Latest / Strachey Lectures / Strachey Lecture: Mixed Signals
Transcript
- 0:01Hello, everybody. Welcome to this term strategy lecture. We're going to be waiting just a few minutes because I can see a lot of people joining,
- 0:09there was a technical difficulty at the beginning, so I'm sorry about that.
- 0:12But please, let's just wait a minute and let the people who are trying to join get in.
- 0:16OK. So, on behalf of the Department of Computer Science at Oxford University, I'd like to welcome all of you to this term straight to lecture.
- 0:24So this is a series of distinguished lectures that we have one a term in memory of Professor Christopher Straightly,
- 0:30who is actually the first professor of computer science at Oxford Street, who founded Oxford Programming Research Group in nineteen sixty five.
- 0:39And together with Dana Scott, he founded the field of Denotation with Semantics,
- 0:43which provided a firm mathematical foundation for programming languages.
- 0:47Before I get the pleasure of introducing today's speaker, I get another pleasure.
- 0:52I'd like to just really strongly thank Oxford Asset Management, who are really generously supporting this sequence of lectures.
- 1:00They've actually been supporting the series since 2014, and without that support,
- 1:04we wouldn't be able to bring this really, really high calibre series of speakers.
- 1:09So great thanks to them. It's great pleasure today to welcome Professor Cecilia Mascolo.
- 1:17Cecily is a professor of mobile systems at the Department of Computer Science and Technology of the University of Cambridge.
- 1:24At at Cambridge, Cecilia is actually the head of the Mobile Wearable Systems and Augmented Intelligence Group.
- 1:31She's also holding NERC Advanced Grant at the moment on the topic of audio based mobile health diagnostics.
- 1:37So this explain both her research area and the area of the talk.
- 1:42The Sisulu's got a huge string of awards, so I had to kind of shorten it so that you would have time to hear from her.
- 1:48Before her ERC advanced grant, she had an network advanced research fellowship.
- 1:53There's been a fellow of the Turing Institute shows a huge number of exciting keynote talks,
- 1:59so I just looked for this year and amongst this year I found AI Tripoli Health Care Summit,
- 2:05IWC and Smart Comp,
- 2:08and from last year ACM welcomed that hot mobile addition cited this year for the I Talk and has a whole also the best paper awards,
- 2:18including recently a 10 year impact award at ACM.
- 2:22Giving up her talk today is entitled Mixed Signals Audio and Wearable Data Analysis for Health Diagnostics, so we're really looking forward to that.
- 2:32Before I welcome Cecilia, I just want to make one technical comment since we're still in pandemic mode and that's that during the talk,
- 2:40what you can do is you can type questions into the chat, and at the end of the talk,
- 2:45I will be reading those out so that Cecilia can answer some of our questions.
- 2:49OK, Cecilia, it's a huge pleasure to welcome you virtually to Oxford.
- 2:56Leslie, thank you very much. So before I share my slides, I would like to thank you and.
- 3:10A. A, I guess you can hear it, so, Leslie, thank you very much.
- 3:16I was muted for a while and I would like to thank you and your predecessor, Michael Wooldridge, for this invitation.
- 3:23It's a great honour to be here. I'm sorry that I can't meet you all in person and have the live interaction that we could have.
- 3:30But I will now show my slides and hopefully this will be.
- 3:35Some interaction was still happening, so I will now assume you can see my slides and I thought my talk.
- 3:45And so there is now in our daily lives,
- 3:50a constellation of wearable devices that are sensing our behaviour and impartially in a perhaps a more indirect way.
- 3:58Our health. And so one would imagine if you have some of these like phones, watches and durables that this area is kind of dumb,
- 4:10that our health is kind of transformed and there is no research for us in academia to do around this anymore.
- 4:19Well, in this talk, I would like to really highlight that what we're doing at the moment and what we see in these devices that go into
- 4:27consumers hands is that we are really playing with the sensing and with the data that comes out of it quite superficially.
- 4:35And we really need to go through a number of breakthrough to really transform health.
- 4:42And so in this talk,
- 4:44I will first talk about the challenges that we're facing in the exciting possible opportunity that this and this could could innovate.
- 4:56So these are only some. So I have this challenge.
