in estimating the heart rate with the mean absolute error (MAE) of 1.78 BPM, reducing the MAE by 34.31 % compared to the recent method, on the MMSE-HR dataset. The MAE for estimating the systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 10.19 mmHg and 7.09 mmHg. On the V4V dataset, the MAE for the heart rate, SBP, and DBP were 3.83 BPM, 13.64 mmHg, and 9.4 mmHg, respectively.

  • 2 authors
·
Jan 9, 2024

Robust and Generalizable Heart Rate Estimation via Deep Learning for Remote Photoplethysmography in Complex Scenarios

Non-contact remote photoplethysmography (rPPG) technology enables heart rate measurement from facial videos. However, existing network models still face challenges in accu racy, robustness, and generalization capability under complex scenarios. This paper proposes an end-to-end rPPG extraction network that employs 3D convolutional neural networks to reconstruct accurate rPPG signals from raw facial videos. We introduce a differential frame fusion module that integrates differential frames with original frames, enabling frame-level representations to capture blood volume pulse (BVP) variations. Additionally, we incorporate Temporal Shift Module (TSM) with self-attention mechanisms, which effectively enhance rPPG features with minimal computational overhead. Furthermore, we propose a novel dynamic hybrid loss function that provides stronger supervision for the network, effectively mitigating over fitting. Comprehensive experiments were conducted on not only the PURE and UBFC-rPPG datasets but also the challenging MMPD dataset under complex scenarios, involving both intra dataset and cross-dataset evaluations, which demonstrate the superior robustness and generalization capability of our network. Specifically, after training on PURE, our model achieved a mean absolute error (MAE) of 7.58 on the MMPD test set, outperforming the state-of-the-art models.

  • 3 authors
·
Jul 10, 2025

TYrPPG: Uncomplicated and Enhanced Learning Capability rPPG for Remote Heart Rate Estimation

Remote photoplethysmography (rPPG) can remotely extract physiological signals from RGB video, which has many advantages in detecting heart rate, such as low cost and no invasion to patients. The existing rPPG model is usually based on the transformer module, which has low computation efficiency. Recently, the Mamba model has garnered increasing attention due to its efficient performance in natural language processing tasks, demonstrating potential as a substitute for transformer-based algorithms. However, the Mambaout model and its variants prove that the SSM module, which is the core component of the Mamba model, is unnecessary for the vision task. Therefore, we hope to prove the feasibility of using the Mambaout-based module to remotely learn the heart rate. Specifically, we propose a novel rPPG algorithm called uncomplicated and enhanced learning capability rPPG (TYrPPG). This paper introduces an innovative gated video understanding block (GVB) designed for efficient analysis of RGB videos. Based on the Mambaout structure, this block integrates 2D-CNN and 3D-CNN to enhance video understanding for analysis. In addition, we propose a comprehensive supervised loss function (CSL) to improve the model's learning capability, along with its weakly supervised variants. The experiments show that our TYrPPG can achieve state-of-the-art performance in commonly used datasets, indicating its prospects and superiority in remote heart rate estimation. The source code is available at https://github.com/Taixi-CHEN/TYrPPG.

  • 2 authors
·
Nov 7, 2025

Exploring Remote Physiological Signal Measurement under Dynamic Lighting Conditions at Night: Dataset, Experiment, and Analysis

Remote photoplethysmography (rPPG) is a non-contact technique for measuring human physiological signals. Due to its convenience and non-invasiveness, it has demonstrated broad application potential in areas such as health monitoring and emotion recognition. In recent years, the release of numerous public datasets has significantly advanced the performance of rPPG algorithms under ideal lighting conditions. However, the effectiveness of current rPPG methods in realistic nighttime scenarios with dynamic lighting variations remains largely unknown. Moreover, there is a severe lack of datasets specifically designed for such challenging environments, which has substantially hindered progress in this area of research. To address this gap, we present and release a large-scale rPPG dataset collected under dynamic lighting conditions at night, named DLCN. The dataset comprises approximately 13 hours of video data and corresponding synchronized physiological signals from 98 participants, covering four representative nighttime lighting scenarios. DLCN offers high diversity and realism, making it a valuable resource for evaluating algorithm robustness in complex conditions. Built upon the proposed Happy-rPPG Toolkit, we conduct extensive experiments and provide a comprehensive analysis of the challenges faced by state-of-the-art rPPG methods when applied to DLCN. The dataset and code are publicly available at https://github.com/dalaoplan/Happp-rPPG-Toolkit.

