Tomas I. Gonzales

Dimitris Spathis, Ignacio Perez-Pozuelo, Tomas I. Gonzales et al. · cambridge

Cardiorespiratory fitness is an established predictor of metabolic disease and mortality. Fitness is directly measured as maximal oxygen consumption (VO$_{2}max$), or indirectly assessed using heart rate responses to standard exercise tests. However, such testing is costly and burdensome because it requires specialized equipment such as treadmills and oxygen masks, limiting its utility. Modern wearables capture dynamic real-world data which could improve fitness prediction. In this work, we design algorithms and models that convert raw wearable sensor data into cardiorespiratory fitness estimates. We validate these estimates' ability to capture fitness profiles in free-living conditions using the Fenland Study (N=11,059), along with its longitudinal cohort (N=2,675), and a third external cohort using the UK Biobank Validation Study (N=181) who underwent maximal VO$_{2}max$ testing, the gold standard measurement of fitness. Our results show that the combination of wearables and other biomarkers as inputs to neural networks yields a strong correlation to ground truth in a holdout sample (r = 0.82, 95CI 0.80-0.83), outperforming other approaches and models and detects fitness change over time (e.g., after 7 years). We also show how the model's latent space can be used for fitness-aware patient subtyping paving the way to scalable interventions and personalized trial recruitment. These results demonstrate the value of wearables for fitness estimation that today can be measured only with laboratory tests.

Yu Wu, Dimitris Spathis, Hong Jia et al. · cambridge

Deep learning models have shown great promise in various healthcare applications. However, most models are developed and validated on small-scale datasets, as collecting high-quality (gold-standard) labels for health applications is often costly and time-consuming. As a result, these models may suffer from overfitting and not generalize well to unseen data. At the same time, an extensive amount of data with imprecise labels (silver-standard) is starting to be generally available, as collected from inexpensive wearables like accelerometers and electrocardiography sensors. These currently underutilized datasets and labels can be leveraged to produce more accurate clinical models. In this work, we propose UDAMA, a novel model with two key components: Unsupervised Domain Adaptation and Multi-discriminator Adversarial training, which leverage noisy data from source domain (the silver-standard dataset) to improve gold-standard modeling. We validate our framework on the challenging task of predicting lab-measured maximal oxygen consumption (VO$_{2}$max), the benchmark metric of cardio-respiratory fitness, using free-living wearable sensor data from two cohort studies as inputs. Our experiments show that the proposed framework achieves the best performance of corr = 0.665 $\pm$ 0.04, paving the way for accurate fitness estimation at scale.