Patient-Level Multimodal Question Answering from Multi-Site Auscultation Recordings
Organizations: Agentic Systems Lab, ETH Zurich Switzerland · Eindhoven University of Technology Netherlands · Centre for Digital Health Interventions, ETH Zurich · Centre for Digital Health Interventions, University of St. Gallen Switzerland · Stanford Mussallem Center for Biodesign, Stanford University USA
Abstract
Auscultation is a vital diagnostic tool, yet its utility is often limited by subjective interpretation. While general-purpose Audio-Language Models (ALMs) excel in general domains, they struggle with the nuances of physiological signals. We propose a framework that aligns multi-site auscultation recordings directly with a frozen Large Language Model (LLM) embedding space via gated cross-attention. By leveraging the LLM's latent world knowledge, our approach moves beyond isolated classification toward holistic, patient-level assessment. On the CaReSound benchmark, our model achieves a state-of-the-art 0.865 F1-macro and 0.952 BERTScore. We demonstrate that lightweight, domain-specific encoders rival large-scale ALMs and that multi-site aggregation provides spatial redundancy that mitigates temporal truncation. This alignment of medical acoustics with text foundations offers a scalable path for bridging signal processing and clinical assessment.
Figures & tables
| Dataset | Patients | Audios | Audios/pt | QAs | QA/pt |
|---|---|---|---|---|---|
| CirCor | 942 | 3,163 | 3.4 | 3,284 | 3.5 |
| ICBHI | 126 | 920 | 7.3 | 20,728 | 164 |
| SPRSound | 292 | 2,683 | 9.2 | 5,029 | 17.2 |
| KAUH | 336 | 336 | 1.0 | 1,009 | 3.0 |
| ZCHSound | 1,259 | 1,259 | 1.0 | 2,527 | 2.0 |
| Total | 2,951 | 8,361 | - | 32,577 | - |
| Approach | Yes/No Acc (%) | Yes/No F1 | Contains-Match (%) | ROUGE-L | METEOR | BERTScore | |
|---|---|---|---|---|---|---|---|
| Model | Audio-Flamingo3 (8B) | 85.00 | 0.545 | 5.51 | 0.2883 | 0.2842 | 0.8851 |
| Qwen2-Audio (7B) | 17.83 | 0.171 | 4.33 | 0.2951 | 0.3592 | 0.8996 | |
| Qwen2.5-Omni (0.5B) | 84.62 | 0.523 | 6.74 | 0.1351 | 0.2276 | 0.8648 | |
| CaReAQA (3B) | 93.12 | 0.846 | 34.85 | 0.6117 | 0.5107 | 0.9423 | |
| Ours (1.4B) | 93.50 | 0.865 | 42.60 | 0.6732 | 0.6432 | 0.9519 | |
| Encoder | Raw | 93.50 | 0.8648 | 42.60 | 0.6732 | 0.6432 | 0.9519 |