  • 7 authors
·
Jul 6, 2025

PPGFlowECG: Latent Rectified Flow with Cross-Modal Encoding for PPG-Guided ECG Generation and Cardiovascular Disease Detection

In clinical practice, electrocardiography (ECG) remains the gold standard for cardiac monitoring, providing crucial insights for diagnosing a wide range of cardiovascular diseases (CVDs). However, its reliance on specialized equipment and trained personnel limits feasibility for continuous routine monitoring. Photoplethysmography (PPG) offers accessible, continuous monitoring but lacks definitive electrophysiological information, preventing conclusive diagnosis. Generative models present a promising approach to translate PPG into clinically valuable ECG signals, yet current methods face substantial challenges, including the misalignment of physiological semantics in generative models and the complexity of modeling in high-dimensional signals. To this end, we propose PPGFlowECG, a two-stage framework that aligns PPG and ECG in a shared latent space via the CardioAlign Encoder and employs latent rectified flow to generate ECGs with high fidelity and interpretability. To the best of our knowledge, this is the first study to experiment on MCMED, a newly released clinical-grade dataset comprising over 10 million paired PPG-ECG samples from more than 118,000 emergency department visits with expert-labeled cardiovascular disease annotations. Results demonstrate the effectiveness of our method for PPG-to-ECG translation and cardiovascular disease detection. Moreover, cardiologist-led evaluations confirm that the synthesized ECGs achieve high fidelity and improve diagnostic reliability, underscoring our method's potential for real-world cardiovascular screening.

  • 9 authors
·
Sep 24, 2025

A Hybrid Deep Learning Model for Robust Biometric Authentication from Low-Frame-Rate PPG Signals

Photoplethysmography (PPG) signals, which measure changes in blood volume in the skin using light, have recently gained attention in biometric authentication because of their non-invasive acquisition, inherent liveness detection, and suitability for low-cost wearable devices. However, PPG signal quality is challenged by motion artifacts, illumination changes, and inter-subject physiological variability, making robust feature extraction and classification crucial. This study proposes a lightweight and cost-effective biometric authentication framework based on PPG signals extracted from low-frame-rate fingertip videos. The CFIHSR dataset, comprising PPG recordings from 46 subjects at a sampling rate of 14 Hz, is employed for evaluation. The raw PPG signals undergo a standard preprocessing pipeline involving baseline drift removal, motion artifact suppression using Principal Component Analysis (PCA), bandpass filtering, Fourier-based resampling, and amplitude normalization. To generate robust representations, each one-dimensional PPG segment is converted into a two-dimensional time-frequency scalogram via the Continuous Wavelet Transform (CWT), effectively capturing transient cardiovascular dynamics. We developed a hybrid deep learning model, termed CVT-ConvMixer-LSTM, by combining spatial features from the Convolutional Vision Transformer (CVT) and ConvMixer branches with temporal features from a Long Short-Term Memory network (LSTM). The experimental results on 46 subjects demonstrate an authentication accuracy of 98%, validating the robustness of the model to noise and variability between subjects. Due to its efficiency, scalability, and inherent liveness detection capability, the proposed system is well-suited for real-world mobile and embedded biometric security applications.

  • 2 authors
·
Nov 5, 2025

ALPHA: AnomaLous Physiological Health Assessment Using Large Language Models

This study concentrates on evaluating the efficacy of Large Language Models (LLMs) in healthcare, with a specific focus on their application in personal anomalous health monitoring. Our research primarily investigates the capabilities of LLMs in interpreting and analyzing physiological data obtained from FDA-approved devices. We conducted an extensive analysis using anomalous physiological data gathered in a simulated low-air-pressure plateau environment. This allowed us to assess the precision and reliability of LLMs in understanding and evaluating users' health status with notable specificity. Our findings reveal that LLMs exhibit exceptional performance in determining medical indicators, including a Mean Absolute Error (MAE) of less than 1 beat per minute for heart rate and less than 1% for oxygen saturation (SpO2). Furthermore, the Mean Absolute Percentage Error (MAPE) for these evaluations remained below 1%, with the overall accuracy of health assessments surpassing 85%. In image analysis tasks, such as interpreting photoplethysmography (PPG) data, our specially adapted GPT models demonstrated remarkable proficiency, achieving less than 1 bpm error in cycle count and 7.28 MAE for heart rate estimation. This study highlights LLMs' dual role as health data analysis tools and pivotal elements in advanced AI health assistants, offering personalized health insights and recommendations within the future health assistant framework.

  • 7 authors
·
Nov 21, 2023

QualityFM: a Multimodal Physiological Signal Foundation Model with Self-Distillation for Signal Quality Challenges in Critically Ill Patients

