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Aaqib Saeed

Publications and source records attributed to Aaqib Saeed.

At least 19 recordsLinked to original sources
arXiv2026

Zero-Shot Respiratory Sound Classification through LLM-Augmented Audio-Text Alignment

Self-supervised respiratory encoders lack semantic grounding in clinical domain needed for zero-shot inference, limiting their utility without task-specific labeled data. We propose a framework that aligns these encoders with medical terminology in a shared latent space turning them into a zero-shot-capable foundation model. To address paired data scarcity, we use a medical LLM to synthesize structured reports from metadata, creating dense semantic anchors for contrastive learning. Our training combines a sigmoid-based contrastive loss with encoder's native SSL objective and similarity-aware negative sampling to sharpen pathological boundaries. Across 9 tasks on 6 datasets, our method achieves a 61.3% mean zero-shot AUC, surpassing CLAP (51.4%) and Qwen2-Audio (54.9%) while reaching the highest linear probing AUC (71.6%) with only 43% of data used by full-scale baselines, showing that structured semantic alignment outperforms large-scale, general-purpose models in clinical diagnostics.

cs.CL↗
arXiv2026

CardioState-JEPA: Delay-Aware Cross-Modal Learning of a Shared Cardiac Representation

Electrocardiography (ECG), photoplethysmography (PPG), and phonocardiography (PCG) provide complementary views of the same cardiac cycle, yet existing cardiac foundation models are trained for a single sensing modality, leaving the shared physiology across sensors unexploited. We introduce CardioState-JEPA, a cardiac foundation model to learn a single shared representation jointly across ECG, PPG, and PCG, built on a physiology-aware joint-embedding predictive architecture. The model maps heterogeneous waveforms into a common token space, processes them with a single shared Transformer encoder, and learns by predicting masked latent cardiac states, placing the pretraining target on shared physiology rather than sensor-specific waveform appearance. To handle the temporal offsets between electrical, mechanical, and hemodynamic events, cross-modal prediction uses a learned delay aligner that matches signals at the corresponding cardiac time. Because synchronized multi-sensor recordings are scarce, CardioState-JEPA first learns within-modality structure from abundant unimodal data and then uses paired data to align modalities in latent cardiac time. Evaluated as a frozen encoder across 25 downstream tasks spanning ECG, PPG, and PCG, our encoder improves average PPG classification by 8.2 AUROC points, PCG murmur detection by 18.8 AUROC points, and ECG classification by 15.5 AUROC points over the best self-supervised signal baseline and matches or exceeds cardiac models trained with privileged clinical text or supervised labels on several ECG benchmarks. These results establish that heterogeneous cardiac signals can mutually supervise a single foundation model of cardiac physiology.

cs.LG↗
arXiv2026

Unlocking In-Context Learning in Audio-Language Models from Decentralized Medical Audio

Clinical audio diagnosis in low-resource settings requires models that identify conditions from minimal examples without large annotated corpora. We propose Federated Self-Contextualization (FSC), a multimodal language model framework for in-context clinical audio diagnosis across federated hospital clients. FSC constructs pseudo-label episodes via unsupervised clustering of audio representations, bypassing scarce real diagnostic labels, and enables contextual reasoning from support-query pairs. Our progressive three-stage pipeline first aligns audio embeddings with the language model via caption-based pretraining, then adapts it for episodic in-context inference through federated optimization. At test time, given a small labeled support set, the model diagnoses an unseen query through multimodal reasoning. On held-out respiratory and cardiac conditions, FSC achieves 71.6% accuracy in 2-way 2-shot evaluation, outperforming audio-language baselines by over 9%.

cs.LG↗
arXiv2026

VitalAgent: A Tool-Augmented Agent for Reactive and Proactive Physiological Monitoring over Wearable Health Data

Wearable devices enable continuous monitoring of physiological signals such as ECG and PPG, but existing mHealth systems are largely limited to task-specific prediction pipelines or reactive question answering over static summaries. They lack the ability to support temporal reasoning, persistent physiological context, and proactive monitoring over long-term signal streams. We propose VitalAgent, a tool-augmented agentic framework for ECG/PPG-based mHealth that supports both reactive question answering and proactive monitoring. VitalAgent is built on a longitudinal physiological memory and a tool-augmented reasoning interface that enables dynamic computation over raw signals. We further introduce VitalBench, a longitudinal physiological monitoring benchmark dataset comprising 1,862 QA pairs for reactive question answering and 90.2 hours of continuous ECG/PPG recordings for proactive monitoring, covering cardiac, physical activity, and stress-related tasks. Experiments demonstrate that VitalAgent achieves over 25% improvement over prompt-based and ReAct baselines in reactive evaluation and supports proactive alert monitoring over long-term physiological signals, highlighting the importance of dynamic tool use and long-term physiological monitoring.

