Ensemble transfer learning for classifying physical examinations in GP consultation: a multi-model approach to...

This study aims to automatically classify physical examinations performed during general practitioner (GP) consultations using a deep learning fusion model. The model distinguishes between two interaction types: Human-Object Activities (HOA), such as blood pressure measurement, and Human-Human Activities (HHA), such as gland palpation.

A multi-component ensemble transfer learning framework was developed that integrates spatial and temporal feature analysis. The model comprises: (1) a CNN-LSTM module for spatial feature extraction and sequential modelling, (2) an ensemble of EfficientNet-B7, DenseNet-121, and Inception-v3 to capture diverse spatial representations, and (3) a fusion module that concatenates outputs from both streams, refined by an attention mechanism to prioritise salient features. Transfer learning was applied to fine-tune pre-trained networks on GP consultation video data. Model performance was evaluated using five-fold stratified video-level cross-validation, reporting mean ± SD for precision, recall, F1-score, specificity, Cohen's κ, and PR-AUC.

The fusion model achieved robust overall performance, with a precision of 92.1 ± 1.4%, recall of 89.9 ± 1.8%, F1-score of 90.9 ± 1.5%, specificity of 93.1 ± 1.3%, Cohen's κ of 0.90 ± 0.02, and PR-AUC of 0.935 ± 0.02. It consistently outperformed ten state-of-the-art baselines, while ablation analysis showed F1-score improvements of 17% over CNN-LSTM and 16% over the ensemble model, confirming the benefit of combining spatial and temporal analysis.

The proposed fusion framework accurately recognises physical examinations in GP consultations and supports future telehealth and diagnostic research.