Photoplethysmogram (PPG) and electrocardiogram (ECG) are commonly recorded in intesive care unit (ICU) and operating room (OR). However, the high incidence of poor, incomplete, and inconsistent signal quality, can lead to false alarms or diagnostic inaccuracies. The methods explored so far suffer from limited generalizability, reliance on extensive labeled data, and poor cross-task transferability. To overcome these challenges, we introduce QualityFM, a novel multimodal foundation model for these physiological signals, designed to acquire a general-purpose understanding of signal quality. Our model is pre-trained on an large-scale dataset comprising over 21 million 30-second waveforms and 179,757 hours of data. Our approach involves a dual-track architecture that processes paired physiological signals of differing quality, leveraging a self-distillation strategy where an encoder for high-quality signals is used to guide the training of an encoder for low-quality signals. To efficiently handle long sequential signals and capture essential local quasi-periodic patterns, we integrate a windowed sparse attention mechanism within our Transformer-based model. Furthermore, a composite loss function, which combines direct distillation loss on encoder outputs with indirect reconstruction loss based on power and phase spectra, ensures the preservation of frequency-domain characteristics of the signals. We pre-train three models with varying parameter counts (9.6 M to 319 M) and demonstrate their efficacy and practical value through transfer learning on three distinct clinical tasks: false alarm of ventricular tachycardia detection, the identification of atrial fibrillation and the estimation of arterial blood pressure (ABP) from PPG and ECG signals.

  • 3 authors
·
Sep 8, 2025

Large Language Models for Cuffless Blood Pressure Measurement From Wearable Biosignals

Large language models (LLMs) have captured significant interest from both academia and industry due to their impressive performance across various textual tasks. However, the potential of LLMs to analyze physiological time-series data remains an emerging research field. Particularly, there is a notable gap in the utilization of LLMs for analyzing wearable biosignals to achieve cuffless blood pressure (BP) measurement, which is critical for the management of cardiovascular diseases. This paper presents the first work to explore the capacity of LLMs to perform cuffless BP estimation based on wearable biosignals. We extracted physiological features from electrocardiogram (ECG) and photoplethysmogram (PPG) signals and designed context-enhanced prompts by combining these features with BP domain knowledge and user information. Subsequently, we adapted LLMs to BP estimation tasks through fine-tuning. To evaluate the proposed approach, we conducted assessments of ten advanced LLMs using a comprehensive public dataset of wearable biosignals from 1,272 participants. The experimental results demonstrate that the optimally fine-tuned LLM significantly surpasses conventional task-specific baselines, achieving an estimation error of 0.00 pm 9.25 mmHg for systolic BP and 1.29 pm 6.37 mmHg for diastolic BP. Notably, the ablation studies highlight the benefits of our context enhancement strategy, leading to an 8.9% reduction in mean absolute error for systolic BP estimation. This paper pioneers the exploration of LLMs for cuffless BP measurement, providing a potential solution to enhance the accuracy of cuffless BP measurement.

  • 8 authors
·
Jun 26, 2024

Sensing Cardiac Health Across Scenarios and Devices: A Multi-Modal Foundation Model Pretrained on Heterogeneous Data from 1.7 Million Individuals

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.

  • 13 authors
·
Jun 23, 2025

Artificial Intelligence-derived Vascular Age from Photoplethysmography: A Novel Digital Biomarker for Cardiovascular Health

With the increasing availability of wearable devices, photoplethysmography (PPG) has emerged as a promising non-invasive tool for monitoring human hemodynamics. We propose a deep learning framework to estimate vascular age (AI-vascular age) from PPG signals, incorporating a distribution-aware loss to address biases caused by imbalanced data. The model was developed using data from the UK Biobank (UKB), with 98,672 participants in the development cohort and 113,559 participants (144,683 data pairs) for clinical evaluation. After adjusting for key confounders, individuals with a vascular age gap (AI-vascular age minus calendar age) exceeding 9 years had a significantly higher risk of major adverse cardiovascular and cerebrovascular events (MACCE) (HR = 2.37, p < 0.005) and secondary outcomes, including diabetes (HR = 2.69, p < 0.005), hypertension (HR = 2.88, p < 0.005), coronary heart disease (HR = 2.20, p < 0.005), heart failure (HR = 2.15, p < 0.005), myocardial infarction (HR = 2.51, p < 0.005), stroke (HR = 2.55, p < 0.005), and all-cause mortality (HR = 2.51, p < 0.005). Conversely, participants with a vascular age gap below -9 years exhibited a significantly lower incidence of these outcomes. We further evaluated the longitudinal applicability of AI-vascular age using serial PPG data from the UKB, demonstrating its value in risk stratification by leveraging AI-vascular age at two distinct time points to predict future MACCE incidence. External validation was performed on a MIMIC-III-derived cohort (n = 2,343), where each one-year increase in vascular age gap was significantly associated with elevated in-hospital mortality risk (OR = 1.02, p < 0.005). In conclusion, our study establishes AI-vascular age as a novel, non-invasive digital biomarker for cardiovascular health assessment.

