Contextual Discrepancy-Aware Contrastive Learning for Robust Medical Time Series Diagnosis in Small-Sample Scenarios

Medical time series data, such as EEG and ECG, are vital for diagnosing neurological and cardiovascular diseases. However, their precise interpretation faces significant challenges due to high annotation costs, leading to data scarcity, and the limitations of traditional contrastive learning in capturing complex temporal patterns. To address these issues, we propose CoDAC (Contextual Discrepancy-Aware Contrastive learning), a novel framework that enhances diagnostic accuracy and generalization, particularly in small-sample settings. CoDAC leverages external healthy data and introduces a Contextual Discrepancy Estimator (CDE), built upon a Transformer-based Autoencoder, to precisely quantify abnormal signals through context-aware anomaly scores. These scores dynamically inform a Dynamic Multi-views Contrastive Framework (DMCF), which adaptively weights different temporal views to focus contrastive learning on diagnostically relevant, discrepant regions. Our encoder combines dilated convolutions with multi-head attention for robust feature extraction. Comprehensive experiments on Alzheimer's Disease EEG, Parkinson's Disease EEG, and Myocardial Infarction ECG datasets demonstrate CoDAC's superior performance across all metrics, consistently outperforming state-of-the-art baselines, especially under low label availability. Ablation studies further validate the critical contributions of CDE and DMCF. CoDAC offers a robust and interpretable solution for medical time series diagnosis, effectively mitigating data scarcity challenges.

XDR-LVLM: An Explainable Vision-Language Large Model for Diabetic Retinopathy Diagnosis

Diabetic Retinopathy (DR) is a major cause of global blindness, necessitating early and accurate diagnosis. While deep learning models have shown promise in DR detection, their black-box nature often hinders clinical adoption due to a lack of transparency and interpretability. To address this, we propose XDR-LVLM (eXplainable Diabetic Retinopathy Diagnosis with LVLM), a novel framework that leverages Vision-Language Large Models (LVLMs) for high-precision DR diagnosis coupled with natural language-based explanations. XDR-LVLM integrates a specialized Medical Vision Encoder, an LVLM Core, and employs Multi-task Prompt Engineering and Multi-stage Fine-tuning to deeply understand pathological features within fundus images and generate comprehensive diagnostic reports. These reports explicitly include DR severity grading, identification of key pathological concepts (e.g., hemorrhages, exudates, microaneurysms), and detailed explanations linking observed features to the diagnosis. Extensive experiments on the Diabetic Retinopathy (DDR) dataset demonstrate that XDR-LVLM achieves state-of-the-art performance, with a Balanced Accuracy of 84.55% and an F1 Score of 79.92% for disease diagnosis, and superior results for concept detection (77.95% BACC, 66.88% F1). Furthermore, human evaluations confirm the high fluency, accuracy, and clinical utility of the generated explanations, showcasing XDR-LVLM's ability to bridge the gap between automated diagnosis and clinical needs by providing robust and interpretable insights.