PaperarXiv:2611.02041

ECGJev: Question-Conditioned Option Scoring for 12-Lead ECG Interpretation (arXiv 2611.02041)

Preprint2026Added Nov 5, 2026

Authors: Zhuoyuan Li, Xidong Wu (equal contribution), Hanyu Cui, Jiansong Gao, Rongrong Fu, Mingke Yan, Haotian Tang (corresponding)

arXiv 2611.02041v1 (2026-11-01); submitted to ISBI 2027

First page or project page of “ECGJev: Question-Conditioned Option Scoring for 12-Lead ECG Interpretation (arXiv 2611.02041)” (opens in a new tab)

Li, Zhuoyuan et al., "ECGJev: Question-Conditioned Option Scoring for 12-Lead ECG Interpretation", arXiv:2611.02041, CC BY-SA 4.0

TL;DR

Encoders: frozen waveform and spectrogram-image ECG encoders. Bridge: 16 question-conditioned ECG tokens. Decoder: StartLux-Decision-0.8B option scorer, LoRA-tuned. Benchmarks: CPSC2018 (9 labels), PTB-XL (5 superclasses), Chapman (4 rhythms), PTB (small).

  • Form factor: clinical-12-lead

Abstract

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.

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Results on ChatPPG leaderboards · 1

All leaderboards
LeaderboardMethodResultRank
Zheng 2020 macro-F1ECG rhythm classificationECGJevvia model ECGJev96.86macro-F1, higher is better#1 of 1

No row is credited to the paper itself; 1 more belong to models it introduces or evaluates. Ranks apply within each leaderboard only, as reported by the source.

Tasks & signals

Signals

Keywords

12 LeadECG QAECG LLMOption ScoringLoRASpectrogramCode ReleasedNo Weights

Datasets used

Models

How it works

How ECGJev works: Setup → Method → TargetSetup: Signals (ecg); Form factor (clinical-12-lead). Method: ECGJev (Language-aligned).SetupSignals: ecgSignalsecgForm factor: clinical-12-leadForm factorclinical-12-leadMethodECGJevLanguage-aligned

Cite this paper

Cite this paper with the fields recorded here. Check it against the publisher before submitting.

Li, Z., Wu, X., Cui, H., Gao, J., Fu, R., Yan, M., & Tang, H. (2026). ECGJev: Question-Conditioned Option Scoring for 12-Lead ECG Interpretation (arXiv 2611.02041). arXiv 2611.02041v1. https://arxiv.org/abs/2611.02041
Li, Zhuoyuan, Xidong Wu, Hanyu Cui, Jiansong Gao, Rongrong Fu, Mingke Yan, and Haotian Tang. 2026. "ECGJev: Question-Conditioned Option Scoring for 12-Lead ECG Interpretation (arXiv 2611.02041)." arXiv 2611.02041v1. https://arxiv.org/abs/2611.02041.
Li, Z., Wu, X., Cui, H., Gao, J., Fu, R., Yan, M. and Tang, H. (2026) 'ECGJev: Question-Conditioned Option Scoring for 12-Lead ECG Interpretation (arXiv 2611.02041)', arXiv 2611.02041v1. Available at: https://arxiv.org/abs/2611.02041
Li, Zhuoyuan, et al. "ECGJev: Question-Conditioned Option Scoring for 12-Lead ECG Interpretation (arXiv 2611.02041)." arXiv 2611.02041v1, 2026. https://arxiv.org/abs/2611.02041.
Z. Li et al., "ECGJev: Question-Conditioned Option Scoring for 12-Lead ECG Interpretation (arXiv 2611.02041)," arXiv 2611.02041v1, 2026, [Online]. Available: https://arxiv.org/abs/2611.02041.
@misc{li2026ecgjev,
  title         = {{ECGJev: Question-Conditioned Option Scoring for 12-Lead ECG Interpretation (arXiv 2611.02041)}},
  author        = {Li, Zhuoyuan and Wu, Xidong and Cui, Hanyu and Gao, Jiansong and Fu, Rongrong and Yan, Mingke and Tang, Haotian},
  year          = {2026},
  howpublished  = {arXiv 2611.02041v1},
  eprint        = {2611.02041},
  archivePrefix = {arXiv}
}

Source metadata: 2026

Record updated Nov 5, 2026

Added to the ChatPPG research hub