Multi-expert ensemble ECG diagnostic algorithm using mutually exclusive–symbiotic correlation between 254 hierarchical multiple labels

Electrocardiograms (ECGs) are a cheap and convenient means of assessing heart health and provide an important basis for diagnosis and treatment by cardiologists. However, existing intelligent ECG diagnostic approaches can only detect up to several tens of ECG terms, which barely cover the most common arrhythmias. Thus, further diagnosis is required by cardiologists in clinical settings. This paper describes the development of a multi-expert ensemble learning model that can recognize 254 ECG terms. Based on data from 191,804 wearable 12-lead ECGs, mutually exclusive–symbiotic correlations between hierarchical multiple labels are applied at the loss level to improve the diagnostic performance of the model and make its predictions more reasonable while alleviating the difficulty of class imbalance. The model achieves an average area under the receiver operating characteristics curve of 0.973 and 0.956 on offline and online test sets, respectively. We select 130 terms from the 254 available for clinical settings by considering the classification performance and clinical significance, providing real-time and comprehensive ancillary support for the public.