Turning Silver into Gold: Domain Adaptation with Noisy Labels for Wearable Cardio-Respiratory Fitness Prediction

Deep learning models have shown great promise in various healthcare applications. However, most models are developed and validated on small-scale datasets, as collecting high-quality (gold-standard) labels for health applications is often costly and time-consuming. As a result, these models may suffer from overfitting and not generalize well to unseen data. At the same time, an extensive amount of data with imprecise labels (silver-standard) is starting to be generally available, as collected from inexpensive wearables like accelerometers and electrocardiography sensors. These currently underutilized datasets and labels can be leveraged to produce more accurate clinical models. In this work, we propose UDAMA, a novel model with two key components: Unsupervised Domain Adaptation and Multi-discriminator Adversarial training, which leverage noisy data from source domain (the silver-standard dataset) to improve gold-standard modeling. We validate our framework on the challenging task of predicting lab-measured maximal oxygen consumption (VO$_{2}$max), the benchmark metric of cardio-respiratory fitness, using free-living wearable sensor data from two cohort studies as inputs. Our experiments show that the proposed framework achieves the best performance of corr = 0.665 $\pm$ 0.04, paving the way for accurate fitness estimation at scale.

Looking for Out-of-Distribution Environments in Critical Care: A case study with the eICU Database

Generalizing to new populations and domains in machine learning is still an open problem which has seen increased interest recently. In particular, clinical models show a significant performance drop when tested in settings not seen during training, e.g., new hospitals or population demographics. Recently proposed models for domain generalisation promise to alleviate this problem by learning invariant characteristics across environments, however, there is still scepticism about whether they improve over traditional training. In this work, we take a principled approach to identifying Out of Distribution (OoD) environments, motivated by the problem of cross-hospital generalization in critical care. We propose model-based and heuristic approaches to identify OoD environments and systematically compare models with different levels of held-out information. In particular, based on the assumption that models with access to OoD data should outperform other models, we train models across a range of experimental setups that include leave-one-hospital-out training and cross-sectional feature splits. We find that access to OoD data does not translate to increased performance, pointing to inherent limitations in defining potential OoD environments in the eICU Database potentially due to data harmonisation and sampling. Echoing similar results with other popular clinical benchmarks in the literature, new approaches are required to evaluate robust models in critical care.

Longitudinal cardio-respiratory fitness prediction through free-living wearable sensors

Cardiorespiratory fitness is an established predictor of metabolic disease and mortality. Fitness is directly measured as maximal oxygen consumption (VO2max), or indirectly assessed using heart rate response to a standard exercise test. However, such testing is costly and burdensome, limiting its utility and scalability. Fitness can also be approximated using resting heart rate and self-reported exercise habits but with lower accuracy. Modern wearables capture dynamic heart rate data which, in combination with machine learning models, could improve fitness prediction. In this work, we analyze movement and heart rate signals from wearable sensors in free-living conditions from 11,059 participants who also underwent a standard exercise test, along with a longitudinal repeat cohort of 2,675 participants. We design algorithms and models that convert raw sensor data into cardio-respiratory fitness estimates, and validate these estimates' ability to capture fitness profiles in a longitudinal cohort over time while subjects engaged in real-world (non-exercise) behaviour. Additionally, we validate our methods with a third external cohort of 181 participants who underwent maximal VO2max testing, which is considered the gold standard measurement because it requires reaching one's maximum heart rate and exhaustion level. Our results show that the developed models yield a high correlation (r = 0.82, 95CI 0.80-0.83), when compared to the ground truth in a holdout sample. These models outperform conventional non-exercise fitness models and traditional bio-markers using measurements of normal daily living without the need for a specific exercise test. Additionally, we show the adaptability and applicability of this approach for detecting fitness change over time in the longitudinal subsample that repeated measurements after 7 years.

A Summary of the ComParE COVID-19 Challenges

The COVID-19 pandemic has caused massive humanitarian and economic damage. Teams of scientists from a broad range of disciplines have searched for methods to help governments and communities combat the disease. One avenue from the machine learning field which has been explored is the prospect of a digital mass test which can detect COVID-19 from infected individuals' respiratory sounds. We present a summary of the results from the INTERSPEECH 2021 Computational Paralinguistics Challenges: COVID-19 Cough, (CCS) and COVID-19 Speech, (CSS).

COVID-19 Disease Progression Prediction via Audio Signals: A Longitudinal Study

Recent work has shown the potential of the use of audio data in screening for COVID-19. However, very little exploration has been done of monitoring disease progression, especially recovery in COVID-19 through audio. Tracking disease progression characteristics and patterns of recovery could lead to tremendous insights and more timely treatment or treatment adjustment, as well as better resources management in health care systems. The primary objective of this study is to explore the potential of longitudinal audio dynamics for COVID-19 monitoring using sequential deep learning techniques, focusing on prediction of disease progression and, especially, recovery trend prediction. We analysed crowdsourced respiratory audio data from 212 individuals over 5 days to 385 days, alongside their self-reported COVID-19 test results. We first explore the benefits of capturing longitudinal dynamics of audio biomarkers for COVID-19 detection. The strong performance, yielding an AUC-ROC of 0.79, sensitivity of 0.75 and specificity of 0.70, supports the effectiveness of the approach compared to methods that do not leverage longitudinal dynamics. We further examine the predicted disease progression trajectory, which displays high consistency with the longitudinal test results with a correlation of 0.76 in the test cohort, and 0.86 in a subset of the test cohort with 12 participants who report disease recovery. Our findings suggest that monitoring COVID-19 progression via longitudinal audio data has enormous potential in the tracking of individuals' disease progression and recovery.

