ProtoEFNet: Dynamic Prototype Learning for Inherently Interpretable Ejection Fraction Estimation in Echocardiography
Bibliographic record
Abstract
Ejection fraction (EF) is a crucial metric for assessing cardiac function and diagnosing conditions such as heart failure. Traditionally, EF estimation requires manual tracing and domain expertise, making the process time-consuming and subject to interobserver variability. Most current deep learning methods for EF prediction are black-box models with limited transparency, which reduces clinical trust. Some post-hoc explainability methods have been proposed to interpret the decision-making process after the prediction is made. However, these explanations do not guide the model's internal reasoning and therefore offer limited reliability in clinical applications. To address this, we introduce ProtoEFNet, a novel video-based prototype learning model for continuous EF regression. The model learns dynamic spatiotemporal prototypes that capture clinically meaningful cardiac motion patterns. Additionally, the proposed Prototype Angular Separation (PAS) loss enforces discriminative representations across the continuous EF spectrum. Our experiments on the EchonetDynamic dataset show that ProtoEFNet can achieve accuracy on par with its non-interpretable counterpart while providing clinically relevant insight. The ablation study shows that the proposed loss boosts performance with a 2% increase in F1 score from 77.67$\pm$2.68 to 79.64$\pm$2.10. Our source code is available at: https://github.com/DeepRCL/ProtoEF
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".