arXiv:2611.02041 · v1
ECGJev: Question-Conditioned Option Scoring for 12-Lead ECG Interpretation
摘要
Clinical interpretation of a 12-lead electrocardiogram (ECG) often requires answering targeted diagnostic questions with clear, quantifiable decisions. We introduce ECGJev, the first ECG framework built on a decision decoder, a pretrained language model trained to return a probability for every listed option. A question-conditioned bridge compresses frozen waveform and spectrogram features into 16 ECG tokens, and a two-stage procedure adapts the bridge and low-rank adapters on the decoder's native option readout using diagnostic labels alone, scoring all options for a question in one forward pass. Evaluated across four ECG benchmarks, ECGJev achieves the highest macro-F1 on CPSC2018 (80.46%), PTB-XL (71.68%) and Chapman (96.86%), and generalizes competitively to the small-sample PTB cohort. Concept probes and perturbation analyses further show that its predictions rely directly on the ECG input, remain stable under option-order and wording variations, and transfer zero-shot to unseen waveform concepts. Our code is available at https://github.com/zhuoyuanli-lab/ECGJev.
作者备注：5 pages (4 pages plus ethics statement and references), 2 figures. Submitted to IEEE ISBI 2027. Zhuoyuan Li and Xidong Wu contributed equally