Evaluator-Dependent Patient-Adaptive ECG Lead-Channel Allocation

Abstract

The diagnostic value of an ECG channel depends on the model that interprets it. We test whether adaptive acquisition retains its advantage over fixed protocols when that model changes. Two policies developed with a logistic evaluator are frozen and assessed with a masked waveform ResNet1D, using exhaustive, metric-matched fixed comparators. On PTB-XL, replacing the evaluator reverses the mean adaptive advantage in negative log-likelihood and Brier score across the tested budgets, while calibration responds less uniformly. The shift persists with common fixed references and broader training-mask exposure. Training a policy against the stronger evaluator partly recovers the lost advantage. These retrospective exploratory results show that acquisition quality cannot be assessed independently of the downstream evaluator and motivate validating adaptive policies with the model intended for diagnosis.

17 pages: 5-page main paper and 12-page supplementary material; 6 figures and 16 supplementary tables. Updated figures and supplementary material; clarified evaluation provenance and limitations