# StethoLM: Audio Language Model for Cardiopulmonary Analysis Across Clinical Tasks

arXiv: https://arxiv.org/abs/2603.00355 · HTML: https://mlsanity.com/paper/2603.00355/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 33 of its 55 references that are in the map.
- First posted on arXiv 27 Feb 2026.

## Builds on (most cited first, 30 of 33)

- [Qwen3 Technical Report](https://mlsanity.com/paper/2505.09388/) (2025)
- [Direct Preference Optimization: Your Language Model is Secretly a Reward Model](https://mlsanity.com/paper/2305.18290/) (2023)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [Gemini 2.5: Pushing the Frontier with Advanced Reasoning, Multimodality, Long Context, and Next Generation Agentic Capabilities](https://mlsanity.com/paper/2507.06261/) (2025)
- [Self-Instruct: Aligning Language Models with Self-Generated Instructions](https://mlsanity.com/paper/2212.10560/) (2022)
- [DeBERTa: Decoding-enhanced BERT with Disentangled Attention](https://mlsanity.com/paper/2006.03654/) (2020)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Qwen3 Embedding: Advancing Text Embedding and Reranking Through Foundation Models](https://mlsanity.com/paper/2506.05176/) (2025)
- [Qwen2.5-Omni Technical Report](https://mlsanity.com/paper/2503.20215/) (2025)
- [Large-scale Contrastive Language-Audio Pretraining with Feature Fusion and Keyword-to-Caption Augmentation](https://mlsanity.com/paper/2211.06687/) (2022)
- [Instruction Tuning with GPT-4](https://mlsanity.com/paper/2304.03277/) (2023)
- [Masked Autoencoders that Listen](https://mlsanity.com/paper/2207.06405/) (2022)
- [Pengi: An Audio Language Model for Audio Tasks](https://mlsanity.com/paper/2305.11834/) (2023)
- [Audio Flamingo 3: Advancing Audio Intelligence with Fully Open Large Audio Language Models](https://mlsanity.com/paper/2507.08128/) (2025)
- [Listen, Think, and Understand](https://mlsanity.com/paper/2305.10790/) (2023)
- [Trustworthy AI: From Principles to Practices](https://mlsanity.com/paper/2110.01167/) (2021)
- [GAMA: A Large Audio-Language Model with Advanced Audio Understanding and Complex Reasoning Abilities](https://mlsanity.com/paper/2406.11768/) (2024)
- [Does Synthetic Data Generation of LLMs Help Clinical Text Mining?](https://mlsanity.com/paper/2303.04360/) (2023)
- [Towards Accurate Differential Diagnosis with Large Language Models](https://mlsanity.com/paper/2312.00164/) (2023)
- [mDPO: Conditional Preference Optimization for Multimodal Large Language Models](https://mlsanity.com/paper/2406.11839/) (2024)
- [MedRAX: Medical Reasoning Agent for Chest X-ray](https://mlsanity.com/paper/2502.02673/) (2025)
- [The COUGHVID crowdsourcing dataset: A corpus for the study of large-scale cough analysis algorithms](https://mlsanity.com/paper/2009.11644/) (2020)
- [RespireNet: A Deep Neural Network for Accurately Detecting Abnormal Lung Sounds in Limited Data Setting](https://mlsanity.com/paper/2011.00196/) (2020)
- [The CirCor DigiScope Dataset: From Murmur Detection to Murmur Classification](https://mlsanity.com/paper/2108.00813/) (2021)
- [Towards Open Respiratory Acoustic Foundation Models: Pretraining and Benchmarking](https://mlsanity.com/paper/2406.16148/) (2024)
- [Deep Neural Network for Respiratory Sound Classification in Wearable Devices Enabled by Patient Specific Model Tuning](https://mlsanity.com/paper/2004.08287/) (2020)
- [RespLLM: Unifying Audio and Text with Multimodal LLMs for Generalized Respiratory Health Prediction](https://mlsanity.com/paper/2410.05361/) (2024)
- [How Does Vision-Language Adaptation Impact the Safety of Vision Language Models?](https://mlsanity.com/paper/2410.07571/) (2024)
- [CaReAQA: A Cardiac and Respiratory Audio Question Answering Model for Open-Ended Diagnostic Reasoning](https://mlsanity.com/paper/2505.01199/) (2025)
- [A Survey of Deep Learning-based Radiology Report Generation Using Multimodal Data](https://mlsanity.com/paper/2405.12833/) (2024)

## Built on by (most cited first, 1 of 1)

- [CardioState-JEPA: Delay-Aware Cross-Modal Learning of a Shared Cardiac Representation](https://mlsanity.com/paper/2608.12944/) (2026)

## Abstract (arXiv)

Listening to heart and lung sounds - auscultation - is one of the first and most fundamental steps in a clinical examination. Despite being fast and non-invasive, it demands years of experience to interpret subtle audio cues. Recent deep learning methods have made progress in automating cardiopulmonary sound analysis, yet most are restricted to simple classification and offer little clinical interpretability or decision support. We present StethoLM, the first audio-language model specialized for cardiopulmonary auscultation, capable of performing instruction-driven clinical tasks across the full spectrum of auscultation analysis. StethoLM integrates audio encoding with a medical language model backbone and is trained on StethoBench, a comprehensive benchmark comprising 77,027 instruction-response pairs synthesized from 16,125 labeled cardiopulmonary recordings spanning seven clinical task categories: binary classification, detection, reporting, reasoning, differential diagnosis, comparison, and location-based analysis. Through multi-stage training that combines supervised fine-tuning and direct preference optimization, StethoLM achieves substantial gains in performance and robustness on out-of-distribution data. Our work establishes a foundation for instruction-following AI systems in clinical auscultation.