This work illuminates the limitations of current MLLMs in electrophysiology and provides a foundational benchmark for long-term medical MLLMs, including Holtercare-Bench, a multimodal benchmark that evaluates models on temporal localization, clinical diagnosis, and global summarization.
Abstract
While multimodal large language models (MLLMs) excel in medical applications, most of them favor static images or short-term signals. In the critical field of dynamic electrocardiograms (ECG), models struggle with complex temporal reasoning and diagnostic report generation due to a lack of high-quality datasets and benchmarks. To address this, we introduce (i) Holtercare-23K, a large-scale multimodal dynamic ECG dataset comprising 22,980 QA pairs derived from 788 clinical Holter records and featuring a novel signal-video-text tri-modal alignment. Based on this dataset, we present (ii) Holtercare-Bench, a multimodal benchmark that evaluates models on temporal localization, clinical diagnosis, and global summarization. Zero-shot evaluations of leading MLLMs reveal a significant performance gap in processing ultra-long pathological sequences. However, fine-tuning representative models yields substantial improvements. This work illuminates the limitations of current MLLMs in electrophysiology and provides a foundational benchmark for long-term medical MLLMs. Our project is available at https://github.com/ZJU4HealthCare/Holtercare-Bench.
Electrocardiograms (ECGs) are inexpensive, widely used, and well-suited to deep learning. Interest has grown in ECG foundation models that generalise across diverse downstream tasks. However, current evaluation rarely reflects the full capabilities expected of ECG foundation models, with prior work often using narrow...
R. Lunelli, A. Nicolson, S. Pröll et al.· npj Digital Medicine· 0 citations
ECGQuest provides a reproducible benchmark for contextual ECG knowledge and shows that parameter-efficient fine-tuning can make smaller language models competitive with substantially larger commercial models.
M. Hassannia, Matthew A. Reyna, R. Sameni· 0 citations
Stroke is a leading cause of death and long-term disability, and auxiliary methods for rapid patient identification are needed. Previous studies based on electrocardiography (ECG) have attempted stroke classification using quantitative measurements and future stroke risk prediction using raw signals. However, measureme...
Soyun Im, Chulho Kim, Yu-Seop Kim· Bioengineering· 0 citations
Electrocardiography (ECG) records the electrical activity of the heart, aiding diagnosis by detecting abnormalities in cardiac function. ECG foundation models have demonstrated promising results, but are limited by a reliance on ECG interpretation reports as their sole supervision. Because interpretation reports only c...
Robert A. Lewis, I-Min Chiu, Kyle Verrier et al.· 0 citations
Medical time series (MedTS), including electrocardiograms (ECG), electroencephalograms (EEG), photoplethysmography (PPG), and vital-sign recordings, are central to clinical diagnosis and health monitoring. As large language models (LLMs) have advanced, a growing body of work has examined how their reasoning, generation...
Yu Han, Cigdem Beyan, Xiang Zhang et al.· 0 citations