The aim of this study is to explore the relationship between lifestyle choices, subjective experiences and objective biometric data in a single individual. The participant, at the time a male in his twenties, used the EliteHRV app to perform Heart Rate Variability Readings across twenty-six months accompanied by logs about the previous days activity as well as current emotional and physical state. The study will use a mixed-methods approach to analyze the data, including quantitative analysis of the biometric data and correlation analysis between the biometric data and subjective experience tags. Qualitative analysis of the daily logs will also be conducted to gain a deeper understanding of the participant's experiences and to identify keywords, people, or ideas that affect biometric output. The results of this study will provide insights into the relationship between subjective and objective measures, and the potential benefits or drawbacks of certain lifestyle choices and ways of thinking. The findings could have implications for the development of wearable-based personalized interventions for improving mental health and well-being.
This study addresses the classification of heartbeats from ECG signals through two distinct approaches: traditional machine learning utilizing hand-crafted features and deep learning via transformed images of ECG beats. The dataset underwent preprocessing steps, including downsampling, filtering, and normalization, to ensure consistency and relevance for subsequent analysis. In the first approach, features such as heart rate variability (HRV), mean, variance, and RR intervals were extracted to train various classifiers, including SVM, Random Forest, AdaBoost, LSTM, Bi-directional LSTM, and LightGBM. The second approach involved transforming ECG signals into images using Gramian Angular Field (GAF), Markov Transition Field (MTF), and Recurrence Plots (RP), with these images subsequently classified using CNN architectures like VGG and Inception. Experimental results demonstrate that the LightGBM model achieved the highest performance, with an accuracy of 99% and an F1 score of 0.94, outperforming the image-based CNN approach (F1 score of 0.85). Models such as SVM and AdaBoost yielded significantly lower scores, indicating limited suitability for this task. The findings underscore the superior ability of hand-crafted features to capture temporal and morphological variations in ECG signals compared to image-based representations of individual beats. Future investigations may benefit from incorporating multi-lead ECG signals and temporal dependencies across successive beats to enhance classification accuracy further.
Psychiatric disorders affect millions globally, yet their diagnosis faces significant challenges in clinical practice due to subjective assessments and accessibility concerns, leading to potential delays in treatment. To help address this issue, we present Heart2Mind, a human-centered contestable psychiatric disorder diagnosis system using wearable electrocardiogram (ECG) monitors. Our approach leverages cardiac biomarkers, particularly heart rate variability (HRV) and R-R intervals (RRI) time series, as objective indicators of autonomic dysfunction in psychiatric conditions. The system comprises three key components: (1) a Cardiac Monitoring Interface (CMI) for real-time data acquisition from Polar H9/H10 devices; (2) a Multi-Scale Temporal-Frequency Transformer (MSTFT) that processes RRI time series through integrated time-frequency domain analysis; (3) a Contestable Diagnosis Interface (CDI) combining Self-Adversarial Explanations (SAEs) with contestable Large Language Models (LLMs). Our MSTFT achieves 91.7% accuracy on the HRV-ACC dataset using leave-one-out cross-validation, outperforming state-of-the-art methods. SAEs successfully detect inconsistencies in model predictions by comparing attention-based and gradient-based explanations, while LLMs enable clinicians to validate correct predictions and contest erroneous ones. This work demonstrates the feasibility of combining wearable technology with Explainable Artificial Intelligence (XAI) and contestable LLMs to create a transparent, contestable system for psychiatric diagnosis that maintains clinical oversight while leveraging advanced AI capabilities. Our implementation is publicly available at: https://github.com/Analytics-Everywhere-Lab/heart2mind.