- 4:59I will introduce them a bit and I have two reputation, two examples from my research that in which I try to explain some of this.
- 5:08So the obvious first one is that sensory modalities, of course, new and new sensors.
- 5:14My colleagues in engineering are coming up with new ways of sensing our behaviour.
- 5:19So I have a colleague who works on EEG.
- 5:22Portable EEG sensors are becoming smaller more or less and that they are being weaved into a fabric, possibly even tattoos.
- 5:32Pills are being developed so they can be ingested, and contactless communication between ingested sensors and external devices can happen so that
- 5:42you can can sense since our health in a less invasive way or disruptive for our activities.
- 5:51But at the same time, existing sensors that are already on devices that we wear generate amounts of data that we are not
- 5:59quite at the stage of being able to being good at modelling the kind of final aims that we have.
- 6:08And this can can be taken further by saying that these devices generate data.
- 6:13Often the granularity we haven't seen before and can be placed because of the type of data they are.
- 6:19They can be placed in in in parts of our body sometimes that we have never thought of sensing.
- 6:27So some interesting conversations I've been having with them with clinicians are often of the style.
- 6:34But what if I could give the long term sense and continuous sensing from perhaps your abdomen?
- 6:43What kind of things would you be able to do?
- 6:46And this is so far from what they're used to see that even that kind of conversation of what can can be done with the sort of data is missing.
- 6:56In my examples today, I will talk about longitudinal sensing,
- 7:00the fact that now it is much easier not just to have fine grained data continuously, but also for a long, long time,
- 7:08which means that we can assess differences from past and present,
- 7:13present and possibly future when that comes and look at predictions with this sort of longitudinal data.
- 7:21One thing that is important here is that the studies and the techniques that have been used are often until now used on small scale trials.
- 7:32Small small cohorts and often the free living aspect of the analysis is somehow missing you.
- 7:42You have more control over the labels of the data sometimes in this study.
- 7:47And you know there is less ability to adapt to unforeseen and noisy data comes out of that.
- 7:56And I'm sure for the fourth bullet point, I'm preaching to the choir in this department and that but I will I will talk about this nevertheless.
- 8:04And perhaps it leads to an interesting conversation where we are talking about clinical and diagnostic.
- 8:11Six aspects of uncertainty. So the ability to go beyond the concept of accuracy of a prediction is important,
- 8:21but so the angle perhaps that is new to this department is the fact that in I will, I will show that in in mobile.
- 8:30In the case of mobile data, it is possible to weave this uncertainty in the pipeline on how the data is collected and recollected,
- 8:39because the entry point of rerecording and getting more data is so low that if it drops a prediction of certain data is uncertain,
- 8:47then maybe we can easily collect more data. I hope this is clear to a point that it is not clear.
- 8:53I have some examples on this,
- 8:56and the last point is obviously one that if I don't talk about amassed at the end of the lecture and is related to privacy.
- 9:02My perspective on this is that privacy is somehow could be embedded in the process
- 9:11that we develop to make sure that a lot of this can be done closer to the users.
- 9:16And as a systems researcher, I will show at the end some examples of how perhaps we can bring this further closer to
- 9:23the users by perhaps developing models as a clinical trial with the side effect is the,
- 9:30you know, the lack of privacy for their users in the trial. But once we develop more and more models, the models can be deployed at scale,
- 9:40and the privacy of the users is respected because those models will run on devices close to the users and on their data locally.
- 9:49And so there is more of this.
- 9:50I wanted to give you an anticipations because I know your attention, especially online, is limited, so I will try to start with the first example.
- 10:00So as I said, I have two on two different types of diseases and data syncing data that we use for that.
- 10:09So the first one is about cardiorespiratory fitness. I don't know how many of you know,
- 10:14and I certainly was surprised by the fact that cardiorespiratory fitness is a
- 10:18very important factor that is inversely associated with cardiovascular diseases.
- 10:25And, interestingly enough, is much more indicative than cholesterol, diabetes, hypertension and even smoking.
- 10:36So it's very important to assess cardiorespiratory fitness, and this is a project we're doing with MRC epidemiology.
- 10:43And so if I was in a live lecture theatre,
- 10:46I would now ask you to raise your hand if you have ever done one of the strenuous tests and with on tests in which you go on a treadmill or bike.
