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Nils Strodthoff

Nils Strodthoff contributes to research discovery and scholarly infrastructure.

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Machine Learning Artificial Intelligence eess.SP Computer Vision cond-mat.stat-mech hep-lat physics.comp-ph

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preprint2026arXiv

A Multimodal Deep Learning Framework for Predicting ICU Deterioration: Integrating ECG Waveforms with Clinical Data and Clinician Benchmarking

Artificial intelligence holds strong potential to support clinical decision making in intensive care units where timely and accurate risk assessment is critical. However, many existing models focus on isolated outcomes or limited data types, while clinicians integrate longitudinal history, real time physiology, and heterogeneous clinical information. To address this gap, we developed MDS ICU, a unified multimodal machine learning framework that fuses routinely collected data including demographics, biometrics, vital signs, laboratory values, ECG waveforms, surgical procedures, and medical device usage to provide continuous predictive support during ICU stays. Using 63001 samples from 27062 patients in MIMIC IV, we trained a deep learning architecture that combines structured state space S4 encoders for ECG waveforms with multilayer perceptron RealMLP encoders for tabular data to jointly predict 33 clinically relevant outcomes spanning mortality, organ dysfunction, medication needs, and acute deterioration. The model achieved strong discrimination with AUROCs of 0.90 for 24 hour mortality, 0.92 for sedative administration, 0.97 for invasive mechanical ventilation, and 0.93 for coagulation dysfunction. Calibration analysis showed close agreement between predicted and observed risks, with consistent gains from ECG waveform integration. Comparisons with clinicians and large language models showed that model predictions alone outperformed both, and that providing model outputs as decision support further improved their performance. These results demonstrate that multimodal AI can deliver clinically meaningful risk stratification across diverse ICU outcomes while augmenting rather than replacing clinical expertise, establishing a scalable foundation for precision critical care decision support.

preprint2026arXiv

FeatInv: Spatially resolved mapping from feature space to input space using conditional diffusion models

Internal representations are crucial for understanding deep neural networks, such as their properties and reasoning patterns, but remain difficult to interpret. While mapping from feature space to input space aids in interpreting the former, existing approaches often rely on crude approximations. We propose using a conditional diffusion model - a pretrained high-fidelity diffusion model conditioned on spatially resolved feature maps - to learn such a mapping in a probabilistic manner. We demonstrate the feasibility of this approach across various pretrained image classifiers from CNNs to ViTs, showing excellent reconstruction capabilities. Through qualitative comparisons and robustness analysis, we validate our method and showcase possible applications, such as the visualization of concept steering in input space or investigations of the composite nature of the feature space. This approach has broad potential for improving feature space understanding in computer vision models.

preprint2026arXiv

FeatMap: Understanding image manipulation in the feature space and its implications for feature space geometry

Intermediate feature representations represent the backbone for the expressivity and adaptability of deep neural networks. However, their geometric structure remains poorly understood. In this submission, we provide indirect insights into this matter by applying a broad selection of manipulations in input space, ranging from geometric and photometric transformations to local masking and semantic manipulations using generative image editing models, and assess the feasibility of learning a mapping in the feature space, mapping from the original to the manipulated feature map. To this end, we devise different types of mappings, from linear to non-linear and local to global mappings and assess both the reconstruction quality of the mapping as well as the semantic content of the mapped representations. We demonstrate the feasibility of learning such mappings for all considered transformations. While global (transformer) models that operate on the full feature map often achieve best results, we show that the same can be achieved with a shared linear model operating on a single feature vector typically with very little degradation in reconstruction quality, even for highly non-trivial semantic manipulations. We analyze the corresponding mappings across different feature layers and characterize them according to dominance of weight vs. bias and the effective rank of the linear transformations. These results provide hints for the hypothesis that the feature space is to a first degree of approximation organized in linear structures. From a broader perspective, the study demonstrates that generative image editing models might open the door to a deeper understanding of the feature space through input manipulation.