The dynamic nature of human health and comfort calls for adaptive systems that respond to individual physiological needs in real time. This paper presents an AI-enhanced digital twin framework that integrates biometric signals, specifically electrocardiogram (ECG) data, with environmental parameters such as temperature, humidity, and ventilation. Leveraging IoT-enabled sensors and biometric monitoring devices, the system continuously acquires, synchronises, and preprocesses multimodal data streams to construct a responsive virtual replica of the physical environment. To validate this framework, a detailed case study is conducted using the MIT-BIH noise stress test dataset. ECG signals are filtered and segmented using dynamic sliding windows, followed by extracting heart rate variability (HRV) features such as SDNN, BPM, QTc, and LF/HF ratio. Relative deviation metrics are computed against clean baselines to quantify stress responses. A random forest classifier is trained to predict stress levels across five categories, and Shapley Additive exPlanations (SHAP) is used to interpret model behaviour and identify key contributing features. These predictions are mapped to a structured set of environmental interventions using a Five Level Stress Intervention Mapping, which activates multi-scale responses across personal, room, building, and landscape levels. This integration of physiological insight, explainable AI, and adaptive control establishes a new paradigm for health-responsive built environments. It lays the foundation for the future development of intelligent, personalised healing spaces.
Monitoring and analyzing electrocardiogram (ECG) signals, even under varying physiological conditions, including those influenced by physical activity, drugs and stress, is crucial to accurately assess cardiac health. However, current AI-based methods often fail to account for how these factors interact and alter ECG patterns, ultimately limiting their applicability in real-world settings. This study introduces IKrNet, a novel neural network model, which identifies drug-specific patterns in ECGs amidst certain physiological conditions. IKrNet's architecture incorporates spatial and temporal dynamics by using a convolutional backbone with varying receptive field size to capture spatial features. A bi-directional Long Short-Term Memory module is also employed to model temporal dependencies. By treating heart rate variability as a surrogate for physiological fluctuations, we evaluated IKrNet's performance across diverse scenarios, including conditions with physical stress, drug intake alone, and a baseline without drug presence. Our assessment follows a clinical protocol in which 990 healthy volunteers were administered 80mg of Sotalol, a drug which is known to be a precursor to Torsades-de-Pointes, a life-threatening arrhythmia. We show that IKrNet outperforms state-of-the-art models' accuracy and stability in varying physiological conditions, underscoring its clinical viability.
Wearable sensors are widely used to collect physiological data and develop stress detection models. However, most studies focus on a single dataset, rarely evaluating model reproducibility across devices, populations, or study conditions. We previously assessed the reproducibility of stress detection models across multiple studies, testing models trained on one dataset against others using heart rate (with R-R interval) and electrodermal activity (EDA). In this study, we extended our stress detection reproducibility to consumer wearable sensors. We compared validated research-grade devices, to consumer wearables - Biopac MP160, Polar H10, Empatica E4, to the Garmin Forerunner 55s, assessing device-specific stress detection performance by conducting a new stress study on undergraduate students. Thirty-five students completed three standardized stress-induction tasks in a lab setting. Biopac MP160 performed the best, being consistent with our expectations of it as the gold standard, though performance varied across devices and models. Combining heart rate variability (HRV) and EDA enhanced stress prediction across most scenarios. However, Empatica E4 showed variability; while HRV and EDA improved stress detection in leave-one-subject-out (LOSO) evaluations (AUROC up to 0.953), device-specific limitations led to underperformance when tested with our pre-trained stress detection tool (AUROC 0.723), highlighting generalizability challenges related to hardware-model compatibility. Garmin Forerunner 55s demonstrated strong potential for real-world stress monitoring, achieving the best mental arithmetic stress detection performance in LOSO (AUROC up to 0.961) comparable to research-grade devices like Polar H10 (AUROC 0.954), and Empatica E4 (AUROC 0.905 with HRV-only model and AUROC 0.953 with HRV+EDA model), with the added advantage of consumer-friendly wearability for free-living contexts.
Biosignal monitoring, in particular heart activity through heart rate (HR) and heart rate variability (HRV) tracking, is vital in enabling continuous, non-invasive tracking of physiological and cognitive states. Recent studies have explored compact, head-worn devices for HR and HRV monitoring to improve usability and reduce stigma. However, this approach is challenged by the current reliance on wet electrodes, which limits usability, the weakness of ear-derived signals, making HR/HRV extraction more complex, and the incompatibility of current algorithms for embedded deployment. This work introduces a single-ear wearable system for real-time ECG (Electrocardiogram) parameter estimation, which directly runs on BioGAP, an energy-efficient device for biosignal acquisition and processing. By combining SoA in-ear electrode technology, an optimized DeepMF algorithm, and BioGAP, our proposed subject-independent approach allows for robust extraction of HR/HRV parameters directly on the device with just 36.7 uJ/inference at comparable performance with respect to the current state-of-the-art architecture, achieving 0.49 bpm and 25.82 ms for HR/HRV mean errors, respectively and an estimated battery life of 36h with a total system power consumption of 7.6 mW. Clinical relevance: The ability to reconstruct ECG signals and extract HR and HRV paves the way for continuous, unobtrusive cardiovascular monitoring with head-worn devices. In particular, the integration of cardiovascular measurements in everyday-use devices (such as earbuds) has potential in continuous at-home monitoring to enable early detection of cardiovascular irregularities.
