CARDEA: Auditable Reasoning Grounded in Spatial Evidence for End-to-End Coronary Angiography Interpretation
Updated 45 min ago · first seen 11 Sept 2026
paper_01M294WYE3GBKCJKNS04PRXVA8
- Published
- 7 Sept 2026
- T2 · 48 min ago
- arXiv
- 2609.06931
- T2 · 48 min ago
Abstract
Invasive coronary angiography (CAG) is the gold standard for diagnosing coronary artery disease, but interpretation varies substantially among observers. Existing AI systems can improve consistency but lack auditable decision processes and are limited in comprehensive open-ended assessment, undermining clinician trust and clinical adoption readiness. We developed CARDEA, a unified large vision-language model that serves as the inference core of a CAG pipeline. It was trained solely on public datasets and closed-ended tasks in three stages: visual feature alignment, a self-distilled Chain-of-Box (CoB) cold start, and reinforcement learning with verifiable rewards (RLVR) with a CoB reward encouraging bounding-box use in the reasoning trace. We assessed its two study-level diagnoses, dominance classification and complexity assessment, against a dedicated classifier and two interventional cardiologists. Report generation was excluded from training and evaluated zero-shot across stages on an external cohort using vessel-severity macro-F_1. CARDEA trailed the classifier on in-distribution dominance but drew level under domain shift (accuracy, 0.91 [95% confidence interval (CI), 0.86 to 0.95]) and was comparable to the cardiologists on complexity assessment (accuracy, 0.90 [CI, 0.82 to 0.97]). Only RLVR improved zero-shot report generation, raising its vessel-severity macro-F_1 (0.686 [CI, 0.664 to 0.707]) above the untuned base model (0.513) and over twice the always-normal floor (0.312). CARDEA runs an end-to-end CAG pipeline from raw multi-view videos through keyframe selection to study-level diagnosis while exposing auditable spatial evidence behind its conclusions. RLVR on verifiable closed-ended tasks surfaced open-ended reporting ability that supervised imitation did not. Clinical use requires prospective validation against expert cardiologists.
Authors 5
Jia-Jen Lee, Shih-Yen Hou, Kee Koon Ng, Wei-Chun Wang, Shih-Sheng Chang
Specification
- Official page
Source:Hugging Face Hub (public pages, model cards, papers)T2observed 48 min agomedium
- arXiv id
- 2609.06931
Source:Hugging Face Hub (public pages, model cards, papers)T2observed 48 min agomedium
- Github repo
- benbayibaurba/cardea
Source:Hugging Face Hub (public pages, model cards, papers)T2observed 48 min agomedium
- Hf paper url
- https://huggingface.co/papers/2609.06931
Source:Hugging Face Hub (public pages, model cards, papers)T2observed 48 min agomedium
- Github stars
- 0
Source:Hugging Face Hub (public pages, model cards, papers)T2observed 45 min agomedium
- Hf comments
- 1
Source:Hugging Face Hub (public pages, model cards, papers)T2observed 45 min agomedium
- Upvotes
- 4
Source:Hugging Face Hub (public pages, model cards, papers)T2observed 45 min agomedium
Source:Hugging Face Hub (public pages, model cards, papers)T2observed 48 min agomedium
- Published
- 7 Sept 2026
Source:Hugging Face Hub (public pages, model cards, papers)T2observed 48 min agomedium
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T211
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45 min ago
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Claim history
Official pageofficial_url1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| https://arxiv.org/abs/2609.06931 | → current | current | Hugging Face Hub (public pages, model cards, papers)T2 | medium | deterministic |
Abstractabstract1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| Invasive coronary angiography (CAG) is the gold standard for diagnosing coronary artery disease, but interpretation varies substantially among observers. Existing AI systems can improve consistency but lack auditable decision processes and are limited in comprehensive open-ended assessment, undermining clinician trust and clinical adoption readiness. We developed CARDEA, a unified large vision-language model that serves as the inference core of a CAG pipeline. It was trained solely on public datasets and closed-ended tasks in three stages: visual feature alignment, a self-distilled Chain-of-Box (CoB) cold start, and reinforcement learning with verifiable rewards (RLVR) with a CoB reward encouraging bounding-box use in the reasoning trace. We assessed its two study-level diagnoses, dominance classification and complexity assessment, against a dedicated classifier and two interventional cardiologists. Report generation was excluded from training and evaluated zero-shot across stages on an external cohort using vessel-severity macro-F_1. CARDEA trailed the classifier on in-distribution dominance but drew level under domain shift (accuracy, 0.91 [95% confidence interval (CI), 0.86 to 0.95]) and was comparable to the cardiologists on complexity assessment (accuracy, 0.90 [CI, 0.82 to 0.97]). Only RLVR improved zero-shot report generation, raising its vessel-severity macro-F_1 (0.686 [CI, 0.664 to 0.707]) above the untuned base model (0.513) and over twice the always-normal floor (0.312). CARDEA runs an end-to-end CAG pipeline from raw multi-view videos through keyframe selection to study-level diagnosis while exposing auditable spatial evidence behind its conclusions. RLVR on verifiable closed-ended tasks surfaced open-ended reporting ability that supervised imitation did not. Clinical use requires prospective validation against expert cardiologists. | → current | current | Hugging Face Hub (public pages, model cards, papers)T2 | medium | deterministic |
arXiv idarxiv_id1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| 2609.06931 | → current | current | Hugging Face Hub (public pages, model cards, papers)T2 | medium | deterministic |
Github repogithub_repo1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| benbayibaurba/cardea | → current | current | Hugging Face Hub (public pages, model cards, papers)T2 | medium | deterministic |
Hf paper urlhf_paper_url1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| https://huggingface.co/papers/2609.06931 | → current | current | Hugging Face Hub (public pages, model cards, papers)T2 | medium | deterministic |
Github starsmetric.github_stars1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| 0 | → current | current | Hugging Face Hub (public pages, model cards, papers)T2 | medium | deterministic |
Hf commentsmetric.hf_comments1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| 1 | → current | current | Hugging Face Hub (public pages, model cards, papers)T2 | medium | deterministic |
Upvotesmetric.upvotes1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| 4 | → current | current | Hugging Face Hub (public pages, model cards, papers)T2 | medium | deterministic |
PDFpdf_url1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| https://arxiv.org/pdf/2609.06931 | → current | current | Hugging Face Hub (public pages, model cards, papers)T2 | medium | deterministic |
Publishedpublished_at1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| 7 Sept 2026 | → current | current | Hugging Face Hub (public pages, model cards, papers)T2 | medium | deterministic |
Claims are temporal and append-only: a new observation closes the previous claim (valid_to) instead of overwriting it. Conflicting claims from different sources are kept side by side and flagged — never averaged. Methodology →
- New paperPaperCARDEA: Auditable Reasoning Grounded in Spatial Evidence for End-to-End Coronary Angiography Interpretation
New paper: CARDEA: Auditable Reasoning Grounded in Spatial Evidence for End-to-End Coronary Angiography Interpretation
huggingface
| Source | Document | Type | Tier | Last observed | Snapshots |
|---|---|---|---|---|---|
| Hugging Face Hub (public pages, model cards, papers) | huggingface.co/papers | listing | T2· Quality secondary | 45 min ago | 2 |
Tier 1 = official/primary, 2 = quality secondary, 3 = community, 4 = unverified. Every snapshot is archived; see all sources and the methodology.