- 10:55And then you have a mask. And this test is cumbersome, is very strenuous because they often push it to the end of your abilities.
- 11:03And this is to measure your cardiorespiratory fitness as a means to by by, by measuring your VO2 Max,
- 11:12which is the maximum volume of oxygen that you can breathe in and then that is transported
- 11:18through the bloodstream and then eventually transform into energy by your muscles.
- 11:22Now, as you can imagine, this test is is is actually not very scalable.
- 11:28You need equipment and it is strenuous. So what could be a geologist and and people who study this sort of relationship and been doing
- 11:40for for the moment is to proxy this with other measures such as anthropometric measures,
- 11:47demographics, height, weight, BMI, as well as questionnaires about how many times to exercise, what type of type Typekit exists.
- 11:55And this is this is a good proxy already, but you can imagine, you know, you probably know where I'm going now.
- 12:02There are lots of wearable data that could be used as a proxy of that sort of questionnaire data and turns out that also resting heart rate,
- 12:11which can be measured quite easily at least more easily than exercise, is a very good proxy indicative proxy for that.
- 12:21So where are we with bringing wearables into the detection of VO2 Max?
- 12:26Well, if you have one of these most modern devices, you know that some of them,
- 12:31when you tell them what exercise you're doing, are giving you already an estimate of VO2 Max.
- 12:36And so this is happening in real life. There are very few studies that are showing the effectiveness of this promising of the
- 12:46wearable data measuring activity as well as heart rate and is a proxy for VO2 Max.
- 12:52And most importantly, there are essentially none that do this in free living conditions.
- 12:58If you remember, my first life free living condition was one of the important thing because you really don't want
- 13:03to have all having to have to label the data so much from from the perspective of the user.
- 13:10So. The free living aspect is very important.
- 13:14And so now I have a few slides on the study we are doing as this is a keynote, I hate to present research that we have already always published,
- 13:26so I always tried to push myself to present something that is something that we are doing.
- 13:30And so this is not yet something out. This is something we are working on.
- 13:35And so this is the measurement of cardiorespiratory fitness through wearable data in free living.
- 13:41And this is way this works with data. The MRC epidemiology is collected.
- 13:45It's a study called Fenland.
- 13:48It's a data set and they have a number of participant 11000 in the first cohort and then seven years later, and they have another cohort.
- 13:57Then in this particular case, we're using a subset of that. Of all these people, they do two max tests on them.
- 14:05So they do do the test. They measure anthropometric measures, as I say, demographics as well as height, weight, BMI and they ask questions them.
- 14:13But they also ask and this is this is, I think, invaluable them to wear an accelerometer on their wrist,
- 14:20as well as an EKG chest strap to measure their heart for six days, essentially very much continuously.
- 14:29So this data is a lot of data, and I remind everyone that this is in free living, we know nothing about what they're doing in those days,
- 14:37but this six continuous days is not too much of it either, but it still generates a lot of data.
- 14:43So what we are doing with this is by using his input,
- 14:48their heart rate and the movement data on which we calculate a bunch of features which you can imagine just to, you know, aggregate all this data.
- 14:57We feed this into, you know, two layers of a connected neural network,
- 15:04and we use this to do a few things now in the next slide and show you some results.
- 15:09But essentially first thing is that we try to use this data to proxy the prediction, the fitness levels and the VO2 Max test.
- 15:19And the fact is that we have the Granton. So we can you can.
- 15:22You can tell how well we're doing and which which sensor which aspect of the data is more important.
- 15:30We've also tried to see if the models are robust enough. So if we train on the original cohort, how does the model do on the later cohort?
- 15:41And we're trying to understand these sort of aspects as well as looking if perhaps maybe movement is also a good indicator of heart,
- 15:51you know, heart rate, for example, and this is what you're going to see next.
- 15:57And so here, I guess let's go straight to the figure, which is the the easiest thing to interpret here on the x axis,
- 16:05you have the VO2max of the users and the the two different distributions are the predictive versus the to the ground through distribution as you see,
- 16:15they match reasonably well. We are still, I would say, under predicting for a portion of them, as you can see the purple coming out to the back there.
