Ayse S. Cakmak

Ayse Cakmak, Erik Reinertsen, Shamim Nemati et al.

The pattern of state changes in a biomedical time series can be related to health or disease. This work presents a principled approach for selecting a changepoint detection algorithm for a specific task, such as disease classification. Eight key algorithms were compared, and the performance of each algorithm was evaluated as a function of temporal tolerance, noise, and abnormal conduction (ectopy) on realistic artificial cardiovascular time series data. All algorithms were applied to real data (cardiac time series of 22 patients with REM-behavior disorder (RBD) and 15 healthy controls) using the parameters selected on artificial data. Finally, features were derived from the detected changepoints to classify RBD patients from healthy controls using a K-Nearest Neighbors approach. On artificial data, Modified Bayesian Changepoint Detection algorithm provided superior positive predictive value for state change identification while Recursive Mean Difference Maximization (RMDM) achieved the highest true positive rate. For the classification task, features derived from the RMDM algorithm provided the highest leave one out cross validated accuracy of 0.89 and true positive rate of 0.87. Automatically detected changepoints provide useful information about subject's physiological state which cannot be directly observed. However, the choice of change point detection algorithm depends on the nature of the underlying data and the downstream application, such as a classification task. This work represents the first time change point detection algorithms have been compared in a meaningful way and utilized in a classification task, which demonstrates the effect of changepoint algorithm choice on application performance.

Ayse S. Cakmak, Samuel Densen, Gabriel Najarro et al.

Objective: Worldwide, heart failure (HF) is a major cause of morbidity and mortality and one of the leading causes of hospitalization. Early detection of HF symptoms and pro-active management may reduce adverse events. Approach: Twenty-eight participants were monitored using a smartphone app after discharge from hospitals, and each clinical event during the enrollment (N=110 clinical events) was recorded. Motion, social, location, and clinical survey data collected via the smartphone-based monitoring system were used to develop and validate an algorithm for predicting or classifying HF decompensation events (hospitalizations or clinic visit) versus clinic monitoring visits in which they were determined to be compensated or stable. Models based on single modality as well as early and late fusion approaches combining patient-reported outcomes and passive smartphone data were evaluated. Results: The highest AUCPr for classifying decompensation with a late fusion approach was 0.80 using leave one subject out cross-validation. Significance: Passively collected data from smartphones, especially when combined with weekly patient-reported outcomes, may reflect behavioral and physiological changes due to HF and thus could enable prediction of HF decompensation.

Ayse S. Cakmak, Nina Thigpen, Garrett Honke et al.

Depression and post-traumatic stress disorder (PTSD) are psychiatric conditions commonly associated with experiencing a traumatic event. Estimating mental health status through non-invasive techniques such as activity-based algorithms can help to identify successful early interventions. In this work, we used locomotor activity captured from 1113 individuals who wore a research grade smartwatch post-trauma. A convolutional variational autoencoder (VAE) architecture was used for unsupervised feature extraction from four weeks of actigraphy data. By using VAE latent variables and the participant's pre-trauma physical health status as features, a logistic regression classifier achieved an area under the receiver operating characteristic curve (AUC) of 0.64 to estimate mental health outcomes. The results indicate that the VAE model is a promising approach for actigraphy data analysis for mental health outcomes in long-term studies.