A Domain Generalization Approach for Out-Of-Distribution 12-lead ECG Classification with Convolutional Neural Networks

Deep Learning systems have achieved great success in the past few years, even surpassing human intelligence in several cases. As of late, they have also established themselves in the biomedical and healthcare domains, where they have shown a lot of promise, but have not yet achieved widespread adoption. This is in part due to the fact that most methods fail to maintain their performance when they are called to make decisions on data that originate from a different distribution than the one they were trained on, namely Out-Of-Distribution (OOD) data. For example, in the case of biosignal classification, models often fail to generalize well on datasets from different hospitals, due to the distribution discrepancy amongst different sources of data. Our goal is to demonstrate the Domain Generalization problem present between distinct hospital databases and propose a method that classifies abnormalities on 12-lead Electrocardiograms (ECGs), by leveraging information extracted across the architecture of a Deep Neural Network, and capturing the underlying structure of the signal. To this end, we adopt a ResNet-18 as the backbone model and extract features from several intermediate convolutional layers of the network. To evaluate our method, we adopt publicly available ECG datasets from four sources and handle them as separate domains. To simulate the distributional shift present in real-world settings, we train our model on a subset of the domains and leave-out the remaining ones. We then evaluate our model both on the data present at training time (intra-distribution) and the held-out data (out-of-distribution), achieving promising results and surpassing the baseline of a vanilla Residual Network in most of the cases.