- 16:25And on the table, for those of you who do like tables, we break down the different results on the arrow,
- 16:33the arrows, the Arabs and the Romans square in the column there.
- 16:39And then you see if I can point to it of the virus just using anthropometric,
- 16:44excuse me, resting heart rate mix in them and then adding the wearable data.
- 16:50As you can see, of course, the wearable data is interesting. It does help the prediction.
- 16:55And while I was discussing this predictions with the Finnish biologist, I, you know, I always ask, Well, is this improvement reasonable?
- 17:03And their also is quite interesting because they say, well, it depends what you're trying to do.
- 17:08So sometimes we really need even just this one point more to to really be precise and so that,
- 17:15you know, they're striving to get this obviously down as much as possible.
- 17:19As I said, this is this is really, you know, at the beginning that we think it's the right direction and interesting to look at this.
- 17:28The thing to remember that this data is from people that are not all athletes, which is something you find often in in some of the studies.
- 17:37These are normal people in which this information is very interesting and could lead to good outcome prediction along the same lines.
- 17:49We are trying now to also see if the wearable data, which we input in some other machine learning framework, the details.
- 17:58I just put some people down at the bottom. You can look on my web page if you want the details of the technical stuff.
- 18:03I don't think this talk is particularly about all the details of the neural network architecture used.
- 18:09So we use the the data from the wristwatch and trying to see if we can forecast heart rate from that.
- 18:19So now this is the the main task that is being performed and the next slide, we'll have some results in full of where we are with that.
- 18:28But also in the meanwhile,
- 18:30what is interesting I think of this technique is the fact that the later representation at the penultimate layer of the network,
- 18:39the network is learnt from this data of the activity is quite predictive of other clinically relevant information,
- 18:46such as BMI, age, sex and energy expenditure. And so we have all of a sudden,
- 18:53interesting relationship between what the network is learning and what what the characteristics of these individuals are.
- 19:05And here are your numbers, essentially. And so in the first table here, if you see my mouse, I'm not sure you see that.
- 19:16We have tried to stick to what is our technique and we've tried to use it just with acceleration,
- 19:22data acceleration and the temporal features that are embedded into the data that we have, as well as adding additional resting heart rate.
- 19:31Now, as I said at the beginning, resting heart rate is a measure that one can conceivably think.
- 19:38To get reasonably in a reasonably discreet manner is something that you can ask can be checked in a very quiet moment of your time.
- 19:48Maybe when you lie down and and not so frequently so it's something that is conceivable as a measurement that doesn't cost much to add.
- 19:56And as you can see, you know, I see I see is substantially decreasing, I would say reasonably decreasing when you use,
- 20:07when you start using the rest of our trade in addition to an acceleration. So clearly, I mean, epidemiologists know about this.
- 20:13They know that this is an important feature of your your fitness and clearly
- 20:18in the obviously very correlated with your general heart trade in general.
- 20:22And here we have the acceleration indicating the amount of activity that is indicative
- 20:27also and and drives can be a proxy for your heart rate variability and not mobility level.
- 20:36And the other table, we see this outcomes that we have and, you know,
- 20:42with various principal component analysis reductions from the from the features we
- 20:48have that we we have reasonable prediction of some of the demographics height six,
- 20:54somehow even age, BMI and weight. And so so here, I guess with this first part of the work,
- 21:02what I wanted to highlight amongst the original bullets of things that we have are a few things one three living data is more difficult to deal with,
- 21:14possibly more confusing. You often don't get this beautiful results,
- 21:19but we need to work with this because if you talk to epidemiologists or people that do this kind of large scale work,
- 21:28they are interesting in monitoring the population and they cannot afford to do this with something that is very controlled.
- 21:35So we need to find techniques to do it.
- 21:39The second aspect is the continuous and the longitudinal. Now I probably in the result, have really just scratched the surface of you.
- 21:46So we have Finland one, Finland two. We have, you know, people monitor a difference of seven years.
- 21:52The only thing we have done in that respect is to monitor, you know, monitor.
- 21:57Our models were robust at the moment in time. But there is a lot more that we think we can do now for the rest of the talk.
- 22:05I will I will bring back this, but for the moment,
- 22:08I will just move into another example in another sensor that we have been used
- 22:15using quite a bit and that's related to the microphone that is in our devices.