cs.AI↗
arXiv2026

Adaptive Test-Time Scaling for Zero-Shot Respiratory Audio Classification

Automated respiratory audio analysis promises scalable, non-invasive disease screening, yet progress is limited by scarce labeled data and costly expert annotation. Zero-shot inference eliminates task-specific supervision, but existing methods apply uniform computation to every input regardless of difficulty. We introduce TRIAGE, a tiered zero-shot framework that adaptively scales test-time compute by routing each audio sample through progressively richer reasoning stages: fast label-cosine scoring in a joint audio-text embedding space (Tier-L), structured matching with clinician-style descriptors (Tier-M), and retrieval-augmented large language model reasoning (Tier-H). A confidence-based router finalizes easy predictions early while allocating additional computation to ambiguous inputs, enabling nearly half of all samples to exit at the cheapest tier. Across nine respiratory classification tasks without task-specific training, TRIAGE achieves a mean AUROC of 0.744, outperforming prior zero-shot methods and matching or exceeding supervised baselines on multiple tasks. Our analysis show that test-time scaling concentrates gains where they matter: uncertain cases see up to 19% relative improvement while confident predictions remain unchanged at minimal cost.

cs.SD↗
arXiv2026

Learning ECG Image Representations via Dual Physiological-Aware Alignments

Electrocardiograms (ECGs) are among the most widely used diagnostic tools for cardiovascular diseases, and a large amount of ECG data worldwide appears only in image form. However, most existing automated ECG analysis methods rely on access to raw signal recordings, limiting their applicability in real-world and resource-constrained settings. In this paper, we present ECG-Scan, a self-supervised framework for learning clinically generalized representations from ECG images through dual physiological-aware alignments: 1) Our approach optimizes image representation learning using multimodal contrastive alignment between image and gold-standard signal-text modalities. 2) We further integrate domain knowledge via soft-lead constraints, regularizing the reconstruction process and improving signal lead inter-consistency. Extensive benchmarking across multiple datasets and downstream tasks demonstrates that our image-based model achieves superior performance compared to existing image baselines and notably narrows the gap between ECG image and signal analysis. These results highlight the potential of self-supervised image modeling to unlock large-scale legacy ECG data and broaden access to automated cardiovascular diagnostics.

cs.LG↗
arXiv2026

StethoLM: Audio Language Model for Cardiopulmonary Analysis Across Clinical Tasks

Listening to heart and lung sounds - auscultation - is one of the first and most fundamental steps in a clinical examination. Despite being fast and non-invasive, it demands years of experience to interpret subtle audio cues. Recent deep learning methods have made progress in automating cardiopulmonary sound analysis, yet most are restricted to simple classification and offer little clinical interpretability or decision support. We present StethoLM, the first audio-language model specialized for cardiopulmonary auscultation, capable of performing instruction-driven clinical tasks across the full spectrum of auscultation analysis. StethoLM integrates audio encoding with a medical language model backbone and is trained on StethoBench, a comprehensive benchmark comprising 77,027 instruction-response pairs synthesized from 16,125 labeled cardiopulmonary recordings spanning seven clinical task categories: binary classification, detection, reporting, reasoning, differential diagnosis, comparison, and location-based analysis. Through multi-stage training that combines supervised fine-tuning and direct preference optimization, StethoLM achieves substantial gains in performance and robustness on out-of-distribution data. Our work establishes a foundation for instruction-following AI systems in clinical auscultation.