Photoplethysmography (PPG) is a widely adopted, non-invasive technique for monitoring cardiovascular health and physiological parameters in both consumer and clinical settings. While motion artifacts in dynamic environments have been extensively studied, suboptimal skin-sensor contact in sedentary conditions - a critical yet underexplored issue - can distort PPG waveform morphology, leading to the loss or misalignment of key features and compromising sensing accuracy. In this work, we propose CP-PPG, a novel framework that transforms Contact Pressure-distorted PPG signals into high-fidelity waveforms with ideal morphology. CP-PPG integrates a custom data collection protocol, a carefully designed signal processing pipeline, and a novel deep adversarial model trained with a custom PPG-aware loss function. We validated CP-PPG through comprehensive evaluations, including 1) morphology transformation performance on our self-collected dataset, 2) downstream physiological monitoring performance on public datasets, and 3) in-the-wild study. Extensive experiments demonstrate substantial and consistent improvements in signal fidelity (Mean Absolute Error: 0.09, 40% improvement over the original signal) as well as downstream performance across all evaluations in Heart Rate (HR), Heart Rate Variability (HRV), Respiration Rate (RR), and Blood Pressure (BP) estimation (on average, 21% improvement in HR; 41-46% in HRV; 6% in RR; and 4-5% in BP). These findings highlight the critical importance of addressing skin-sensor contact issues to enhance the reliability and effectiveness of PPG-based physiological monitoring. CP-PPG thus holds significant potential to improve the accuracy of wearable health technologies in clinical and consumer applications.
This study investigates long-term cardiovascular complications in COVID-19 patients using advanced clustering techniques. The objective was to analyse ECG parameters, demographic data, comorbidities, and hospitalization details to identify patterns in cardiovascular health outcomes. We applied K-means clustering and identified three distinct clusters: Cluster 0 with moderate heart rate variability and ICU admissions, Cluster 1 with lower heart rate variability and ICU admissions, and Cluster 2 with higher heart rate variability and ICU admissions, indicating higher risk profiles.
Major depressive disorder (MDD) is a chronic mental illness which affects people's well-being and is often detected at a later stage of depression with a likelihood of suicidal ideation. Early detection of MDD is thus necessary to reduce the impact, however, it requires monitoring vitals in daily living conditions. EEG is generally multi-channel and due to difficulty in signal acquisition, it is unsuitable for home-based monitoring, whereas, wearable sensors can collect single-channel ECG. Classical machine-learning based MDD detection studies commonly use various heart rate variability features. Feature generation, which requires domain knowledge, is often challenging, and requires computation power, often unsuitable for real time processing, MDDBranchNet is a proposed parallel-branch deep learning model for MDD binary classification from a single channel ECG which uses additional ECG-derived signals such as R-R signal and degree distribution time series of horizontal visibility graph. The use of derived branches was able to increase the model's accuracy by around 7%. An optimal 20-second overlapped segmentation of ECG recording was found to be beneficial with a 70% prediction threshold for maximum MDD detection with a minimum false positive rate. The proposed model evaluated MDD prediction from signal excerpts, irrespective of location (first, middle or last one-third of the recording), instead of considering the entire ECG signal with minimal performance variation stressing the idea that MDD phenomena are likely to manifest uniformly throughout the recording.
