Safety
SHIFT-M3: Pre-fusion Alignment-based Consistency Screening for Multimodal ECG Record Integrity
arXiv:2609.13874v1 Announce Type: new Abstract: Multimodal clinical AI typically assumes that the waveform, report, metadata, and downstream predictions attached to a record belong to the same patient
arXiv:2609.13874v1 Announce Type: new Abstract: Multimodal clinical AI typically assumes that the waveform, report, metadata, and downstream predictions attached to a record belong to the same patient. In practice, linkage failures can silently assemble individually plausible but cross-patient components, creating a safety problem that standard predictive models are not designed to detect. We study this problem as multimodal record integrity triage: given an assembled record, should its modalities be trusted to belong together? We introduce SHIFT-M3, a lightweight text-based pre-fusion screen that measures alignment-based consistency between two separately produced ECG text views: an LLM-generated interpretation and a clinical report summary. On 784,680 MEETI ECG records, SHIFT-M3 achieves 97.6% TPR@5% FPR for full text-view swaps (AUROC 0.996), 90.3% for partial swaps (AUROC 0.974), and 97.7% for label-matched hard negatives (AUROC 0.996) with only 573,569 parameters. Compared with same-dataset lexical baselines, the gains are largest on partial swaps and hard negatives, suggesting that the model is learning more than surface overlap. We also introduce the CMST (Conflict-type Multimodal Stress Test) evaluation taxonomy, a three-seed stability study, a loss ablation, a temporal-tolerance sweep, and a shared-token masking control. The main remaining failure mode is longitudinal ambiguity: at the default operating point, same-patient cross-visit pairs still produce 87.0% Type-II false positives.
Related
- Target leakage, not model class, explains reported accuracy in survey-based cardiovascular screening: a leakage-tiered audit of glass-box and tabular foundation models
- Case2Flow: Bridging Patient Cases and Guideline Flowcharts through Multimodal Retrieval
- QU-NLP at ArchEHR-QA 2026: Two-Stage QLoRA Fine-Tuning of Qwen3-4B for Patient-Oriented Clinical Question Answering and Evidence Sentence Alignment
- CURA: Clinical Uncertainty Risk Alignment for Language Model-Based Risk Prediction
Source: arXiv cs.CL | 2026-09-15