cs.LG↗
arXiv2026

PulseLM: A Foundation Dataset and Benchmark for PPG-Text Learning

Photoplethysmography (PPG) is a widely used non-invasive sensing modality for continuous cardiovascular and physiological monitoring across clinical, laboratory, and wearable settings. While existing PPG datasets support a broad range of downstream tasks, they typically provide supervision in the form of numerical measurements or task-specific labels, limiting their compatibility with language-based interfaces and multimodal foundation models. In this work, we introduce PulseLM, a large-scale PPG-text question-answering dataset that bridges raw PPG waveforms and natural language through a unified question-answering (QA) formulation. PulseLM aggregates PPG recordings from sixteen publicly available sources and harmonizes heterogeneous annotations into 12 downstream tasks. The dataset comprises over 1 million standardized 10-second PPG segments, associated with nearly 2.5 million question-answer pairs. We further define reproducible data pipeline, training, and evaluation protocols and establish baseline benchmarks using multimodal PPG-aware large language models. PulseLM provides a standardized foundation for studying language-grounded physiological inference, cross-dataset generalization, and scalable benchmarking of PPG-based multimodal models. We publicly release the dataset and code at https://huggingface.co/datasets/Manhph2211/PulseLM and https://github.com/manhph2211/PULSE-LM, respectively.

cs.CL↗
arXiv2026

UniPACT: A Multimodal Framework for Prognostic Question Answering on Raw ECG and Structured EHR

Accurate clinical prognosis requires synthesizing structured Electronic Health Records (EHRs) with real-time physiological signals like the Electrocardiogram (ECG). Large Language Models (LLMs) offer a powerful reasoning engine for this task but struggle to natively process these heterogeneous, non-textual data types. To address this, we propose UniPACT (Unified Prognostic Question Answering for Clinical Time-series), a unified framework for prognostic question answering that bridges this modality gap. UniPACT's core contribution is a structured prompting mechanism that converts numerical EHR data into semantically rich text. This textualized patient context is then fused with representations learned directly from raw ECG waveforms, enabling an LLM to reason over both modalities holistically. We evaluate UniPACT on the comprehensive MDS-ED benchmark, it achieves a state-of-the-art mean AUROC of 89.37% across a diverse set of prognostic tasks including diagnosis, deterioration, ICU admission, and mortality, outperforming specialized baselines. Further analysis demonstrates that our multimodal, multi-task approach is critical for performance and provides robustness in missing data scenarios.

cs.LG↗
arXiv2025

Language Models as Semantic Teachers: Post-Training Alignment for Medical Audio Understanding

Pre-trained audio models excel at detecting acoustic patterns in auscultation sounds but often fail to grasp their clinical significance, limiting their use and performance in diagnostic tasks. To bridge this gap, we introduce AcuLa (Audio-Clinical Understanding via Language Alignment), a lightweight post-training framework that instills semantic understanding into any audio encoder by aligning it with a medical language model, which acts as a "semantic teacher." To enable alignment at scale, we construct a large-scale dataset by leveraging off-the-shelf large language models to translate the rich, structured metadata accompanying existing audio recordings into coherent clinical reports. Our alignment strategy combines a representation-level contrastive objective with a self-supervised modeling, ensuring that the model learns clinical semantics while preserving fine-grained temporal cues. AcuLa achieves state-of-the-art results across 18 diverse cardio-respiratory tasks from 10 different datasets, improving the mean AUROC on classification benchmarks from 0.68 to 0.79 and, on the most challenging COVID-19 cough detection task, boosting the AUROC from 0.55 to 0.89. Our work demonstrates that this audio-language alignment transforms purely acoustic models into clinically-aware diagnostic tools, establishing a novel paradigm for enhancing physiological understanding in audio-based health monitoring.

cs.SD↗
arXiv2025

Interpretable Multimodal Zero-Shot ECG Diagnosis via Structured Clinical Knowledge Alignment

Electrocardiogram (ECG) interpretation is essential for cardiovascular disease diagnosis, but current automated systems often struggle with transparency and generalization to unseen conditions. To address this, we introduce ZETA, a zero-shot multimodal framework designed for interpretable ECG diagnosis aligned with clinical workflows. ZETA uniquely compares ECG signals against structured positive and negative clinical observations, which are curated through an LLM-assisted, expert-validated process, thereby mimicking differential diagnosis. Our approach leverages a pre-trained multimodal model to align ECG and text embeddings without disease-specific fine-tuning. Empirical evaluations demonstrate ZETA's competitive zero-shot classification performance and, importantly, provide qualitative and quantitative evidence of enhanced interpretability, grounding predictions in specific, clinically relevant positive and negative diagnostic features. ZETA underscores the potential of aligning ECG analysis with structured clinical knowledge for building more transparent, generalizable, and trustworthy AI diagnostic systems. We will release the curated observation dataset and code to facilitate future research.

