Fusing Echocardiography Images and Medical Records for Continuous Patient Stratification
Bibliographic record
Abstract
Deep learning enables automatic and robust extraction of cardiac function descriptors from echocardiographic sequences, such as ejection fraction or strain. These descriptors provide fine-grained information that physicians consider, in conjunction with more global variables from the clinical record, to assess patients' condition. Drawing on novel Transformer models applied to tabular data, we propose a method that considers all descriptors extracted from medical records and echocardiograms to learn the representation of a cardiovascular pathology with a difficult-to-characterize continuum, namely hypertension. Our method first projects each variable into its own representation space using modality-specific approaches. These standardized representations of multimodal data are then fed to a Transformer encoder, which learns to merge them into a comprehensive representation of the patient through the task of predicting a clinical rating. This stratification task is formulated as an ordinal classification to enforce a pathological continuum in the representation space. We observe the major trends along this continuum on a cohort of 239 hypertensive patients, providing unprecedented details in the description of hypertension's impact on various cardiac function descriptors. Our analysis shows that i) the XTab foundation model's architecture allows to reach outstanding performance (96.8% AUROC) even with limited data (less than 200 training samples), ii) stratification across the population is reproducible between trainings (within 5.7% mean absolute error), and iii) patterns emerge in descriptors, some of which align with established physiological knowledge about hypertension, while others could pave the way for a more comprehensive understanding of this pathology. Code is available at https://github.com/creatis-myriad/didactic.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".