Photoplethysmography (PPG) sensors have been widely used in consumer wearable devices to monitor heart rates (HR) and heart rate variability (HRV). Despite the prevalence, PPG signals can be contaminated by motion artifacts induced from daily activities. Existing approaches mainly use the amplitude information to perform PPG peak detection. However, these approaches cannot accurately identify peaks, since motion artifacts may bring random and significant amplitude variations. To improve the performance of PPG peak detection, the time information can be used. Specifically, heart rates exhibit temporal consistency that consecutive heartbeat intervals in a normal person can have limited variations. To leverage the temporal consistency, we propose the Temporal Attentive U-Net, i.e., TAU, to accurately detect peaks from PPG signals. In TAU, we design a time module that encodes temporal consistency in temporal embeddings. We integrate the amplitude information with temporal embeddings using the attention mechanism to estimate peak labels. Our experimental results show that TAU outperforms eleven baselines on heart rate estimation by more than 22.4%. Our TAU model achieves the best performance across various Signal-to-Noise Ratio (SNR) levels. Moreover, we achieve Pearson correlation coefficients higher than 0.9 (p < 0.01) on estimating HRV features from low-noise-level PPG signals.
Electrocardiograms (ECGs) are essential for monitoring cardiac health, allowing clinicians to analyze heart rate variability (HRV), detect abnormal rhythms, and diagnose cardiovascular diseases. However, ECG signals, especially those from wearable devices, are often affected by noise artifacts caused by motion, muscle activity, or device-related interference. These artifacts distort R-peaks and the characteristic QRS complex, making HRV analysis unreliable and increasing the risk of misdiagnosis. Despite this, the few existing studies on ECG noise detection have primarily focused on a single dataset, limiting the understanding of how well noise detection models generalize across different datasets. In this paper, we investigate the generalizability of noise detection in ECG using a novel HRV-based approach through cross-dataset experiments on four datasets. Our results show that machine learning achieves an average accuracy of over 90\% and an AUPRC of more than 0.9. These findings suggest that regardless of the ECG data source or the type of noise, the proposed method maintains high accuracy even on unseen datasets, demonstrating the feasibility of generalizability.
This paper aims to initiate new conversations about the use of physiological indicators when assessing the welfare of dogs. There are significant concerns about construct validity - whether the measures used accurately reflect welfare. The goal is to provide recommendations for future inquiry and encourage debate. We acknowledge that the scientific understanding of animal welfare has evolved and bring attention to the shortcomings of commonly used biomarkers like cortisol. These indicators are frequently used in isolation and with limited salient dog descriptors, so fail to reflect the canine experience adequately. Using a systems approach, we explore various physiological systems and alternative indicators, such as heart rate variability and oxidative stress, to address this limitation. It is essential to consider factors like age, body weight, breed, and sex when interpreting these biomarkers correctly, and researchers should report on these in their studies. This discussion identifies possible indicators for both positive and negative experiences. In conclusion, we advocate for a practical, evidence-based approach to assessing indicators of canine welfare, including non-invasive collection methods. We acknowledge the complexity of evaluating experiential responses in dogs across different situations and the need for continued work to improve practices and refine terminology. This will enhance our ability to accurately understand welfare and improve the wellbeing of dogs, serving to inform standards of animal welfare assessment. We hope this will promote more fundamental research in canine physiology to improve construct validity, leading to better practices, ultimately improving the lives of dogs.
Heart rate variability (HRV) is widely recognized as a valuable biomarker for assessing autonomic cardiac regulation. Pulse rate variability (PRV) is a common surrogate of HRV given the wide usability of PPG in commercially available devices. However, there is no clear conclusion on whether PRV can replace HRV given their different physiological mechanisms. This study evaluates the interchangeability of young adults HRV and PRV during supine-to-stand (STS) tests which are known as common posture transitions in daily life monitoring. Fifteen features from time, frequency and nonlinear domains were extracted from both electrocardiography and PPG signals. Paired t-tests and Wilcoxon signed-rank tests examined the difference between the extracted HRV and PRV features during supine, transition and standing phases separately. One feature showed significant difference in the supine phase, and this discrepancy increased to four in the transition and standing phases. These findings suggested that PRV is different from HRV in the STS tests, despite the fact that both metrics can reflect the sympathetic activation triggered by the posture changes.