- 22:21So it's about the application of this to auscultation and auscultation in general.
- 22:27So perhaps auscultation that you as an audience know most is related to how it auscultation or
- 22:37respiratory auscultation to stay that what turns out and what what I've been told also in person.
- 22:44But then I come.
- 22:45The citation is that auscultation is very difficult for a human ear, and often junior doctors are not skilled and and this these are from what I hear,
- 23:00not so train in this auscultation because this can easily be proxy by other devices.
- 23:06So for cardiac echocardiograms, how substituting auscultation by it and just the the the stethoscope.
- 23:17On the other hand, machines and microphones are in our hands and they are cheap.
- 23:24And most importantly, they are with us all day,
- 23:27which means that with respect to the discrete auscultation that the doctor could do on us, this thing can listen to us continuously.
- 23:37Now this has advantages well of its challenges, but also opportunities.
- 23:43And so I will start with with an example of of of audio that you might be familiar with.
- 23:50And that's, you know, voice in 2017, this MIT tech review highlighted that voice could be indicative not just of
- 24:02perhaps what these to you more intuitive psychiatric and psychological diseases,
- 24:10the voice and the fact that perhaps you can hear stress from the voice is kind of something that you might have heard those,
- 24:16but also even heart disease.
- 24:17And the intuition behind that is the the vocal cords and the respiratory tract is somehow very intertwined with the cardiovascular tract.
- 24:27So perhaps a hardening of the arteries might make changes in your voice more prominent.
- 24:35So that's kind of, you know, I can do the time computer scientist interpretation and in lay terms of what the situation is.
- 24:47So it's not just about data that comes out from our vocal respiratory tract.
- 24:55It could also be data that comes from our heart. We know we have EKGs in our watches already.
- 25:02There's a one lead in the in my Apple Watch, but there are pathologies that can only be heard of or seen through an echo cardiogram.
- 25:13So auscultation is important.
- 25:16There are the start to be collections of data set from digital stethoscope that can be used for auscultation of heart pathology and below.
- 25:28If you're interested in again, a reference of one of the one of the work,
- 25:31and we're not the only one working on this and on on on how this can, can be can be done.
- 25:39The problem in general is that while for speech and there are very many datasets available and people are really concentrating on the techniques here,
- 25:51there's very limited data and in some cases there is really no data.
- 25:56I was talking to a colleague who is a respiratory clinician, and I was asking them how they trained their doctors.
- 26:04And she was telling me that the main technique is to listen to the same patient.
- 26:10So the consultant listen. The trainee listens, and then they learn how to understand respiratory.
- 26:19But, you know, having data banks and which, you know, I'm sure you know where I'm going with this.
- 26:26So the collection of these data is as important as the analysis of it.
- 26:31This is a review from 2017 and one of the many that can be found,
- 26:34so people are really clear on the fact that having data can be useful in creating models.
- 26:43And here are the examples of things that can be detected using this data asthma, COPD pneumonia are three in this particular abstract.
- 26:54And so while I was mulling over this as part of my IAC Advance Grand Corbett, it started to happen and a couple of colleagues been in touch.
- 27:04They knew about my project and restarted collection of data through an app that we pushed for.
- 27:14Now I can get a separate talk about how difficult it was to push out an app to collect sounds had COVID in the name at pandemic time.
- 27:27This was March, April 2020. Yeah.
- 27:31You know, you can ask me at the end and I have thoughts about how this can be changed because the time we're really trying to do something useful.
- 27:39But the result of this collection, and I'll talk a bit more about what the data we're collecting is is contained into a large scale
- 27:49dataset that we've just pushed onto the new dataset track and will be released momentarily.
- 27:57We already released subsets of the data in this data is private and very sensitive,
- 28:05and therefore we are releasing this phase with data transfer agreement between institutions.
- 28:11I can say more if you have more to ask in the end, what does that do?
- 28:15I'm spending a little bit more time on this because it's very timely and I think we've learnt a lot by doing this and we're still we're still on it.
- 28:23You know, in addition to record demographics, medical history and symptoms which many other apps are doing,
- 28:30we are recording songs for recording breathing songs or recording costs on some rare recording voice sounds.
