Interpreting large volumes of high-dimensional, unlabeled data in a manner that is comprehensible to humans remains a significant challenge across various domains. In unsupervised healthcare data analysis, interpreting clustered data can offer meaningful insights into patients' health outcomes, which hold direct implications for healthcare providers. This paper addresses the problem of interpreting clustered sensor data collected from older adult patients recovering from lower-limb fractures in the community. A total of 560 days of multimodal sensor data, including acceleration, step count, ambient motion, GPS location, heart rate, and sleep, alongside clinical scores, were remotely collected from patients at home. Clustering was first carried out separately for each data modality to assess the impact of feature sets extracted from each modality on patients' recovery trajectories. Then, using context-aware prompting, a large language model was employed to infer meaningful cluster labels for the clusters derived from each modality. The quality of these clusters and their corresponding labels was validated through rigorous statistical testing and visualization against clinical scores collected alongside the multimodal sensor data. The results demonstrated the statistical significance of most modality-specific cluster labels generated by the large language model with respect to clinical scores, confirming the efficacy of the proposed method for interpreting sensor data in an unsupervised manner. This unsupervised data analysis approach, relying solely on sensor data, enables clinicians to identify at-risk patients and take timely measures to improve health outcomes.

BACKGROUND: Atrial fibrillation (AF), the most common arrhythmia, is linked to high morbidity and mortality. In a fast-evolving AF rhythm control treatment era, predicting AF recurrence after its onset may be crucial to achieve the optimal therapeutic approach, yet traditional scores like CHADS2-VASc, HATCH, and APPLE show limited predictive accuracy. Moreover, early diagnosis studies often rely on codified electronic health record (EHR) data, which may contain errors and missing information. OBJECTIVE: This study aims to predict AF recurrence between one month and two years after onset by evaluating traditional clinical scores, ML models, and our LTM approach. Moreover, another objective is to develop a methodology for integrating structured and unstructured data to enhance tabular dataset quality. METHODS: A tabular dataset was generated by combining structured clinical data with free-text discharge reports processed through natural language processing techniques, reducing errors and annotation effort. A total of 1,508 patients with documented AF onset were identified, and models were evaluated on a manually annotated test set. The proposed approach includes a LTM compared against traditional clinical scores and ML models. RESULTS: The proposed LTM approach achieved the highest predictive performance, surpassing both traditional clinical scores and ML models. Additionally, the gender and age bias analyses revealed demographic disparities. CONCLUSION: The integration of structured data and free-text sources resulted in a high-quality dataset. The findings emphasize the limitations of traditional clinical scores in predicting AF recurrence and highlight the potential of ML-based approaches, particularly our LTM model.

Despite the growing demand for digital therapeutics for children with Autism Spectrum Disorder (ASD), there is currently no speech corpus available for Korean children with ASD. This paper introduces a speech corpus specifically designed for Korean children with ASD, aiming to advance speech technologies such as pronunciation and severity evaluation. Speech recordings from speech and language evaluation sessions were transcribed, and annotated for articulatory and linguistic characteristics. Three speech and language pathologists rated these recordings for social communication severity (SCS) and pronunciation proficiency (PP) using a 3-point Likert scale. The total number of participants will be 300 for children with ASD and 50 for typically developing (TD) children. The paper also analyzes acoustic and linguistic features extracted from speech data collected and completed for annotation from 73 children with ASD and 9 TD children to investigate the characteristics of children with ASD and identify significant features that correlate with the clinical scores. The results reveal some speech and linguistic characteristics in children with ASD that differ from those in TD children or another subgroup of ASD categorized by clinical scores, demonstrating the potential for developing automatic assessment systems for SCS and PP.

Background: Medical decision-making impacts both individual and public health. Clinical scores are commonly used among a wide variety of decision-making models for determining the degree of disease deterioration at the bedside. AutoScore was proposed as a useful clinical score generator based on machine learning and a generalized linear model. Its current framework, however, still leaves room for improvement when addressing unbalanced data of rare events. Methods: Using machine intelligence approaches, we developed AutoScore-Imbalance, which comprises three components: training dataset optimization, sample weight optimization, and adjusted AutoScore. All scoring models were evaluated on the basis of their area under the curve (AUC) in the receiver operating characteristic analysis and balanced accuracy (i.e., mean value of sensitivity and specificity). By utilizing a publicly accessible dataset from Beth Israel Deaconess Medical Center, we assessed the proposed model and baseline approaches in the prediction of inpatient mortality. Results: AutoScore-Imbalance outperformed baselines in terms of AUC and balanced accuracy. The nine-variable AutoScore-Imbalance sub-model achieved the highest AUC of 0.786 (0.732-0.839) while the eleven-variable original AutoScore obtained an AUC of 0.723 (0.663-0.783), and the logistic regression with 21 variables obtained an AUC of 0.743 (0.685-0.800). The AutoScore-Imbalance sub-model (using down-sampling algorithm) yielded an AUC of 0. 0.771 (0.718-0.823) with only five variables, demonstrating a good balance between performance and variable sparsity. Conclusions: The AutoScore-Imbalance tool has the potential to be applied to highly unbalanced datasets to gain further insight into rare medical events and to facilitate real-world clinical decision-making.

A group based out of the Spaulding Motion Analysis Lab at Spaulding Rehabilitation Hospital published "Enabling Precision Rehabilitation Interventions Using Wearable Sensors and Machine Learning to Track Motor Recovery" in the newest issue of Nature Digital Medicine. The aim of the study is to lay the groundwork for the design of "precision rehabilitation" interventions by using wearable technologies to track the motor recovery of individuals with brain injury. The study found that the technology is suitable to accurately track motor recovery and thus allow clinicians to choose more effective interventions and to improve outcomes. The study was a collaborative effort under students and former students connected to the Motion Analysis Lab under faculty mentorship. Paolo Bonato, Ph.D., Director of the Spaulding Motion Analysis Lab and senior author on the study said, "By providing clinicians precise data will enable them to design more effective interventions to improve the care we deliver. To have so many of our talented young scientists and researchers from our lab collaborate to create this meaningful paper is especially gratifying for all of our faculty who support our ongoing research enterprise."

Current diagnostic methods for mental pathologies, including Post-Traumatic Stress Disorder (PTSD), involve a clinician-coded interview, which can be subjective. Heart rate and skin conductance, as well as other peripheral physiology measures, have previously shown utility in predicting binary diagnostic decisions. The binary decision problem is easier, but misses important information on the severity of the patient’s condition. This work utilizes a novel experimental set-up that exploits virtual reality videos and peripheral physiology for PTSD diagnosis. In pursuit of an automated physiology-based objective diagnostic method, we propose a learning formulation that integrates the description of the experimental data and expert knowledge on desirable properties of a physiological diagnostic score. From a list of desired criteria, we derive a new cost function that combines regression and classification while learning the salient features for predicting physiological score. The physiological score produced by Sparse Combined Regression-Classification (SCRC) is assessed with respect to three sets of criteria chosen to reflect design goals for an objective, physiological PTSD score: parsimony and context of selected features, diagnostic score validity, and learning generalizability. For these criteria, we demonstrate that Sparse Combined Regression-Classification performs better than more generic learning approaches.