Evaluating Contrastive Learning on Wearable Timeseries for Downstream Clinical Outcomes

Vast quantities of person-generated health data (wearables) are collected but the process of annotating to feed to machine learning models is impractical. This paper discusses ways in which self-supervised approaches that use contrastive losses, such as SimCLR and BYOL, previously applied to the vision domain, can be applied to high-dimensional health signals for downstream classification tasks of various diseases spanning sleep, heart, and metabolic conditions. To this end, we adapt the data augmentation step and the overall architecture to suit the temporal nature of the data (wearable traces) and evaluate on 5 downstream tasks by comparing other state-of-the-art methods including supervised learning and an adversarial unsupervised representation learning method. We show that SimCLR outperforms the adversarial method and a fully-supervised method in the majority of the downstream evaluation tasks, and that all self-supervised methods outperform the fully-supervised methods. This work provides a comprehensive benchmark for contrastive methods applied to the wearable time-series domain, showing the promise of task-agnostic representations for downstream clinical outcomes.

Sounds of COVID-19: exploring realistic performance of audio-based digital testing

Researchers have been battling with the question of how we can identify Coronavirus disease (COVID-19) cases efficiently, affordably and at scale. Recent work has shown how audio based approaches, which collect respiratory audio data (cough, breathing and voice) can be used for testing, however there is a lack of exploration of how biases and methodological decisions impact these tools' performance in practice. In this paper, we explore the realistic performance of audio-based digital testing of COVID-19. To investigate this, we collected a large crowdsourced respiratory audio dataset through a mobile app, alongside recent COVID-19 test result and symptoms intended as a ground truth. Within the collected dataset, we selected 5,240 samples from 2,478 participants and split them into different participant-independent sets for model development and validation. Among these, we controlled for potential confounding factors (such as demographics and language). The unbiased model takes features extracted from breathing, coughs, and voice signals as predictors and yields an AUC-ROC of 0.71 (95\% CI: 0.65$-$0.77). We further explore different unbalanced distributions to show how biases and participant splits affect performance. Finally, we discuss how the realistic model presented could be integrated in clinical practice to realize continuous, ubiquitous, sustainable and affordable testing at population scale.

Anticipatory Detection of Compulsive Body-focused Repetitive Behaviors with Wearables

Body-focused repetitive behaviors (BFRBs), like face-touching or skin-picking, are hand-driven behaviors which can damage one's appearance, if not identified early and treated. Technology for automatic detection is still under-explored, with few previous works being limited to wearables with single modalities (e.g., motion). Here, we propose a multi-sensory approach combining motion, orientation, and heart rate sensors to detect BFRBs. We conducted a feasibility study in which participants (N=10) were exposed to BFRBs-inducing tasks, and analyzed 380 mins of signals under an extensive evaluation of sensing modalities, cross-validation methods, and observation windows. Our models achieved an AUC > 0.90 in distinguishing BFRBs, which were more evident in observation windows 5 mins prior to the behavior as opposed to 1-min ones. In a follow-up qualitative survey, we found that not only the timing of detection matters but also models need to be context-aware, when designing just-in-time interventions to prevent BFRBs.

The INTERSPEECH 2021 Computational Paralinguistics Challenge: COVID-19 Cough, COVID-19 Speech, Escalation & Primates

The INTERSPEECH 2021 Computational Paralinguistics Challenge addresses four different problems for the first time in a research competition under well-defined conditions: In the COVID-19 Cough and COVID-19 Speech Sub-Challenges, a binary classification on COVID-19 infection has to be made based on coughing sounds and speech; in the Escalation SubChallenge, a three-way assessment of the level of escalation in a dialogue is featured; and in the Primates Sub-Challenge, four species vs background need to be classified. We describe the Sub-Challenges, baseline feature extraction, and classifiers based on the 'usual' COMPARE and BoAW features as well as deep unsupervised representation learning using the AuDeep toolkit, and deep feature extraction from pre-trained CNNs using the Deep Spectrum toolkit; in addition, we add deep end-to-end sequential modelling, and partially linguistic analysis.

SelfHAR: Improving Human Activity Recognition through Self-training with Unlabeled Data

Machine learning and deep learning have shown great promise in mobile sensing applications, including Human Activity Recognition. However, the performance of such models in real-world settings largely depends on the availability of large datasets that captures diverse behaviors. Recently, studies in computer vision and natural language processing have shown that leveraging massive amounts of unlabeled data enables performance on par with state-of-the-art supervised models. In this work, we present SelfHAR, a semi-supervised model that effectively learns to leverage unlabeled mobile sensing datasets to complement small labeled datasets. Our approach combines teacher-student self-training, which distills the knowledge of unlabeled and labeled datasets while allowing for data augmentation, and multi-task self-supervision, which learns robust signal-level representations by predicting distorted versions of the input. We evaluated SelfHAR on various HAR datasets and showed state-of-the-art performance over supervised and previous semi-supervised approaches, with up to 12% increase in F1 score using the same number of model parameters at inference. Furthermore, SelfHAR is data-efficient, reaching similar performance using up to 10 times less labeled data compared to supervised approaches. Our work not only achieves state-of-the-art performance in a diverse set of HAR datasets, but also sheds light on how pre-training tasks may affect downstream performance.