Unlocking the potential of smartphone and ambient sensors for ADL detection.

The detection of Activities of Daily Living (ADL) holds significant importance in a range of applications, including elderly care and health monitoring. Our research focuses on the relevance of ADL detection in elderly care, highlighting the importance of accurate and unobtrusive monitoring. In this paper, we present a novel approach that that leverages smartphone data as the primary source for detecting ADLs. Additionally, we investigate the possibilities offered by ambient sensors installed in smart home environments to complement the smartphone data and optimize the ADL detection. Our approach uses a Long Short-Term Memory (LSTM) model. One of the key contributions of our work is defining ADL detection as a multilabeling problem, allowing us to detect different activities that occur simultaneously. This is particularly valuable since in real-world scenarios, individuals can perform multiple activities concurrently, such as cooking while watching TV. We also made use of unlabeled data to further enhance the accuracy of our model. Performance is evaluated on a real-world collected dataset, strengthening reliability of our findings. We also made the dataset openly available for further research and analysis. Results show that utilizing smartphone data alone already yields satisfactory results, above 50% true positive rate and balanced accuracy for all activities, providing a convenient and non-intrusive method for ADL detection. However, by incorporating ambient sensors, as an additional data source, one can improve the balanced accuracy of the ADL detection by 7% and 8% of balanced accuracy and true positive rate respectively, on average.

Patients with chronic cluster headache may show reduced activity energy expenditure on ambulatory wrist actigraphy recordings during daytime attacks.

OBJECTIVE: To investigate the changes in activity energy expenditure (AEE) throughout daytime cluster headache (CH) attacks in patients with chronic CH and to evaluate the usefulness of actigraphy as a digital biomarker of CH attacks. BACKGROUND: CH is a primary headache disorder characterized by attacks of severe to very severe unilateral pain (orbital, supraorbital, temporal, or in any combination of these sites), with ipsilateral cranial autonomic symptoms and/or a sense of restlessness or agitation. We hypothesized increased AEE from hyperactivity during attacks measured by actigraphy. METHODS: An observational study including patients with chronic CH was conducted. During 21 days, patients wore an actigraphy device on the nondominant wrist and recorded CH attack-related data in a dedicated smartphone application. Accelerometer data were used for the calculation of AEE before and during daytime CH attacks that occurred in ambulatory settings, and without restrictions on acute and preventive headache treatment. We compared the activity and movements during the pre-ictal, ictal, and postictal phases with data from wrist-worn actigraphy with time-concordant intervals during non-headache periods. RESULTS: Four patients provided 34 attacks, of which 15 attacks met the eligibility criteria for further analysis. In contrast with the initial hypothesis of increased energy expenditure during CH attacks, a decrease in movement was observed during the pre-ictal phase (30 min before onset to onset) and during the headache phase. A significant decrease (p < .01) in the proportion of high-intensity movement during headache attacks, of which the majority were oxygen-treated, was observed. This trend was less present for low-intensity movements. CONCLUSION: The unexpected decrease in AEE during the pre-ictal and headache phase of daytime CH attacks in patients with chronic CH under acute and preventive treatment in ambulatory settings has important implications for future research on wrist actigraphy in CH.

From Lab to Real World: Assessing the Effectiveness of Human Activity Recognition and Optimization through Personalization.

Human activity recognition (HAR) algorithms today are designed and evaluated on data collected in controlled settings, providing limited insights into their performance in real-world situations with noisy and missing sensor data and natural human activities. We present a real-world HAR open dataset compiled from a wristband equipped with a triaxial accelerometer. During data collection, participants had autonomy in their daily life activities, and the process remained unobserved and uncontrolled. A general convolutional neural network model was trained on this dataset, achieving a mean balanced accuracy (MBA) of 80%. Personalizing the general model through transfer learning can yield comparable and even superior results using fewer data, with the MBA improving to 85%. To emphasize the issue of insufficient real-world training data, we conducted training of the model using the public MHEALTH dataset, resulting in 100% MBA. However, upon evaluating the MHEALTH-trained model on our real-world dataset, the MBA drops to 62%. After personalizing the model with real-world data, an improvement of 17% in the MBA is achieved. This paper showcases the potential of transfer learning to make HAR models trained in different contexts (lab vs. real-world) and on different participants perform well for new individuals with limited real-world labeled data available.

Assessing the added value of context during stress detection from wearable data.

BACKGROUND: Insomnia, eating disorders, heart problems and even strokes are just some of the illnesses that reveal the negative impact of stress overload on health and well-being. Early detection of stress is therefore of utmost importance. Whereas the gold-standard for detecting stress is by means of questionnaires, more recent work uses wearable sensors to find continuous and qualitative physical markers of stress. As some physiological stress responses, e.g. increased heart rate or sweating and chills, might also occur when doing sports, a more profound approach is needed for stress detection than purely considering physiological data. METHODS: In this paper, we analyse the added value of context information during stress detection from wearable data. We do so by comparing the performance of models trained purely on physiological data and models trained on physiological and context data. We consider the user's activity and hours of sleep as context information, where we compare the influence of user-given context versus machine learning derived context. RESULTS: Context-aware models reach higher accuracy and lower standard deviations in comparison to the baseline (physiological) models. We also observe higher accuracy and improved weighted F1 score when incorporating machine learning predicted, instead of user-given, activities as context information. CONCLUSIONS: In this paper we show that considering context information when performing stress detection from wearables leads to better performance. We also show that it is possible to move away from human labeling and rely only on the wearables for both physiology and context.

mBrain: towards the continuous follow-up and headache classification of primary headache disorder patients.

BACKGROUND: The diagnosis of headache disorders relies on the correct classification of individual headache attacks. Currently, this is mainly done by clinicians in a clinical setting, which is dependent on subjective self-reported input from patients. Existing classification apps also rely on self-reported information and lack validation. Therefore, the exploratory mBrain study investigates moving to continuous, semi-autonomous and objective follow-up and classification based on both self-reported and objective physiological and contextual data. METHODS: The data collection set-up of the observational, longitudinal mBrain study involved physiological data from the Empatica E4 wearable, data-driven machine learning (ML) algorithms detecting activity, stress and sleep events from the wearables' data modalities, and a custom-made application to interact with these events and keep a diary of contextual and headache-specific data. A knowledge-based classification system for individual headache attacks was designed, focusing on migraine, cluster headache (CH) and tension-type headache (TTH) attacks, by using the classification criteria of ICHD-3. To show how headache and physiological data can be linked, a basic knowledge-based system for headache trigger detection is presented. RESULTS: In two waves, 14 migraine and 4 CH patients participated (mean duration 22.3 days). 133 headache attacks were registered (98 by migraine, 35 by CH patients). Strictly applying ICHD-3 criteria leads to 8/98 migraine without aura and 0/35 CH classifications. Adapted versions yield 28/98 migraine without aura and 17/35 CH classifications, with 12/18 participants having mostly diagnosis classifications when episodic TTH classifications (57/98 and 32/35) are ignored. CONCLUSIONS: Strictly applying the ICHD-3 criteria on individual attacks does not yield good classification results. Adapted versions yield better results, with the mostly classified phenotype (migraine without aura vs. CH) matching the diagnosis for 12/18 patients. The absolute number of migraine without aura and CH classifications is, however, rather low. Example cases can be identified where activity and stress events explain patient-reported headache triggers. Continuous improvement of the data collection protocol, ML algorithms, and headache classification criteria (including the investigation of integrating physiological data), will further improve future headache follow-up, classification and trigger detection. Trial registration This trial was retrospectively registered with number NCT04949204 on 24 June 2021 at www. CLINICALTRIALS: gov .