  • 5 authors
·
Feb 18, 2025

PhysDrive: A Multimodal Remote Physiological Measurement Dataset for In-vehicle Driver Monitoring

Robust and unobtrusive in-vehicle physiological monitoring is crucial for ensuring driving safety and user experience. While remote physiological measurement (RPM) offers a promising non-invasive solution, its translation to real-world driving scenarios is critically constrained by the scarcity of comprehensive datasets. Existing resources are often limited in scale, modality diversity, the breadth of biometric annotations, and the range of captured conditions, thereby omitting inherent real-world challenges in driving. Here, we present PhysDrive, the first large-scale multimodal dataset for contactless in-vehicle physiological sensing with dedicated consideration on various modality settings and driving factors. PhysDrive collects data from 48 drivers, including synchronized RGB, near-infrared camera, and raw mmWave radar data, accompanied with six synchronized ground truths (ECG, BVP, Respiration, HR, RR, and SpO2). It covers a wide spectrum of naturalistic driving conditions, including driver motions, dynamic natural light, vehicle types, and road conditions. We extensively evaluate both signal-processing and deep-learning methods on PhysDrive, establishing a comprehensive benchmark across all modalities, and release full open-source code with compatibility for mainstream public toolboxes. We envision PhysDrive will serve as a foundational resource and accelerate research on multimodal driver monitoring and smart-cockpit systems.

  • 9 authors
·
Jul 25, 2025

GraspLook: a VR-based Telemanipulation System with R-CNN-driven Augmentation of Virtual Environment

The teleoperation of robotic systems in medical applications requires stable and convenient visual feedback for the operator. The most accessible approach to delivering visual information from the remote area is using cameras to transmit a video stream from the environment. However, such systems are sensitive to the camera resolution, limited viewpoints, and cluttered environment bringing additional mental demands to the human operator. The paper proposes a novel system of teleoperation based on an augmented virtual environment (VE). The region-based convolutional neural network (R-CNN) is applied to detect the laboratory instrument and estimate its position in the remote environment to display further its digital twin in the VE, which is necessary for dexterous telemanipulation. The experimental results revealed that the developed system allows users to operate the robot smoother, which leads to a decrease in task execution time when manipulating test tubes. In addition, the participants evaluated the developed system as less mentally demanding (by 11%) and requiring less effort (by 16%) to accomplish the task than the camera-based teleoperation approach and highly assessed their performance in the augmented VE. The proposed technology can be potentially applied for conducting laboratory tests in remote areas when operating with infectious and poisonous reagents.

  • 5 authors
·
Oct 24, 2021

A Pressure Ulcer Care System For Remote Medical Assistance: Residual U-Net with an Attention Model Based for Wound Area Segmentation

Increasing numbers of patients with disabilities or elderly people with mobility issues often suffer from a pressure ulcer. The affected areas need regular checks, but they have a difficulty in accessing a hospital. Some remote diagnosis systems are being used for them, but there are limitations in checking a patient's status regularly. In this paper, we present a remote medical assistant that can help pressure ulcer management with image processing techniques. The proposed system includes a mobile application with a deep learning model for wound segmentation and analysis. As there are not enough data to train the deep learning model, we make use of a pretrained model from a relevant domain and data augmentation that is appropriate for this task. First of all, an image preprocessing method using bilinear interpolation is used to resize images and normalize the images. Second, for data augmentation, we use rotation, reflection, and a watershed algorithm. Third, we use a pretrained deep learning model generated from skin wound images similar to pressure ulcer images. Finally, we added an attention module that can provide hints on the pressure ulcer image features. The resulting model provides an accuracy of 99.0%, an intersection over union (IoU) of 99.99%, and a dice similarity coefficient (DSC) of 93.4% for pressure ulcer segmentation, which is better than existing results.

  • 3 authors
·
Jan 23, 2021

One Dimensional CNN ECG Mamba for Multilabel Abnormality Classification in 12 Lead ECG

Accurate detection of cardiac abnormalities from electrocardiogram recordings is regarded as essential for clinical diagnostics and decision support. Traditional deep learning models such as residual networks and transformer architectures have been applied successfully to this task, but their performance has been limited when long sequential signals are processed. Recently, state space models have been introduced as an efficient alternative. In this study, a hybrid framework named One Dimensional Convolutional Neural Network Electrocardiogram Mamba is introduced, in which convolutional feature extraction is combined with Mamba, a selective state space model designed for effective sequence modeling. The model is built upon Vision Mamba, a bidirectional variant through which the representation of temporal dependencies in electrocardiogram data is enhanced. Comprehensive experiments on the PhysioNet Computing in Cardiology Challenges of 2020 and 2021 were conducted, and superior performance compared with existing methods was achieved. Specifically, the proposed model achieved substantially higher AUPRC and AUROC scores than those reported by the best previously published algorithms on twelve lead electrocardiograms. These results demonstrate the potential of Mamba-based architectures to advance reliable ECG classification. This capability supports early diagnosis and personalized treatment, while enhancing accessibility in telemedicine and resource-constrained healthcare systems.

