Kevin Maher

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.

Shenda Hong, Yanbo Xu, Alind Khare et al.

Deep learning models have achieved expert-level performance in healthcare with an exclusive focus on training accurate models. However, in many clinical environments such as intensive care unit (ICU), real-time model serving is equally if not more important than accuracy, because in ICU patient care is simultaneously more urgent and more expensive. Clinical decisions and their timeliness, therefore, directly affect both the patient outcome and the cost of care. To make timely decisions, we argue the underlying serving system must be latency-aware. To compound the challenge, health analytic applications often require a combination of models instead of a single model, to better specialize individual models for different targets, multi-modal data, different prediction windows, and potentially personalized predictions. To address these challenges, we propose HOLMES-an online model ensemble serving framework for healthcare applications. HOLMES dynamically identifies the best performing set of models to ensemble for highest accuracy, while also satisfying sub-second latency constraints on end-to-end prediction. We demonstrate that HOLMES is able to navigate the accuracy/latency tradeoff efficiently, compose the ensemble, and serve the model ensemble pipeline, scaling to simultaneously streaming data from 100 patients, each producing waveform data at 250~Hz. HOLMES outperforms the conventional offline batch-processed inference for the same clinical task in terms of accuracy and latency (by order of magnitude). HOLMES is tested on risk prediction task on pediatric cardio ICU data with above 95% prediction accuracy and sub-second latency on 64-bed simulation.

Yanbo Xu, Siddharth Biswal, Shriprasad R Deshpande et al.

With the improvement of medical data capturing, vast amount of continuous patient monitoring data, e.g., electrocardiogram (ECG), real-time vital signs and medications, become available for clinical decision support at intensive care units (ICUs). However, it becomes increasingly challenging to model such data, due to high density of the monitoring data, heterogeneous data types and the requirement for interpretable models. Integration of these high-density monitoring data with the discrete clinical events (including diagnosis, medications, labs) is challenging but potentially rewarding since richness and granularity in such multimodal data increase the possibilities for accurate detection of complex problems and predicting outcomes (e.g., length of stay and mortality). We propose Recurrent Attentive and Intensive Model (RAIM) for jointly analyzing continuous monitoring data and discrete clinical events. RAIM introduces an efficient attention mechanism for continuous monitoring data (e.g., ECG), which is guided by discrete clinical events (e.g, medication usage). We apply RAIM in predicting physiological decompensation and length of stay in those critically ill patients at ICU. With evaluations on MIMIC- III Waveform Database Matched Subset, we obtain an AUC-ROC score of 90.18% for predicting decompensation and an accuracy of 86.82% for forecasting length of stay with our final model, which outperforms our six baseline models.