PatchCTG: Patch Cardiotocography Transformer for Antepartum Fetal Health Monitoring

TL;DR

PatchCTG is a transformer-based model that improves fetal health monitoring from CTG signals by capturing local and global dependencies, showing promising results on a large clinical dataset.

Contribution

The paper introduces PatchCTG, a novel transformer architecture with patch-based tokenisation for CTG analysis, enhancing interpretability and predictive performance.

Findings

Achieved 77% AUC on the Oxford Maternity dataset.

Demonstrated robustness across different temporal thresholds.

Outperformed traditional methods in predictive accuracy.

Abstract

Antepartum Cardiotocography (CTG) is vital for fetal health monitoring, but traditional methods like the Dawes-Redman system are often limited by high inter-observer variability, leading to inconsistent interpretations and potential misdiagnoses. This paper introduces PatchCTG, a transformer-based model specifically designed for CTG analysis, employing patch-based tokenisation, instance normalisation and channel-independent processing to capture essential local and global temporal dependencies within CTG signals. PatchCTG was evaluated on the Oxford Maternity (OXMAT) dataset, comprising over 20,000 CTG traces across diverse clinical outcomes after applying the inclusion and exclusion criteria. With extensive hyperparameter optimisation, PatchCTG achieved an AUC of 77%, with specificity of 88% and sensitivity of 57% at Youden's index threshold, demonstrating adaptability to various clinical needs. Testing across varying temporal thresholds showed robust predictive performance, particularly with finetuning on data closer to delivery, achieving a sensitivity of 52% and specificity of 88% for near-delivery cases. These findings suggest the potential of PatchCTG to enhance clinical decision-making in antepartum care by providing a reliable, objective tool for fetal health assessment. The source code is available at https://github.com/jaleedkhan/PatchCTG.