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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.