  • 4 authors
·
Oct 14, 2025

Large-scale Training of Foundation Models for Wearable Biosignals

Tracking biosignals is crucial for monitoring wellness and preempting the development of severe medical conditions. Today, wearable devices can conveniently record various biosignals, creating the opportunity to monitor health status without disruption to one's daily routine. Despite widespread use of wearable devices and existing digital biomarkers, the absence of curated data with annotated medical labels hinders the development of new biomarkers to measure common health conditions. In fact, medical datasets are usually small in comparison to other domains, which is an obstacle for developing neural network models for biosignals. To address this challenge, we have employed self-supervised learning using the unlabeled sensor data collected under informed consent from the large longitudinal Apple Heart and Movement Study (AHMS) to train foundation models for two common biosignals: photoplethysmography (PPG) and electrocardiogram (ECG) recorded on Apple Watch. We curated PPG and ECG datasets from AHMS that include data from ~141K participants spanning ~3 years. Our self-supervised learning framework includes participant level positive pair selection, stochastic augmentation module and a regularized contrastive loss optimized with momentum training, and generalizes well to both PPG and ECG modalities. We show that the pre-trained foundation models readily encode information regarding participants' demographics and health conditions. To the best of our knowledge, this is the first study that builds foundation models using large-scale PPG and ECG data collected via wearable consumer devices x2013 prior works have commonly used smaller-size datasets collected in clinical and experimental settings. We believe PPG and ECG foundation models can enhance future wearable devices by reducing the reliance on labeled data and hold the potential to help the users improve their health.

  • 6 authors
·
Dec 8, 2023

ECHOPulse: ECG controlled echocardio-grams video generation

Echocardiography (ECHO) is essential for cardiac assessments, but its video quality and interpretation heavily relies on manual expertise, leading to inconsistent results from clinical and portable devices. ECHO video generation offers a solution by improving automated monitoring through synthetic data and generating high-quality videos from routine health data. However, existing models often face high computational costs, slow inference, and rely on complex conditional prompts that require experts' annotations. To address these challenges, we propose ECHOPULSE, an ECG-conditioned ECHO video generation model. ECHOPULSE introduces two key advancements: (1) it accelerates ECHO video generation by leveraging VQ-VAE tokenization and masked visual token modeling for fast decoding, and (2) it conditions on readily accessible ECG signals, which are highly coherent with ECHO videos, bypassing complex conditional prompts. To the best of our knowledge, this is the first work to use time-series prompts like ECG signals for ECHO video generation. ECHOPULSE not only enables controllable synthetic ECHO data generation but also provides updated cardiac function information for disease monitoring and prediction beyond ECG alone. Evaluations on three public and private datasets demonstrate state-of-the-art performance in ECHO video generation across both qualitative and quantitative measures. Additionally, ECHOPULSE can be easily generalized to other modality generation tasks, such as cardiac MRI, fMRI, and 3D CT generation. Demo can seen from https://github.com/levyisthebest/ECHOPulse_Prelease.

  • 12 authors
·
Oct 4, 2024

GEM: Empowering MLLM for Grounded ECG Understanding with Time Series and Images

While recent multimodal large language models (MLLMs) have advanced automated ECG interpretation, they still face two key limitations: (1) insufficient multimodal synergy between time series signals and visual ECG representations, and (2) limited explainability in linking diagnoses to granular waveform evidence. We introduce GEM, the first MLLM unifying ECG time series, 12-lead ECG images and text for grounded and clinician-aligned ECG interpretation. GEM enables feature-grounded analysis, evidence-driven reasoning, and a clinician-like diagnostic process through three core innovations: a dual-encoder framework extracting complementary time series and image features, cross-modal alignment for effective multimodal understanding, and knowledge-guided instruction generation for generating high-granularity grounding data (ECG-Grounding) linking diagnoses to measurable parameters (e.g., QRS/PR Intervals). Additionally, we propose the Grounded ECG Understanding task, a clinically motivated benchmark designed to comprehensively assess the MLLM's capability in grounded ECG understanding. Experimental results on both existing and our proposed benchmarks show GEM significantly improves predictive performance (CSN 7.4% uparrow), explainability (22.7% uparrow), and grounding (24.8% uparrow), making it more suitable for real-world clinical applications. GitHub repository: https://github.com/lanxiang1017/GEM.git

  • 6 authors
·
Mar 8, 2025

Monash University, UEA, UCR Time Series Extrinsic Regression Archive

Time series research has gathered lots of interests in the last decade, especially for Time Series Classification (TSC) and Time Series Forecasting (TSF). Research in TSC has greatly benefited from the University of California Riverside and University of East Anglia (UCR/UEA) Time Series Archives. On the other hand, the advancement in Time Series Forecasting relies on time series forecasting competitions such as the Makridakis competitions, NN3 and NN5 Neural Network competitions, and a few Kaggle competitions. Each year, thousands of papers proposing new algorithms for TSC and TSF have utilized these benchmarking archives. These algorithms are designed for these specific problems, but may not be useful for tasks such as predicting the heart rate of a person using photoplethysmogram (PPG) and accelerometer data. We refer to this problem as Time Series Extrinsic Regression (TSER), where we are interested in a more general methodology of predicting a single continuous value, from univariate or multivariate time series. This prediction can be from the same time series or not directly related to the predictor time series and does not necessarily need to be a future value or depend heavily on recent values. To the best of our knowledge, research into TSER has received much less attention in the time series research community and there are no models developed for general time series extrinsic regression problems. Most models are developed for a specific problem. Therefore, we aim to motivate and support the research into TSER by introducing the first TSER benchmarking archive. This archive contains 19 datasets from different domains, with varying number of dimensions, unequal length dimensions, and missing values. In this paper, we introduce the datasets in this archive and did an initial benchmark on existing models.

