Anshuman Mishra

Gajendra Katuwal, Advait Koparkar, Salar Abbaspourazad et al.

Health foundation models (FMs) learn useful representations from wearable sensors, but interpreting what they encode and transferring that knowledge across modalities after training remains difficult. We present a post-training framework that decomposes frozen embeddings into interpretable directions, referred to as symbols, and use these symbols to align the embedding spaces without retraining. We evaluate the framework on three FMs for photoplethysmography (PPG) and accelerometer data, independently pretrained on ~20M minutes of unlabeled data from ~172K participants, and analyzed on a held-out cohort of 30K subjects. We find that extracted symbols associate selectively with health conditions and physiological attributes, and these associations are partially shared across modalities and architectures. Cross-modal transfer via symbols retains more than 95% of in-domain performance, is nearly symmetric across domain directions, and saturates with limited paired data, together indicating that alignment recovers a shared low-dimensional subspace rich in physiological information. Overall, these results suggest that health FM embeddings contain an interpretable symbolic organization that is shared across modalities and supports cross-domain transfer without joint training.

Salar Abbaspourazad, Anshuman Mishra, Joseph Futoma et al.

Modern wearable devices can conveniently record various biosignals in the many different environments of daily living, enabling a rich view of individual health. However, not all biosignals are the same: high-fidelity biosignals, such as photoplethysmogram (PPG), contain more physiological information, but require optical sensors with a high power footprint. Alternatively, a lower-fidelity biosignal such as accelerometry has a significantly smaller power footprint and is available in almost any wearable device. While accelerometry is widely used for activity recognition and fitness, it is less explored for health biomarkers and diagnosis. Here, we show that an accelerometry foundation model can predict a wide variety of health targets. To achieve improved performance, we distill representational knowledge from PPG encoders to accelerometery encoders using 20 million minutes of unlabeled data, collected from ~172K participants in the Apple Heart and Movement Study under informed consent. We observe strong cross-modal alignment on unseen data, e.g., 99.2% top-1 accuracy for retrieving PPG embeddings from accelerometry embeddings. We show that distilled accelerometry encoders have significantly more informative representations compared to self-supervised or supervised encoders trained directly on accelerometry data, observed by at least 23%-49% improved performance for predicting heart rate and heart rate variability. We also show that distilled accelerometry encoders are readily predictive of a wide array of downstream health targets, i.e., they are generalist foundation models. We believe accelerometry foundation models for health may unlock new opportunities for developing digital biomarkers from any wearable device.