cs.LG↗
arXiv2025

Helmsman: Autonomous Synthesis of Federated Learning Systems via Collaborative LLM Agents

Federated Learning (FL) offers a powerful paradigm for training models on decentralized data, but its promise is often undermined by the immense complexity of designing and deploying robust systems. The need to select, combine, and tune strategies for multifaceted challenges like data heterogeneity and system constraints has become a critical bottleneck, resulting in brittle, bespoke solutions. To address this, we introduce Helmsman, a novel multi-agent system that automates the end-to-end synthesis of federated learning systems from high-level user specifications. It emulates a principled research and development workflow through three collaborative phases: (1) interactive human-in-the-loop planning to formulate a sound research plan, (2) modular code generation by supervised agent teams, and (3) a closed-loop of autonomous evaluation and refinement in a sandboxed simulation environment. To facilitate rigorous evaluation, we also introduce AgentFL-Bench, a new benchmark comprising 16 diverse tasks designed to assess the system-level generation capabilities of agentic systems in FL. Extensive experiments demonstrate that our approach generates solutions competitive with, and often superior to, established hand-crafted baselines. Our work represents a significant step towards the automated engineering of complex decentralized AI systems.

cs.AI↗
arXiv2025

Unified Acoustic Representations for Screening Neurological and Respiratory Pathologies from Voice

Voice-based health assessment offers unprecedented opportunities for scalable, non-invasive disease screening, yet existing approaches typically focus on single conditions and fail to leverage the rich, multi-faceted information embedded in speech. We present MARVEL (Multi-task Acoustic Representations for Voice-based Health Analysis), a privacy-conscious multitask learning framework that simultaneously detects nine distinct neurological, respiratory, and voice disorders using only derived acoustic features, eliminating the need for raw audio transmission. Our dual-branch architecture employs specialized encoders with task-specific heads sharing a common acoustic backbone, enabling effective cross-condition knowledge transfer. Evaluated on the large-scale Bridge2AI-Voice v2.0 dataset, MARVEL achieves an overall AUROC of 0.78, with exceptional performance on neurological disorders (AUROC = 0.89), particularly for Alzheimer's disease/mild cognitive impairment (AUROC = 0.97). Our framework consistently outperforms single-modal baselines by 5-19% and surpasses state-of-the-art self-supervised models on 7 of 9 tasks, while correlation analysis reveals that the learned representations exhibit meaningful similarities with established acoustic features, indicating that the model's internal representations are consistent with clinically recognized acoustic patterns. By demonstrating that a single unified model can effectively screen for diverse conditions, this work establishes a foundation for deployable voice-based diagnostics in resource-constrained and remote healthcare settings.

cs.SD↗
arXiv2025

CaReAQA: A Cardiac and Respiratory Audio Question Answering Model for Open-Ended Diagnostic Reasoning

Medical audio signals, such as heart and lung sounds, play a crucial role in clinical diagnosis. However, analyzing these signals remains challenging: traditional methods rely on handcrafted features or supervised deep learning models that demand extensive labeled datasets, limiting their scalability and applicability. To address these issues, we propose CaReAQA, an audio-language model that integrates a foundation audio model with the reasoning capabilities of large language models, enabling clinically relevant, open-ended diagnostic responses. Alongside CaReAQA, we introduce CaReSound, a benchmark dataset of annotated medical audio recordings enriched with metadata and paired question-answer examples, intended to drive progress in diagnostic reasoning research. Evaluation results show that CaReAQA achieves 86.2% accuracy on open-ended diagnostic reasoning tasks, outperforming baseline models. It also generalizes well to closed-ended classification tasks, achieving an average accuracy of 56.9% on unseen datasets. Our findings show how audio-language integration and reasoning advances medical diagnostics, enabling efficient AI systems for clinical decision support.

cs.LG↗
arXiv2025

FAST: Federated Active Learning with Foundation Models for Communication-efficient Sampling and Training

