ECGQuest: Benchmarking and Fine-Tuning Language Models for Electrocardiography

ECGQuest is a new benchmark that evaluates language models on the contextual knowledge required for electrocardiogram interpretation, featuring 10,904 True/False questions derived from 23 ECG references and 2003‑2025 Computing in Cardiology proceedings. The study tested 23 commercial and open‑source models, finding that zero‑shot accuracy ranged from 49.5% to 74.4% and that fine‑tuning with Low‑Rank Adaptation improved all open‑source models by 6.5–14.1%, with the best fine‑tuned model achieving 76.3% accuracy and a five‑model ensemble reaching 78.5%. ECGQuest demonstrates that parameter‑efficient fine‑tuning can enable smaller models to compete with larger commercial ones on ECG‑specific tasks.

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• llms
• fine-tuning
• benchmarks
• safety