Xiao Hu

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.

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, 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.

Mingchen Shao, Youjeong Kang, Xiao Hu et al.

Heart Failure (HF) affects millions of Americans and leads to high readmission rates, posing significant healthcare challenges. While Social Determinants of Health (SDOH) such as socioeconomic status and housing stability play critical roles in health outcomes, they are often underrepresented in structured EHRs and hidden in unstructured clinical notes. This study leverages advanced large language models (LLMs) to extract SDOHs from clinical text and uses logistic regression to analyze their association with HF readmissions. By identifying key SDOHs (e.g. tobacco usage, limited transportation) linked to readmission risk, this work also offers actionable insights for reducing readmissions and improving patient care.