# Deep Multimodal Fusion for Surgical Feedback Classification

arXiv: https://arxiv.org/abs/2312.03231 · HTML: https://mlsanity.com/paper/2312.03231/

## Key facts

- Cited by 4 papers in the map (data through 14 Oct 2026).
- Builds on 14 of its 30 references that are in the map.
- First posted on arXiv 6 Dec 2023.

## Builds on (most cited first, 14 of 14)

- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Robust Speech Recognition via Large-Scale Weak Supervision](https://mlsanity.com/paper/2212.04356/) (2022)
- [wav2vec 2.0: A Framework for Self-Supervised Learning of Speech Representations](https://mlsanity.com/paper/2006.11477/) (2020)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [The Kinetics Human Action Video Dataset](https://mlsanity.com/paper/1705.06950/) (2017)
- [VideoMAE: Masked Autoencoders are Data-Efficient Learners for Self-Supervised Video Pre-Training](https://mlsanity.com/paper/2203.12602/) (2022)
- [Oscar: Object-Semantics Aligned Pre-training for Vision-Language Tasks](https://mlsanity.com/paper/2004.06165/) (2020)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [SUPERB: Speech processing Universal PERformance Benchmark](https://mlsanity.com/paper/2105.01051/) (2021)
- [pyannote.audio: neural building blocks for speaker diarization](https://mlsanity.com/paper/1911.01255/) (2019)
- [End-to-end speaker segmentation for overlap-aware resegmentation](https://mlsanity.com/paper/2104.04045/) (2021)
- [Is a PET all you need? A multi-modal study for Alzheimer's disease using 3D CNNs](https://mlsanity.com/paper/2207.02094/) (2022)
- [Early Fusion for Goal Directed Robotic Vision](https://mlsanity.com/paper/1811.08824/) (2018)

## Built on by (most cited first, 4 of 4)

- [Recent Advances, Applications, and Open Challenges in Machine Learning for Health: Reflections from Research Roundtables at ML4H 2023 Symposium](https://mlsanity.com/paper/2403.01628/) (2024)
- [Automating Feedback Analysis in Surgical Training: Detection, Categorization, and Assessment](https://mlsanity.com/paper/2412.00760/) (2024)
- [Generating Natural-Language Surgical Feedback: From Structured Representation to Domain-Grounded Evaluation](https://mlsanity.com/paper/2511.15159/) (2025)
- [Real-Time Multimodal Activity-Aware Error Detection in Robot-Assisted Surgery](https://mlsanity.com/paper/2606.23593/) (2026)

## Abstract (arXiv)

Quantification of real-time informal feedback delivered by an experienced surgeon to a trainee during surgery is important for skill improvements in surgical training. Such feedback in the live operating room is inherently multimodal, consisting of verbal conversations (e.g., questions and answers) as well as non-verbal elements (e.g., through visual cues like pointing to anatomic elements). In this work, we leverage a clinically-validated five-category classification of surgical feedback: "Anatomic", "Technical", "Procedural", "Praise" and "Visual Aid". We then develop a multi-label machine learning model to classify these five categories of surgical feedback from inputs of text, audio, and video modalities. The ultimate goal of our work is to help automate the annotation of real-time contextual surgical feedback at scale. Our automated classification of surgical feedback achieves AUCs ranging from 71.5 to 77.6 with the fusion improving performance by 3.1%. We also show that high-quality manual transcriptions of feedback audio from experts improve AUCs to between 76.5 and 96.2, which demonstrates a clear path toward future improvements. Empirically, we find that the Staged training strategy, with first pre-training each modality separately and then training them jointly, is more effective than training different modalities altogether. We also present intuitive findings on the importance of modalities for different feedback categories. This work offers an important first look at the feasibility of automated classification of real-world live surgical feedback based on text, audio, and video modalities.