Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Wednesday, July 01, 2020 at 8:00 PM to 10:00 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?

Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Jul 23, 2025
Date Accepted: Dec 2, 2025

The final, peer-reviewed published version of this preprint can be found here:

End-to-End Platform for Electrocardiogram Analysis and Model Fine-Tuning: Development and Validation Study

Bickmann L, Plagwitz L, Büscher A, Eckardt L, Varghese J

End-to-End Platform for Electrocardiogram Analysis and Model Fine-Tuning: Development and Validation Study

J Med Internet Res 2026;28:e81116

DOI: 10.2196/81116

PMID: 41616241

PMCID: 12858047

End-to-End Platform for Electrocardiogram Analysis and Model Fine-Tuning: Development and Validation Study

  • Lucas Bickmann; 
  • Lucas Plagwitz; 
  • Antonius Büscher; 
  • Lars Eckardt; 
  • Julian Varghese

ABSTRACT

Background:

Electrocardiogram data, one of the most widely available biosignal data, has become increasingly valuable with the emergence of deep learning methods, providing novel insights into cardiovascular diseases and broader health conditions. However, heterogeneity of electrocardiogram formats, limited access to deep learning model weights, and intricate algorithmic steps for effective fine-tuning for own disease target labels result in complex workflows.

Objective:

In this work, we introduce ExChanGeAI, a web-based end-to-end platform that unifies and streamlines the ECG analysis workflow – from handling diverse file-types, and interactive visualization, to local, privacy-preserving training and fine-tuning.

Methods:

The platform offers state-of-the-art deep learning models for training from scratch, and fine-tuning of the provided pre-trained models. ExChanGeAI is adaptable for use on both personal computers and scalable to high performance server environments. Evaluation is conducted for several classification tasks across three external validation sets, including an entirely new testset extracted from routine care.

Results:

De-novo training with task-specific data outperformed the benchmark foundation model while requiring significantly fewer parameters and lower computational resources. The platform enables users to empirically determine the most suitable model for their specific tasks, based on systematic validations. Conclusion:

Conclusions:

ExChanGeAI simplifies the ECG deep learning workflow, making advanced analysis and model fine-tuning accessible to non-expert users with diverse datasets, while preserving privacy. The platform is available as open-source code under the MIT license.


 Citation

Please cite as:

Bickmann L, Plagwitz L, Büscher A, Eckardt L, Varghese J

End-to-End Platform for Electrocardiogram Analysis and Model Fine-Tuning: Development and Validation Study

J Med Internet Res 2026;28:e81116

DOI: 10.2196/81116

PMID: 41616241

PMCID: 12858047

Download PDF


Request queued. Please wait while the file is being generated. It may take some time.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.