Clinically Calibrated Machine Learning Benchmarks for Large-Scale Multi-Disorder EEG Classification

Clinical electroencephalography is routinely used to evaluate patients with diverse and often overlapping neurological conditions, yet interpretation remains manual, time-intensive, and variable across experts. While automated EEG analysis has been widely studied, most existing methods target isolated diagnostic problems, particularly seizure detection, and provide limited support for multi-disorder clinical screening. This study examines automated EEG-based classification across eleven clinically relevant neurological disorder categories, encompassing acute time-critical conditions, chronic neurocognitive and developmental disorders, and disorders with indirect or weak electrophysiological signatures. EEG recordings are processed using a standard longitudinal bipolar montage and represented through a multi-domain feature set capturing temporal statistics, spectral structure, signal complexity, and inter-channel relationships. Disorder-aware machine learning models are trained under severe class imbalance, with decision thresholds explicitly calibrated to prioritize diagnostic sensitivity. Evaluation on a large, heterogeneous clinical EEG dataset demonstrates that sensitivity-oriented modeling achieves recall exceeding 80% for the majority of disorder categories, with several low-prevalence conditions showing absolute recall gains of 15-30% after threshold calibration compared to default operating points. Feature importance analysis reveals physiologically plausible patterns consistent with established clinical EEG markers. These results establish realistic performance baselines for multi-disorder EEG classification and provide quantitative evidence that sensitivity-prioritized automated analysis can support scalable EEG screening and triage in real-world clinical settings.

Beyond CLIP: Knowledge-Enhanced Multimodal Transformers for Cross-Modal Alignment in Diabetic Retinopathy Diagnosis

Diabetic retinopathy (DR) is a leading cause of preventable blindness worldwide, demanding accurate automated diagnostic systems. While general-domain vision-language models like Contrastive Language-Image Pre-Training (CLIP) perform well on natural image tasks, they struggle in medical domain applications, particularly in cross-modal retrieval for ophthalmological images. We propose a novel knowledge-enhanced joint embedding framework that integrates retinal fundus images, clinical text, and structured patient data through a multimodal transformer architecture to address the critical gap in medical image-text alignment. Our approach employs separate encoders for each modality: a Vision Transformer (ViT-B/16) for retinal images, Bio-ClinicalBERT for clinical narratives, and a multilayer perceptron for structured demographic and clinical features. These modalities are fused through a joint transformer with modality-specific embeddings, trained using multiple objectives including contrastive losses between modality pairs, reconstruction losses for images and text, and classification losses for DR severity grading according to ICDR and SDRG schemes. Experimental results on the Brazilian Multilabel Ophthalmological Dataset (BRSET) demonstrate significant improvements over baseline models. Our framework achieves near-perfect text-to-image retrieval performance with Recall@1 of 99.94% compared to fine-tuned CLIP's 1.29%, while maintaining state-of-the-art classification accuracy of 97.05% for SDRG and 97.97% for ICDR. Furthermore, zero-shot evaluation on the unseen DeepEyeNet dataset validates strong generalizability with 93.95% Recall@1 versus 0.22% for fine-tuned CLIP. These results demonstrate that our multimodal training approach effectively captures cross-modal relationships in the medical domain, establishing both superior retrieval capabilities and robust diagnostic performance.