preprint2026arXiv

Pretraining Strategies and Scaling for ECG Foundation Models: A Systematic Study

Specialized foundation models are beginning to emerge in various medical subdomains, but pretraining methodologies and parametric scaling with the size of the pretraining dataset are rarely assessed systematically and in a like-for-like manner. This work focuses on foundation models for electrocardiography (ECG) data, one of the most widely captured physiological time series world-wide. We present a comprehensive assessment of pretraining methodologies, covering five different contrastive and non-contrastive self-supervised learning objectives for ECG foundation models, and investigate their scaling behavior with pretraining dataset sizes up to 11M input samples, exclusively from publicly available sources. Pretraining strategy has a meaningful and consistent impact on downstream performance, with contrastive predictive coding (slightly ahead of JEPA) yielding the most transferable representations across diverse clinical tasks. Scaling pretraining data continues to yield meaningful improvements up to 11M samples for most objectives. We also compare model architectures across all pretraining methodologies and find evidence for a clear superiority of structured state space models compared to transformers and CNN models. We hypothesize that the strong inductive biases of structured state space models, rather than pretraining scale alone, are the primary driver of effective ECG representation learning, with important implications for future foundation model development in this and potentially other physiological signal domains.

preprint2026arXiv

Uncertainty Reliability Under Domain Shift: An Investigation for Data-Driven Blood Pressure Estimation in Photoplethysmography

Uncertainty quantification (UQ) is critical for safety-critical domains like healthcare, yet it is rarely evaluated under realistic out-of-distribution (OOD) conditions. Here, we assessed predictive performance and uncertainty reliability for deep learning-based blood pressure (BP) estimation from photoplethysmography (PPG) signals under both in-distribution (ID) and OOD settings. Using an XResNet1D-50 trained on PulseDB and tested on four external datasets, we compared deep ensembles (DE) and Monte Carlo dropout (MCD) with Gaussian negative log-likelihood (GNLL) and mean squared error (MSE) losses, optionally followed by post-hoc recalibration via conformal prediction (CP), temperature scaling (TS), and isotonic regression (IR). The key findings of our study are as follows: (1) DE provides stronger predictive robustness under domain shift than MCD, an advantage that becomes clear primarily under external shift. (2) Recalibrated GNLL-based methods yield the best uncertainty calibration (e.g., GNLL+DE+CP for systolic blood pressure (SBP), GNLL+DE+TS for diastolic blood pressure (DBP)), while MSE-based uncertainty requires recalibration to become practically useful. (3) Across settings, CP and TS offer the most consistent gains, with IR remaining competitive in several cases. Overall, our results identify DE-based methods as most robust for predictive performance under domain shift, GNLL as strongest for native UQ, and recalibration as essential for making MSE-based uncertainty practical. These findings highlight the need to jointly assess predictive accuracy and calibration on external data for trustworthy cuffless BP estimation

preprint2022arXiv

Self-supervised representation learning from 12-lead ECG data

Clinical 12-lead electrocardiography (ECG) is one of the most widely encountered kinds of biosignals. Despite the increased availability of public ECG datasets, label scarcity remains a central challenge in the field. Self-supervised learning represents a promising way to alleviate this issue. In this work, we put forward the first comprehensive assessment of self-supervised representation learning from clinical 12-lead ECG data. To this end, we adapt state-of-the-art self-supervised methods based on instance discrimination and latent forecasting to the ECG domain. In a first step, we learn contrastive representations and evaluate their quality based on linear evaluation performance on a recently established, comprehensive, clinical ECG classification task. In a second step, we analyze the impact of self-supervised pretraining on finetuned ECG classifiers as compared to purely supervised performance. For the best-performing method, an adaptation of contrastive predictive coding, we find a linear evaluation performance only 0.5% below supervised performance. For the finetuned models, we find improvements in downstream performance of roughly 1% compared to supervised performance, label efficiency, as well as robustness against physiological noise. This work clearly establishes the feasibility of extracting discriminative representations from ECG data via self-supervised learning and the numerous advantages when finetuning such representations on downstream tasks as compared to purely supervised training. As first comprehensive assessment of its kind in the ECG domain carried out exclusively on publicly available datasets, we hope to establish a first step towards reproducible progress in the rapidly evolving field of representation learning for biosignals.

