Erick Andres Perez Alday

Mircea Dumitru, Qiao Li, Erick Andres Perez Alday et al.

Objective: Gaussian Processes (GP)-based filters, which have been effectively used for various applications including electrocardiogram (ECG) filtering can be computationally demanding and the choice of their hyperparameters is typically ad hoc. Methods: We develop a data-driven GP filter to address both issues, using the notion of the ECG phase domain -- a time-warped representation of the ECG beats onto a fixed number of samples and aligned R-peaks, which is assumed to follow a Gaussian distribution. Under this assumption, the computation of the sample mean and covariance matrix is simplified, enabling an efficient implementation of the GP filter in a data-driven manner, with no ad hoc hyperparameters. The proposed filter is evaluated and compared with a state-of-the-art wavelet-based filter, on the PhysioNet QT Database. The performance is evaluated by measuring the signal-to-noise ratio (SNR) improvement of the filter at SNR levels ranging from -5 to 30dB, in 5dB steps, using additive noise. For a clinical evaluation, the error between the estimated QT-intervals of the original and filtered signals is measured and compared with the benchmark filter. Results: It is shown that the proposed GP filter outperforms the benchmark filter for all the tested noise levels. It also outperforms the state-of-the-art filter in terms of QT-interval estimation error bias and variance. Conclusion: The proposed GP filter is a versatile technique for preprocessing the ECG in clinical and research applications, is applicable to ECG of arbitrary lengths and sampling frequencies, and provides confidence intervals for its performance.

Ismail Sadiq, Erick A. Perez-Alday, Amit J. Shah et al.

Objective: To determine if a realistic, but computationally efficient model of the electrocardiogram can be used to pre-train a deep neural network (DNN) with a wide range of morphologies and abnormalities specific to a given condition - T-wave Alternans (TWA) as a result of Post-Traumatic Stress Disorder, or PTSD - and significantly boost performance on a small database of rare individuals. Approach: Using a previously validated artificial ECG model, we generated 180,000 artificial ECGs with or without significant TWA, with varying heart rate, breathing rate, TWA amplitude, and ECG morphology. A DNN, trained on over 70,000 patients to classify 25 different rhythms, was modified the output layer to a binary class (TWA or no-TWA, or equivalently, PTSD or no-PTSD), and transfer learning was performed on the artificial ECG. In a final transfer learning step, the DNN was trained and cross-validated on ECG from 12 PTSD and 24 controls for all combinations of using the three databases. Main results: The best performing approach (AUROC = 0.77, Accuracy = 0.72, F1-score = 0.64) was found by performing both transfer learning steps, using the pre-trained arrhythmia DNN, the artificial data and the real PTSD-related ECG data. Removing the artificial data from training led to the largest drop in performance. Removing the arrhythmia data from training provided a modest, but significant, drop in performance. The final model showed no significant drop in performance on the artificial data, indicating no overfitting. Significance: In healthcare, it is common to only have a small collection of high-quality data and labels, or a larger database with much lower quality (and less relevant) labels. The paradigm presented here, involving model-based performance boosting, provides a solution through transfer learning on a large realistic artificial database, and a partially relevant real database.

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.