Federated Active Learning (FAL) has emerged as a promising framework to leverage large quantities of unlabeled data across distributed clients while preserving data privacy. However, real-world deployments remain limited by high annotation costs and communication-intensive sampling processes, particularly in a cross-silo setting, when clients possess substantial local datasets. This paper addresses the crucial question: What is the best practice to reduce communication costs in human-in-the-loop learning with minimal annotator effort? Existing FAL methods typically rely on iterative annotation processes that separate active sampling from federated updates, leading to multiple rounds of expensive communication and annotation. In response, we introduce FAST, a two-pass FAL framework that harnesses foundation models for weak labeling in a preliminary pass, followed by a refinement pass focused exclusively on the most uncertain samples. By leveraging representation knowledge from foundation models and integrating refinement steps into a streamlined workflow, FAST substantially reduces the overhead incurred by iterative active sampling. Extensive experiments on diverse medical and natural image benchmarks demonstrate that FAST outperforms existing FAL methods by an average of 4.36% while reducing communication rounds eightfold under a limited 5% labeling budget.

cs.LG↗
arXiv2025

Electrocardiogram-Language Model for Few-Shot Question Answering with Meta Learning

Electrocardiogram (ECG) interpretation requires specialized expertise, often involving synthesizing insights from ECG signals with complex clinical queries posed in natural language. The scarcity of labeled ECG data coupled with the diverse nature of clinical inquiries presents a significant challenge for developing robust and adaptable ECG diagnostic systems. This work introduces a novel multimodal meta-learning method for few-shot ECG question answering, addressing the challenge of limited labeled data while leveraging the rich knowledge encoded within large language models (LLMs). Our LLM-agnostic approach integrates a pre-trained ECG encoder with a frozen LLM (e.g., LLaMA and Gemma) via a trainable fusion module, enabling the language model to reason about ECG data and generate clinically meaningful answers. Extensive experiments demonstrate superior generalization to unseen diagnostic tasks compared to supervised baselines, achieving notable performance even with limited ECG leads. For instance, in a 5-way 5-shot setting, our method using LLaMA-3.1-8B achieves an accuracy of 84.6%, 77.3%, and 69.6% on single verify, choose and query question types, respectively. These results highlight the potential of our method to enhance clinical ECG interpretation by combining signal processing with the nuanced language understanding capabilities of LLMs, particularly in data-constrained scenarios.

cs.LG↗
arXiv2025

Boosting Masked ECG-Text Auto-Encoders as Discriminative Learners

The accurate interpretation of Electrocardiogram (ECG) signals is pivotal for diagnosing cardiovascular diseases. Integrating ECG signals with accompanying textual reports further holds immense potential to enhance clinical diagnostics by combining physiological data and qualitative insights. However, this integration faces significant challenges due to inherent modality disparities and the scarcity of labeled data for robust cross-modal learning. To address these obstacles, we propose D-BETA, a novel framework that pre-trains ECG and text data using a contrastive masked auto-encoder architecture. D-BETA uniquely combines the strengths of generative with boosted discriminative capabilities to achieve robust cross-modal representations. This is accomplished through masked modality modeling, specialized loss functions, and an improved negative sampling strategy tailored for cross-modal alignment. Extensive experiments on five public datasets across diverse downstream tasks demonstrate that D-BETA significantly outperforms existing methods, achieving an average AUC improvement of 15% in linear probing with only one percent of training data and 2% in zero-shot performance without requiring training data over state-of-the-art models. These results highlight the effectiveness of D-BETA, underscoring its potential to advance automated clinical diagnostics through multi-modal representations. Our sample code and checkpoint are made available at https://github.com/manhph2211/D-BETA.

cs.LG↗
arXiv2025

Q-Heart: ECG Question Answering via Knowledge-Informed Multimodal LLMs

Electrocardiography (ECG) offers critical cardiovascular insights, such as identifying arrhythmias and myocardial ischemia, but enabling automated systems to answer complex clinical questions directly from ECG signals (ECG-QA) remains a significant challenge. Current approaches often lack robust multimodal reasoning capabilities or rely on generic architectures ill-suited for the nuances of physiological signals. We introduce Q-Heart, a novel multimodal framework designed to bridge this gap. Q-Heart leverages a powerful, adapted ECG encoder and integrates its representations with textual information via a specialized ECG-aware transformer-based mapping layer. Furthermore, Q-Heart leverages dynamic prompting and retrieval of relevant historical clinical reports to guide tuning the language model toward knowledge-aware ECG reasoning. Extensive evaluations on the benchmark ECG-QA dataset show Q-Heart achieves state-of-the-art performance, outperforming existing methods by a 4% improvement in exact match accuracy. Our work demonstrates the effectiveness of combining domain-specific architectural adaptations with knowledge-augmented LLM instruction tuning for complex physiological ECG analysis, paving the way for more capable and potentially interpretable clinical patient care systems.

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