  • 4 authors
·
Jun 19, 2020

From Token to Rhythm: A Multi-Scale Approach for ECG-Language Pretraining

Electrocardiograms (ECGs) play a vital role in monitoring cardiac health and diagnosing heart diseases. However, traditional deep learning approaches for ECG analysis rely heavily on large-scale manual annotations, which are both time-consuming and resource-intensive to obtain. To overcome this limitation, self-supervised learning (SSL) has emerged as a promising alternative, enabling the extraction of robust ECG representations that can be efficiently transferred to various downstream tasks. While previous studies have explored SSL for ECG pretraining and multi-modal ECG-language alignment, they often fail to capture the multi-scale nature of ECG signals. As a result, these methods struggle to learn generalized representations due to their inability to model the hierarchical structure of ECG data. To address this gap, we introduce MELP, a novel Multi-scale ECG-Language Pretraining (MELP) model that fully leverages hierarchical supervision from ECG-text pairs. MELP first pretrains a cardiology-specific language model to enhance its understanding of clinical text. It then applies three levels of cross-modal supervision-at the token, beat, and rhythm levels-to align ECG signals with textual reports, capturing structured information across different time scales. We evaluate MELP on three public ECG datasets across multiple tasks, including zero-shot ECG classification, linear probing, and transfer learning. Experimental results demonstrate that MELP outperforms existing SSL methods, underscoring its effectiveness and adaptability across diverse clinical applications. Our code is available at https://github.com/HKU-MedAI/MELP.

  • 3 authors
·
Jun 11, 2025

Optimizing Illuminant Estimation in Dual-Exposure HDR Imaging

High dynamic range (HDR) imaging involves capturing a series of frames of the same scene, each with different exposure settings, to broaden the dynamic range of light. This can be achieved through burst capturing or using staggered HDR sensors that capture long and short exposures simultaneously in the camera image signal processor (ISP). Within camera ISP pipeline, illuminant estimation is a crucial step aiming to estimate the color of the global illuminant in the scene. This estimation is used in camera ISP white-balance module to remove undesirable color cast in the final image. Despite the multiple frames captured in the HDR pipeline, conventional illuminant estimation methods often rely only on a single frame of the scene. In this paper, we explore leveraging information from frames captured with different exposure times. Specifically, we introduce a simple feature extracted from dual-exposure images to guide illuminant estimators, referred to as the dual-exposure feature (DEF). To validate the efficiency of DEF, we employed two illuminant estimators using the proposed DEF: 1) a multilayer perceptron network (MLP), referred to as exposure-based MLP (EMLP), and 2) a modified version of the convolutional color constancy (CCC) to integrate our DEF, that we call ECCC. Both EMLP and ECCC achieve promising results, in some cases surpassing prior methods that require hundreds of thousands or millions of parameters, with only a few hundred parameters for EMLP and a few thousand parameters for ECCC.

  • 3 authors
·
Mar 4, 2024

Multimodal Sleep Stage and Sleep Apnea Classification Using Vision Transformer: A Multitask Explainable Learning Approach

Sleep is an essential component of human physiology, contributing significantly to overall health and quality of life. Accurate sleep staging and disorder detection are crucial for assessing sleep quality. Studies in the literature have proposed PSG-based approaches and machine-learning methods utilizing single-modality signals. However, existing methods often lack multimodal, multilabel frameworks and address sleep stages and disorders classification separately. In this paper, we propose a 1D-Vision Transformer for simultaneous classification of sleep stages and sleep disorders. Our method exploits the sleep disorders' correlation with specific sleep stage patterns and performs a simultaneous identification of a sleep stage and sleep disorder. The model is trained and tested using multimodal-multilabel sensory data (including photoplethysmogram, respiratory flow, and respiratory effort signals). The proposed method shows an overall accuracy (cohen's Kappa) of 78% (0.66) for five-stage sleep classification and 74% (0.58) for sleep apnea classification. Moreover, we analyzed the encoder attention weights to clarify our models' predictions and investigate the influence different features have on the models' outputs. The result shows that identified patterns, such as respiratory troughs and peaks, make a higher contribution to the final classification process.

