Saurabh Kataria

Saurabh Kataria, Ran Xiao, Timothy Ruchti et al.

Non-invasive patient monitoring for tracking and predicting adverse acute health events is an emerging area of research. We pursue in-hospital cardiac arrest (IHCA) prediction using only single-channel finger photoplethysmography (PPG) signals. Our proposed two-stage model Feature Extractor-Aggregator Network (FEAN) leverages powerful representations from pre-trained PPG foundation models (PPG-GPT of size up to 1 Billion) stacked with sequential classification models. We propose two FEAN variants ("1H", "FH") which use the latest one-hour and (max) 24-hour history to make decisions respectively. Our study is the first to present IHCA prediction results in ICU patients using only unimodal (continuous PPG signal) waveform deep representations. With our best model, we obtain an average of 0.79 AUROC over 24~h prediction window before CA event onset with our model peaking performance at 0.82 one hour before CA. We also provide a comprehensive analysis of our model through architectural tuning and PaCMAP visualization of patient health trajectory in latent space.

Zeyuan Meng, Lovely Yeswanth Panchumarthi, Saurabh Kataria et al.

Acute Coronary Syndrome (ACS) is a life-threatening cardiovascular condition where early and accurate diagnosis is critical for effective treatment and improved patient outcomes. This study explores the use of ECG foundation models, specifically ST-MEM and ECG-FM, to enhance ACS risk assessment using prehospital ECG data collected in ambulances. Both models leverage self-supervised learning (SSL), with ST-MEM using a reconstruction-based approach and ECG-FM employing contrastive learning, capturing unique spatial and temporal ECG features. We evaluate the performance of these models individually and through a fusion approach, where their embeddings are combined for enhanced prediction. Results demonstrate that both foundation models outperform a baseline ResNet-50 model, with the fusion-based approach achieving the highest performance (AUROC: 0.843 +/- 0.006, AUCPR: 0.674 +/- 0.012). These findings highlight the potential of ECG foundation models for early ACS detection and motivate further exploration of advanced fusion strategies to maximize complementary feature utilization.

Lovely Yeswanth Panchumarthi, Saurabh Kataria, Yi Wu et al.

Foundation models pretrained on physiological data such as photoplethysmography (PPG) signals are increasingly used to improve heart rate (HR) prediction across diverse settings. Fine-tuning these models for local deployment is often seen as a practical and scalable strategy. However, its impact on demographic fairness particularly under domain shifts remains underexplored. We fine-tune PPG-GPT a transformer-based foundation model pretrained on intensive care unit (ICU) data across three heterogeneous datasets (ICU, wearable, smartphone) and systematically evaluate the effects on HR prediction accuracy and gender fairness. While fine-tuning substantially reduces mean absolute error (up to 80%), it can simultaneously widen fairness gaps, especially in larger models and under significant distributional characteristics shifts. To address this, we introduce FairTune, a bias-aware fine-tuning framework in which we benchmark three mitigation strategies: class weighting based on inverse group frequency (IF), Group Distributionally Robust Optimization (GroupDRO), and adversarial debiasing (ADV). We find that IF and GroupDRO significantly reduce fairness gaps without compromising accuracy, with effectiveness varying by deployment domain. Representation analyses further reveal that mitigation techniques reshape internal embeddings to reduce demographic clustering. Our findings highlight that fairness does not emerge as a natural byproduct of fine-tuning and that explicit mitigation is essential for equitable deployment of physiological foundation models.

Minxiao Wang, Runze Yan, Carol Li et al.

Clinical laboratory tests provide essential biochemical measurements for diagnosis and treatment, but are limited by intermittent and invasive sampling. In contrast, photoplethysmogram (PPG) is a non-invasive, continuously recorded signal in intensive care units (ICUs) that reflects cardiovascular dynamics and can serve as a proxy for latent physiological changes. We propose UNIPHY+Lab, a framework that combines a large-scale PPG foundation model for local waveform encoding with a patient-aware Mamba model for long-range temporal modeling. Our architecture addresses three challenges: (1) capturing extended temporal trends in laboratory values, (2) accounting for patient-specific baseline variation via FiLM-modulated initial states, and (3) performing multi-task estimation for interrelated biomarkers. We evaluate our method on the two ICU datasets for predicting the five key laboratory tests. The results show substantial improvements over the LSTM and carry-forward baselines in MAE, RMSE, and $R^2$ among most of the estimation targets. This work demonstrates the feasibility of continuous, personalized lab value estimation from routine PPG monitoring, offering a pathway toward non-invasive biochemical surveillance in critical care.

Minxiao Wang, Saurabh Kataria, Juntong Ni et al.

We present UNIPHY+, a unified physiological foundation model (physioFM) framework designed to enable continuous human health and diseases monitoring across care settings using ubiquitously obtainable physiological data. We propose novel strategies for incorporating contextual information during pretraining, fine-tuning, and lightweight model personalization via multi-modal learning, feature fusion-tuning, and knowledge distillation. We advocate testing UNIPHY+ with a broad set of use cases from intensive care to ambulatory monitoring in order to demonstrate that UNIPHY+ can empower generalizable, scalable, and personalized physiological AI to support both clinical decision-making and long-term health monitoring.