Nighttime features derived from topic models for classification of patients with COPD.

Nighttime symptoms are important indicators of impairment for many diseases and particularly for respiratory diseases such as chronic obstructive pulmonary disease (COPD). The use of wearable sensors to assess sleep in COPD has mainly been limited to the monitoring of limb motions or the duration and continuity of sleep. In this paper we present an approach to concisely describe sleep patterns in subjects with and without COPD. The methodology converts multimodal sleep data into a text representation and uses topic modeling to identify patterns across the dataset composed of more than 6000 assessed nights. This approach enables the discovery of higher level features resembling unique sleep characteristics that are then used to discriminate between healthy subjects and those with COPD and to evaluate patients' disease severity and dyspnea level. Compared to standard features, the discovered latent structures in nighttime data seem to capture important aspects of subjects sleeping behavior related to the effects of COPD and dyspnea.

Cardiorespiratory fitness estimation in free-living using wearable sensors.

OBJECTIVE: In this paper we propose artificial intelligence methods to estimate cardiorespiratory fitness (CRF) in free-living using wearable sensor data. METHODS: Our methods rely on a computational framework able to contextualize heart rate (HR) in free-living, and use context-specific HR as predictor of CRF without need for laboratory tests. In particular, we propose three estimation steps. Initially, we recognize activity primitives using accelerometer and location data. Using topic models, we group activity primitives and derive activities composites. We subsequently rank activity composites, and analyze the relation between ranked activity composites and CRF across individuals. Finally, HR data in specific activity primitives and composites is used as predictor in a hierarchical Bayesian regression model to estimate CRF level from the participant's habitual behavior in free-living. RESULTS: We show that by combining activity primitives and activity composites the proposed framework can adapt to the user and context, and outperforms other CRF estimation models, reducing estimation error between 10.3% and 22.6% on a study population of 46 participants. CONCLUSIONS: Our investigation showed that HR can be contextualized in free-living using activity primitives and activity composites and robust CRF estimation in free-living is feasible.

Cardiorespiratory fitness estimation using wearable sensors: Laboratory and free-living analysis of context-specific submaximal heart rates.

In this work, we propose to use pattern recognition methods to determine submaximal heart rate (HR) during specific contexts, such as walking at a certain speed, using wearable sensors in free living, and using context-specific HR to estimate cardiorespiratory fitness (CRF). CRF of 51 participants was assessed by a maximal exertion test (V̇o2 max). Participants wore a combined accelerometer and HR monitor during a laboratory-based simulation of activities of daily living and for 2 wk in free living. Anthropometrics, HR while lying down, and walking at predefined speeds in laboratory settings were used to estimate CRF. Explained variance (R(2)) was 0.64 for anthropometrics, and increased up to 0.74 for context-specific HR (0.73-0.78 when including fat-free mass). Next, we developed activity recognition and walking speed estimation algorithms to determine the same contexts (i.e., lying down and walking) in free living. Context-specific HR in free living was highly correlated with laboratory measurements (Pearson's r = 0.71-0.75). R(2) for CRF estimation was 0.65 when anthropometrics were used as predictors, and increased up to 0.77 when including free-living context-specific HR (i.e., HR while walking at 5.5 km/h). R(2) varied between 0.73 and 0.80 when including fat-free mass among the predictors. Root mean-square error was reduced from 354.7 to 281.0 ml/min by the inclusion of context-specific HR parameters (21% error reduction). We conclude that pattern recognition techniques can be used to contextualize HR in free living and estimated CRF with accuracy comparable to what can be obtained with laboratory measurements of HR response to walking.

Personalized cardiorespiratory fitness and energy expenditure estimation using hierarchical Bayesian models.

Accurate estimation of energy expenditure (EE) and cardiorespiratory fitness (CRF) is a key element in determining the causal relation between aspects of human behavior related to physical activity and health. In this paper we estimate CRF without requiring laboratory protocols and personalize energy expenditure (EE) estimation models that rely on heart rate data, using CRF. CRF influences the relation between heart rate and EE. Thus, EE estimation based on heart rate typically requires individual calibration. Our modeling technique relies on a hierarchical approach using Bayesian modeling for both CRF and EE estimation models. By including CRF level in a hierarchical Bayesian model, we avoid the need for individual calibration or explicit heart rate normalization since CRF accounts for the different relation between heart rate and EE in different individuals. Our method first estimates CRF level from heart rate during low intensity activities of daily living, showing that CRF can be determined without specific protocols. Reference VO2max and EE were collected on a sample of 32 participants with varying CRF level. CRF estimation error could be reduced up to 27.0% compared to other models. Secondly, we show that including CRF as a group level predictor in a hierarchical model for EE estimation accounts for the relation between CRF, heart rate and EE. Thus, reducing EE estimation error by 18.2% on average. Our results provide evidence that hierarchical modeling is a promising technique for generalized CRF estimation from activities of daily living and personalized EE estimation.

Identifying Physical Activity Profiles in COPD Patients Using Topic Models.

With the growing amount of physical activity (PA) measures, the need for methods and algorithms that automatically analyze and interpret unannotated data increases. In this paper, PA is seen as a combination of multimodal constructs that can cooccur in different ways and proportions during the day. The design of a methodology able to integrate and analyze them is discussed, and its operation is illustrated by applying it to a dataset comprising data from COPD patients and healthy subjects acquired in daily life. The method encompasses different stages. The first stage is a completely automated method of labeling low-level multimodal PA measures. The information contained in the PA labels are further structured using topic modeling techniques, a machine learning method from the text processing community. The topic modeling discovers the main themes that pervade a large set of data. In our case, topic models discover PA routines that are active in the assessed days of the subjects under study. Applying the designed algorithm to our data provides new learnings and insights. As expected, the algorithm discovers that PA routines for COPD patients and healthy subjects are substantially different regarding their composition and moments in time in which transitions occur. Furthermore, it shows consistent trends relating to disease severity as measured by standard clinical practice.

Personalization of Energy Expenditure Estimation in Free Living Using Topic Models.

We introduce an approach to personalize energy expenditure (EE) estimates in free living. First, we use topic models to discover activity composites from recognized activity primitives and stay regions in daily living data. Subsequently, we determine activity composites that are relevant to contextualize heart rate (HR). Activity composites were ranked and analyzed to optimize the correlation to HR normalization parameters. Finally, individual-specific HR normalization parameters were used to normalize HR. Normalized HR was then included in activity-specific regression models to estimate EE. Our HR normalization minimizes the effect of individual fitness differences from entering in EE regression models. By estimating HR normalization parameters in free living, our approach avoids dedicated individual calibration or laboratory tests. In a combined free-living and laboratory study dataset, including 34 healthy volunteers, we show that HR normalization in 14-day free-living data improves accuracy compared to no normalization and normalization based on activity primitives only ( 29.4% and 19.8 % error reduction against lab reference). Based on acceleration and HR, both recorded from a necklace, and GPS acquired from a smartphone, EE estimation error was reduced by 10.7 % in a leave-one-participant-out analysis.