  • 6 authors
·
Feb 18, 2025

EchoingECG: An Electrocardiogram Cross-Modal Model for Echocardiogram Tasks

Electrocardiogram (ECG) is a widely used tool for assessing cardiac function due to its low cost and accessibility. Emergent research shows that ECGs can help make predictions on key outcomes traditionally derived from more complex modalities such as echocardiograms (ECHO), enabling the use of ECGs as a more accessible method to predict broader measurements of cardiac function. ECHO, in particular, are of great importance because they require considerable hospital resources while playing a key role in clinical cardiac assessment. To aid this use case, we introduce EchoingECG, a probabilistic student-teacher model that leverages uncertainty-aware ECG embeddings and ECHO supervision to improve ECG-based cardiac function prediction. Our approach integrates Probabilistic Cross-Modal Embeddings (PCME++), a probabilistic contrastive framework, with ECHO-CLIP, a vision-language pre-trained model trained on ECHO-text pairs, to distill ECHO knowledge into ECG representations. Through experiments and external validation, we showed that EchoingECG outperforms state-of-the-art foundation ECG models in zero-shot, few-shot, and fine-tune settings for ECHO predictions based on ECG. We also highlighted that variance estimation (enabled through our method) enhanced our understanding of model performance by identifying underlying regions of uncertainty within ECGs. The code is available: https://github.com/mcintoshML/EchoingECG.

  • 3 authors
·
Sep 30, 2025

MedVSR: Medical Video Super-Resolution with Cross State-Space Propagation

High-resolution (HR) medical videos are vital for accurate diagnosis, yet are hard to acquire due to hardware limitations and physiological constraints. Clinically, the collected low-resolution (LR) medical videos present unique challenges for video super-resolution (VSR) models, including camera shake, noise, and abrupt frame transitions, which result in significant optical flow errors and alignment difficulties. Additionally, tissues and organs exhibit continuous and nuanced structures, but current VSR models are prone to introducing artifacts and distorted features that can mislead doctors. To this end, we propose MedVSR, a tailored framework for medical VSR. It first employs Cross State-Space Propagation (CSSP) to address the imprecise alignment by projecting distant frames as control matrices within state-space models, enabling the selective propagation of consistent and informative features to neighboring frames for effective alignment. Moreover, we design an Inner State-Space Reconstruction (ISSR) module that enhances tissue structures and reduces artifacts with joint long-range spatial feature learning and large-kernel short-range information aggregation. Experiments across four datasets in diverse medical scenarios, including endoscopy and cataract surgeries, show that MedVSR significantly outperforms existing VSR models in reconstruction performance and efficiency. Code released at https://github.com/CUHK-AIM-Group/MedVSR.

  • 5 authors
·
Sep 25, 2025

MEETI: A Multimodal ECG Dataset from MIMIC-IV-ECG with Signals, Images, Features and Interpretations

Electrocardiogram (ECG) plays a foundational role in modern cardiovascular care, enabling non-invasive diagnosis of arrhythmias, myocardial ischemia, and conduction disorders. While machine learning has achieved expert-level performance in ECG interpretation, the development of clinically deployable multimodal AI systems remains constrained, primarily due to the lack of publicly available datasets that simultaneously incorporate raw signals, diagnostic images, and interpretation text. Most existing ECG datasets provide only single-modality data or, at most, dual modalities, making it difficult to build models that can understand and integrate diverse ECG information in real-world settings. To address this gap, we introduce MEETI (MIMIC-IV-Ext ECG-Text-Image), the first large-scale ECG dataset that synchronizes raw waveform data, high-resolution plotted images, and detailed textual interpretations generated by large language models. In addition, MEETI includes beat-level quantitative ECG parameters extracted from each lead, offering structured parameters that support fine-grained analysis and model interpretability. Each MEETI record is aligned across four components: (1) the raw ECG waveform, (2) the corresponding plotted image, (3) extracted feature parameters, and (4) detailed interpretation text. This alignment is achieved using consistent, unique identifiers. This unified structure supports transformer-based multimodal learning and supports fine-grained, interpretable reasoning about cardiac health. By bridging the gap between traditional signal analysis, image-based interpretation, and language-driven understanding, MEETI established a robust foundation for the next generation of explainable, multimodal cardiovascular AI. It offers the research community a comprehensive benchmark for developing and evaluating ECG-based AI systems.

  • 7 authors
·
Jul 21, 2025

Novel quantitative indicators of digital ophthalmoscopy image quality

With the advent of smartphone indirect ophthalmoscopy, teleophthalmology - the use of specialist ophthalmology assets at a distance from the patient - has experienced a breakthrough, promising enormous benefits especially for healthcare in distant, inaccessible or opthalmologically underserved areas, where specialists are either unavailable or too few in number. However, accurate teleophthalmology requires high-quality ophthalmoscopic imagery. This paper considers three feature families - statistical metrics, gradient-based metrics and wavelet transform coefficient derived indicators - as possible metrics to identify unsharp or blurry images. By using standard machine learning techniques, the suitability of these features for image quality assessment is confirmed, albeit on a rather small data set. With the increased availability and decreasing cost of digital ophthalmoscopy on one hand and the increased prevalence of diabetic retinopathy worldwide on the other, creating tools that can determine whether an image is likely to be diagnostically suitable can play a significant role in accelerating and streamlining the teleophthalmology process. This paper highlights the need for more research in this area, including the compilation of a diverse database of ophthalmoscopic imagery, annotated with quality markers, to train the Point of Acquisition error detection algorithms of the future.