In many pediatric fMRI studies, cardiac signals are often missing or of poor quality. A tool to extract Heart Rate Variation (HRV) waveforms directly from fMRI data, without the need for peripheral recording devices, would be highly beneficial. We developed a machine learning framework to accurately reconstruct HRV for pediatric applications. A hybrid model combining one-dimensional Convolutional Neural Networks (1D-CNN) and Gated Recurrent Units (GRU) analyzed BOLD signals from 628 ROIs, integrating past and future data. The model achieved an 8% improvement in HRV accuracy, as evidenced by enhanced performance metrics. This approach eliminates the need for peripheral photoplethysmography devices, reduces costs, and simplifies procedures in pediatric fMRI. Additionally, it improves the robustness of pediatric fMRI studies, which are more sensitive to physiological and developmental variations than those in adults.
Multi-channel photoplethysmography (PPG) sensors have found widespread adoption in wearable devices for monitoring cardiac health. Channels thereby serve different functions -- whereas green is commonly used for metrics such as heart rate and heart rate variability, red and infrared are commonly used for pulse oximetry. In this paper, we introduce a novel method that simultaneously fuses multi-channel PPG signals into a single recovered PPG signal that can be input to further processing. Via signal fusion, our learning-based method compensates for the artifacts that affect wavelengths to different extents, such as motion and ambient light changes. We evaluate our method on a novel dataset of multi-channel PPG recordings and electrocardiogram recordings for reference from 10 participants over the course of 13 hours during real-world activities outside the laboratory. Using the fusion PPG signal our method recovered, participants' heart rates can be calculated with a mean error of 4.5\,bpm (23\% lower than from green PPG signals at 5.9\,bpm).
Longitudinal monitoring of heart rate (HR) and heart rate variability (HRV) can aid in tracking cardiovascular diseases (CVDs), sleep quality, sleep disorders, and reflect autonomic nervous system activity, stress levels, and overall well-being. These metrics are valuable in both clinical and everyday settings. In this paper, we present a transformer network aimed primarily at detecting the precise timing of heart beats from predicted electrocardiogram (ECG), derived from input Ballistocardiogram (BCG). We compared the performance of segment and subject models across three datasets: a lab dataset with 46 young subjects, an elder dataset with 28 elderly adults, and a combined dataset. The segment model demonstrated superior performance, with correlation coefficients of 0.97 for HR and mean heart beat interval (MHBI) when compared to ground truth. This non-invasive method offers significant potential for long-term, in-home HR and HRV monitoring, aiding in the early indication and prevention of cardiovascular issues.
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.
Wearable sensors have become ubiquitous thanks to a variety of health tracking features. The resulting continuous and longitudinal measurements from everyday life generate large volumes of data; however, making sense of these observations for scientific and actionable insights is non-trivial. Inspired by the empirical success of generative modeling, where large neural networks learn powerful representations from vast amounts of text, image, video, or audio data, we investigate the scaling properties of sensor foundation models across compute, data, and model size. Using a dataset of up to 40 million hours of in-situ heart rate, heart rate variability, electrodermal activity, accelerometer, skin temperature, and altimeter per-minute data from over 165,000 people, we create LSM, a multimodal foundation model built on the largest wearable-signals dataset with the most extensive range of sensor modalities to date. Our results establish the scaling laws of LSM for tasks such as imputation, interpolation and extrapolation, both across time and sensor modalities. Moreover, we highlight how LSM enables sample-efficient downstream learning for tasks like exercise and activity recognition.
The early and accurate diagnosis of sepsis is critical for enhancing patient outcomes. This study aims to use heart rate variability (HRV) features to develop an effective predictive model for sepsis detection. Critical HRV features are identified through feature engineering methods, including statistical bootstrapping and the Boruta algorithm, after which XGBoost and Random Forest classifiers are trained with differential hyperparameter settings. In addition, ensemble models are constructed to pool the prediction probabilities of high-recall and high-precision classifiers and improve model performance. Finally, a neural network model is trained on the HRV features, achieving an F1 score of 0.805, a precision of 0.851, and a recall of 0.763. The best-performing machine learning model is compared to this neural network through an interpretability analysis, where Local Interpretable Model-agnostic Explanations are implemented to determine decision-making criterion based on numerical ranges and thresholds for specific features. This study not only highlights the efficacy of HRV in automated sepsis diagnosis but also increases the transparency of black box outputs, maximizing clinical applicability.