preprint2022arXiv

Sparse Subspace Clustering for Concept Discovery (SSCCD)

Concepts are key building blocks of higher level human understanding. Explainable AI (XAI) methods have shown tremendous progress in recent years, however, local attribution methods do not allow to identify coherent model behavior across samples and therefore miss this essential component. In this work, we study concept-based explanations and put forward a new definition of concepts as low-dimensional subspaces of hidden feature layers. We novelly apply sparse subspace clustering to discover these concept subspaces. Moving forward, we derive insights from concept subspaces in terms of localized input (concept) maps, show how to quantify concept relevances and lastly, evaluate similarities and transferability between concepts. We empirically demonstrate the soundness of the proposed Sparse Subspace Clustering for Concept Discovery (SSCCD) method for a variety of different image classification tasks. This approach allows for deeper insights into the actual model behavior that would remain hidden from conventional input-level heatmaps.

preprint2020arXiv

Asymptotically unbiased estimation of physical observables with neural samplers

We propose a general framework for the estimation of observables with generative neural samplers focusing on modern deep generative neural networks that provide an exact sampling probability. In this framework, we present asymptotically unbiased estimators for generic observables, including those that explicitly depend on the partition function such as free energy or entropy, and derive corresponding variance estimators. We demonstrate their practical applicability by numerical experiments for the 2d Ising model which highlight the superiority over existing methods. Our approach greatly enhances the applicability of generative neural samplers to real-world physical systems.

preprint2020arXiv

Deep Learning for ECG Analysis: Benchmarks and Insights from PTB-XL

Electrocardiography is a very common, non-invasive diagnostic procedure and its interpretation is increasingly supported by automatic interpretation algorithms. The progress in the field of automatic ECG interpretation has up to now been hampered by a lack of appropriate datasets for training as well as a lack of well-defined evaluation procedures to ensure comparability of different algorithms. To alleviate these issues, we put forward first benchmarking results for the recently published, freely accessible PTB-XL dataset, covering a variety of tasks from different ECG statement prediction tasks over age and gender prediction to signal quality assessment. We find that convolutional neural networks, in particular resnet- and inception-based architectures, show the strongest performance across all tasks outperforming feature-based algorithms by a large margin. These results are complemented by deeper insights into the classification algorithm in terms of hidden stratification, model uncertainty and an exploratory interpretability analysis. We also put forward benchmarking results for the ICBEB2018 challenge ECG dataset and discuss prospects of transfer learning using classifiers pretrained on PTB-XL. With this resource, we aim to establish the PTB-XL dataset as a resource for structured benchmarking of ECG analysis algorithms and encourage other researchers in the field to join these efforts.

preprint2020arXiv

Towards Novel Insights in Lattice Field Theory with Explainable Machine Learning

Machine learning has the potential to aid our understanding of phase structures in lattice quantum field theories through the statistical analysis of Monte Carlo samples. Available algorithms, in particular those based on deep learning, often demonstrate remarkable performance in the search for previously unidentified features, but tend to lack transparency if applied naively. To address these shortcomings, we propose representation learning in combination with interpretability methods as a framework for the identification of observables. More specifically, we investigate action parameter regression as a pretext task while using layer-wise relevance propagation (LRP) to identify the most important observables depending on the location in the phase diagram. The approach is put to work in the context of a scalar Yukawa model in (2+1)d. First, we investigate a multilayer perceptron to determine an importance hierarchy of several predefined, standard observables. The method is then applied directly to the raw field configurations using a convolutional network, demonstrating the ability to reconstruct all order parameters from the learned filter weights. Based on our results, we argue that due to its broad applicability, attribution methods such as LRP could prove a useful and versatile tool in our search for new physical insights. In the case of the Yukawa model, it facilitates the construction of an observable that characterises the symmetric phase.

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