  • 1 authors
·
Mar 6, 2019

SpiroLLM: Finetuning Pretrained LLMs to Understand Spirogram Time Series with Clinical Validation in COPD Reporting

Chronic Obstructive Pulmonary Disease (COPD), a major chronic respiratory disease with persistent airflow limitation, is a leading global cause of disability and mortality. Respiratory spirogram time series, routinely collected during pulmonary function tests (PFTs), play a critical role in the early detection of repsiratory diseases and in monitoring lung function over time. However, most current AI models for COPD diagnosis are limited to outputting classification results without providing a rationale for their diagnostic process, while current Large Language Models (LLMs) cannot understand spirograms yet, which severely limits their clinical trust and adoption. To tackle this challenge, we leverage a cohort of 234,028 individuals from the UK Biobank (UKB) to propose SpiroLLM, the first multimodal large language model that can understand spirogram. The model extracts morphological features from respiratory curves via a SpiroEncoder and aligns them with PFT numerical values in a unified latent space using a SpiroProjector, ultimately empowering a large language model to generate a comprehensive diagnostic report. Experimental results confirm that SpiroLLM achieved a diagnostic AUROC of 0.8980 (95% CI: 0.8820-0.9132). In a robustness test with missing core data, it maintained a 100% valid response rate, far surpassing the 13.4% of a text-only model and showcasing the superiority of its multimodal design. This work demonstrates the substantial potential of deeply fusing physiological signals with large language models, establishing a new paradigm for the next generation of interpretable and reliable clinical decision support tools.

  • 8 authors
·
Jul 21, 2025

Reconstructing 12-Lead ECG from 3-Lead ECG using Variational Autoencoder to Improve Cardiac Disease Detection of Wearable ECG Devices

Twelve-lead electrocardiograms (ECGs) are the clinical gold standard for cardiac diagnosis, providing comprehensive spatial coverage of the heart necessary to detect conditions such as myocardial infarction (MI). However, their lack of portability limits continuous and large-scale use. Three-lead ECG systems are widely used in wearable devices due to their simplicity and mobility, but they often fail to capture pathologies in unmeasured regions. To address this, we propose WearECG, a Variational Autoencoder (VAE) method that reconstructs twelve-lead ECGs from three leads: II, V1, and V5. Our model includes architectural improvements to better capture temporal and spatial dependencies in ECG signals. We evaluate generation quality using MSE, MAE, and Frechet Inception Distance (FID), and assess clinical validity via a Turing test with expert cardiologists. To further validate diagnostic utility, we fine-tune ECGFounder, a large-scale pretrained ECG model, on a multi-label classification task involving over 40 cardiac conditions, including six different myocardial infarction locations, using both real and generated signals. Experiments on the MIMIC dataset show that our method produces physiologically realistic and diagnostically informative signals, with robust performance in downstream tasks. This work demonstrates the potential of generative modeling for ECG reconstruction and its implications for scalable, low-cost cardiac screening.

  • 9 authors
·
Oct 13, 2025

HDRT: Infrared Capture for HDR Imaging

Capturing real world lighting is a long standing challenge in imaging and most practical methods acquire High Dynamic Range (HDR) images by either fusing multiple exposures, or boosting the dynamic range of Standard Dynamic Range (SDR) images. Multiple exposure capture is problematic as it requires longer capture times which can often lead to ghosting problems. The main alternative, inverse tone mapping is an ill-defined problem that is especially challenging as single captured exposures usually contain clipped and quantized values, and are therefore missing substantial amounts of content. To alleviate this, we propose a new approach, High Dynamic Range Thermal (HDRT), for HDR acquisition using a separate, commonly available, thermal infrared (IR) sensor. We propose a novel deep neural method (HDRTNet) which combines IR and SDR content to generate HDR images. HDRTNet learns to exploit IR features linked to the RGB image and the IR-specific parameters are subsequently used in a dual branch method that fuses features at shallow layers. This produces an HDR image that is significantly superior to that generated using naive fusion approaches. To validate our method, we have created the first HDR and thermal dataset, and performed extensive experiments comparing HDRTNet with the state-of-the-art. We show substantial quantitative and qualitative quality improvements on both over- and under-exposed images, showing that our approach is robust to capturing in multiple different lighting conditions.

  • 5 authors
·
Jun 8, 2024