Prediction of Heart Failure Onset using Multimodal Data Analysis, Deep Learning and Commercial Wearables Project Summary/Abstract Research: Heart failure is one of the leading causes of mortality and drivers of healthcare costs in the United States. By 2030, the number of heart failure patients is projected to reach 8 million. If we could predict who will develop heart failure, this would create an opportunity to improve patient experiences and outcomes by initiating earlier behavioral and therapeutic interventions. Electronic health records (EHR) contain information that can be used to predict heart failure before its onset. However, the existing models lead to a large number of false positive predictions, limiting their clinical utility. The PI proposes to augment the EHR data with electrocardiogram (ECG) and heart rate variability (HRV) features to improve the accuracy of predicting the onset of heart failure 12 months in advance. The three modalities of data (EHR, ECG and HRV) will be analyzed using deep learning methods, including novel techniques proposed by the PI. The models will be developed and validated retrospectively using patient data available at Michigan Medicine. The second aim of the proposal is to increase the impact of this research by replacing the clinically measured ECG and HRV with those obtained by consumer wearables such as smart watches. A prospective cohort of patients will wear a wearable device for seven days, which will allow the PI to determine whether the collected information (intermittent ECG, continuous HRV derived from photoplethysmography, and actigraphy), combined with EHR, can provide clinicians with a more effective tool to identify which patients are at risk of heart failure. While this approach will benefit a larger population of patients, it will still be limited to those with past medical history. To further expand the impact of this research to those who wear consumer wearables but have no previous medical history, a limited model that depends only on the information gathered by the wearable device will be evaluated. Thus, the outcomes of this study will include multiple models targeting various populations, such as those with and without prior medical history. Candidate / Career Development: Dr. Sardar Ansari is a computer scientist and statistician with expertise in biomedical signal processing, machine learning, and medical wearable devices. His past research experience includes analysis of ECG signal to improve detection of cardiac arrhythmias and reduce false alarms in intensive care units; detection and removal of noise and motion artifacts in biomedical signals such as ECG and bioimpedance; prediction of hemodynamic decompensation using HRV; and detection of hemorrhagic shock, intradialytic hypotension, and low cardiac index using wearable technology. This award will allow Dr. Ansari to acquire needed additional training in cardiovascular physiology and heart failure pathophysiology through men...