Transforming Wearable Data into Health Insights using Large Language Model Agents

Despite the proliferation of wearable health trackers and the importance of sleep and exercise to health, deriving actionable personalized insights from wearable data remains a challenge because doing so requires non-trivial open-ended analysis of these data. The recent rise of large language model (LLM) agents, which can use tools to reason about and interact with the world, presents a promising opportunity to enable such personalized analysis at scale. Yet, the application of LLM agents in analyzing personal health is still largely untapped. In this paper, we introduce the Personal Health Insights Agent (PHIA), an agent system that leverages state-of-the-art code generation and information retrieval tools to analyze and interpret behavioral health data from wearables. We curate two benchmark question-answering datasets of over 4000 health insights questions. Based on 650 hours of human and expert evaluation we find that PHIA can accurately address over 84% of factual numerical questions and more than 83% of crowd-sourced open-ended questions. This work has implications for advancing behavioral health across the population, potentially enabling individuals to interpret their own wearable data, and paving the way for a new era of accessible, personalized wellness regimens that are informed by data-driven insights.

Towards a Personal Health Large Language Model

In health, most large language model (LLM) research has focused on clinical tasks. However, mobile and wearable devices, which are rarely integrated into such tasks, provide rich, longitudinal data for personal health monitoring. Here we present Personal Health Large Language Model (PH-LLM), fine-tuned from Gemini for understanding and reasoning over numerical time-series personal health data. We created and curated three datasets that test 1) production of personalized insights and recommendations from sleep patterns, physical activity, and physiological responses, 2) expert domain knowledge, and 3) prediction of self-reported sleep outcomes. For the first task we designed 857 case studies in collaboration with domain experts to assess real-world scenarios in sleep and fitness. Through comprehensive evaluation of domain-specific rubrics, we observed that Gemini Ultra 1.0 and PH-LLM are not statistically different from expert performance in fitness and, while experts remain superior for sleep, fine-tuning PH-LLM provided significant improvements in using relevant domain knowledge and personalizing information for sleep insights. We evaluated PH-LLM domain knowledge using multiple choice sleep medicine and fitness examinations. PH-LLM achieved 79% on sleep and 88% on fitness, exceeding average scores from a sample of human experts. Finally, we trained PH-LLM to predict self-reported sleep quality outcomes from textual and multimodal encoding representations of wearable data, and demonstrate that multimodal encoding is required to match performance of specialized discriminative models. Although further development and evaluation are necessary in the safety-critical personal health domain, these results demonstrate both the broad knowledge and capabilities of Gemini models and the benefit of contextualizing physiological data for personal health applications as done with PH-LLM.

Multimodal LLMs for health grounded in individual-specific data

Foundation large language models (LLMs) have shown an impressive ability to solve tasks across a wide range of fields including health. To effectively solve personalized health tasks, LLMs need the ability to ingest a diversity of data modalities that are relevant to an individual's health status. In this paper, we take a step towards creating multimodal LLMs for health that are grounded in individual-specific data by developing a framework (HeLM: Health Large Language Model for Multimodal Understanding) that enables LLMs to use high-dimensional clinical modalities to estimate underlying disease risk. HeLM encodes complex data modalities by learning an encoder that maps them into the LLM's token embedding space and for simple modalities like tabular data by serializing the data into text. Using data from the UK Biobank, we show that HeLM can effectively use demographic and clinical features in addition to high-dimensional time-series data to estimate disease risk. For example, HeLM achieves an AUROC of 0.75 for asthma prediction when combining tabular and spirogram data modalities compared with 0.49 when only using tabular data. Overall, we find that HeLM outperforms or performs at parity with classical machine learning approaches across a selection of eight binary traits. Furthermore, we investigate the downstream uses of this model such as its generalizability to out-of-distribution traits and its ability to power conversations around individual health and wellness.

Predicting Cardiovascular Disease Risk using Photoplethysmography and Deep Learning

Cardiovascular diseases (CVDs) are responsible for a large proportion of premature deaths in low- and middle-income countries. Early CVD detection and intervention is critical in these populations, yet many existing CVD risk scores require a physical examination or lab measurements, which can be challenging in such health systems due to limited accessibility. Here we investigated the potential to use photoplethysmography (PPG), a sensing technology available on most smartphones that can potentially enable large-scale screening at low cost, for CVD risk prediction. We developed a deep learning PPG-based CVD risk score (DLS) to predict the probability of having major adverse cardiovascular events (MACE: non-fatal myocardial infarction, stroke, and cardiovascular death) within ten years, given only age, sex, smoking status and PPG as predictors. We compared the DLS with the office-based refit-WHO score, which adopts the shared predictors from WHO and Globorisk scores (age, sex, smoking status, height, weight and systolic blood pressure) but refitted on the UK Biobank (UKB) cohort. In UKB cohort, DLS's C-statistic (71.1%, 95% CI 69.9-72.4) was non-inferior to office-based refit-WHO score (70.9%, 95% CI 69.7-72.2; non-inferiority margin of 2.5%, p<0.01). The calibration of the DLS was satisfactory, with a 1.8% mean absolute calibration error. Adding DLS features to the office-based score increased the C-statistic by 1.0% (95% CI 0.6-1.4). DLS predicts ten-year MACE risk comparable with the office-based refit-WHO score. It provides a proof-of-concept and suggests the potential of a PPG-based approach strategies for community-based primary prevention in resource-limited regions.

Knowledge distillation for fast and accurate DNA sequence correction

Accurate genome sequencing can improve our understanding of biology and the genetic basis of disease. The standard approach for generating DNA sequences from PacBio instruments relies on HMM-based models. Here, we introduce Distilled DeepConsensus - a distilled transformer-encoder model for sequence correction, which improves upon the HMM-based methods with runtime constraints in mind. Distilled DeepConsensus is 1.3x faster and 1.5x smaller than its larger counterpart while improving the yield of high quality reads (Q30) over the HMM-based method by 1.69x (vs. 1.73x for larger model). With improved accuracy of genomic sequences, Distilled DeepConsensus improves downstream applications of genomic sequence analysis such as reducing variant calling errors by 39% (34% for larger model) and improving genome assembly quality by 3.8% (4.2% for larger model). We show that the representations learned by Distilled DeepConsensus are similar between faster and slower models.