- 28:36And again, I can't give another talk about how we decided to go for this sentence that you see on the third
- 28:42screen about what the user needs to read and perhaps what we should have told them to read.
- 28:48Once I talked to better experts, you learn by doing. Why?
- 28:53What's the holy grail here? Well, we have all this very cheap lateral flow tests.
- 28:58We have more precise speakers, but we think for these diseases, perhaps having additional scalable,
- 29:06contactless, affordable and I should add sustainable ways of testing.
- 29:12Even that lower precision would be very valuable.
- 29:16And after working for more than a year on this,
- 29:20the conclusion I came through is that this is really a very valuable tool when you're looking at respiratory disease progression because,
- 29:29you know, the licence is a digital device could be really, really, really valuable.
- 29:37And so, again, just because this sort of I like grass and this is interesting,
- 29:42this is the data we have collected, so we do ask for some ground truth to the user.
- 29:47We asked them to report if they have tested for COVID.
- 29:50All of this is crowdsourced so they can lie.
- 29:53People have been miaowing into the app, so we have lots of noisy, dirty data that we have to clean and look at.
- 30:01And so mainly most of the data is in fact negative, as you would imagine, and we have some COVID positive data as well.
- 30:09We ask the users where they're from.
- 30:12You can see the bumps into the data collection down in the when we did a press release or someone court heard about our app.
- 30:23And, you know, age and gender and smoking status information are also in this graphs.
- 30:33One thing I should say, because I'm sure you're you're asking yourself this is, well, why would you be able to see this?
- 30:41Why, why is COVID different? Well, we don't have that information yet.
- 30:45I would start by saying that other researchers have been in touch with the researchers, obviously have been trying to do similar things.
- 30:52And I just point you to one which I thought was particularly useful by the group in CMU by Rita Singh,
- 30:59who is as done analyses of characteristics of COVID voices.
- 31:04And since then, we've been contacted by many clinicians who are essentially saying,
- 31:10I think I can hear it when a patient comes around and sort of people are really
- 31:14on the ground in the front line and they thought they could hear something.
- 31:20The reality is that, you know, depending on what data we have, we can perhaps do a different set of predictions.
- 31:30So will we be able to distinguish COVID from the flu?
- 31:33Well, we have absolutely no data from the flu, so this is something that we, you know, we are very interesting in trying to to understand.
- 31:41But let let's not get ahead of myself too much.
- 31:45This is just one slide that shows you. Well, we're done to get to the task.
- 31:51Can I distinguish from the sounds of a person if they're COVID positive?
- 31:55And we have used the pre-trained model of each model, which was strained on previous audio like large scale audio datasets and then
- 32:06extracted the features and then concatenated them and used them in a for it.
- 32:10That then was used for the prediction. And then you have to task.
- 32:14One is really the diagnostic task trying to say, is this sample yes or no?
- 32:19And one that we're still working on more longitudinal. I'll leave it there for for later.
- 32:26Now I give you only one one one information, one piece of information.
- 32:31I mean, these are three papers we published. The last one, which is under review,
- 32:35is this one that explores the realistic performance of audio based digital testing because we
- 32:40realised that there was a lot of hype at some point people claiming performance of 90 plus percent,
- 32:46which we didn't really believe.
- 32:48And we think a realistic tool that perhaps says data not yet about colds and flu could be around 0.7 percent performance.
- 33:02However, as I said, every time we tried to integrate our dataset with other dataset that had other diseases,
- 33:09the machine learning framework was too smart and would detect the dataset rather than the disease.
- 33:15If you have questions on this, I'm happy to take it and we're still exploring what this sort of thing can be useful for
- 33:22and having a better ground truth and having better data of other diseases is important.
- 33:28One test we have done is to try the model on data that we have of people with asthma, and you seem that there.
- 33:35The model wasn't easily confused by that, but I'm sure it would be confused by other diseases.
- 33:40So it's a matter of deciding what this could be useful for is more of a, you know,
- 33:46a public health question than a methodological machine learning question at that point.
- 33:52Now the final important aspect here for me is that the.
- 33:59After we reflected over this for a year,
- 34:02I think the sort of tools will become invaluable to keep patients out of hospital and look at their onset, as well as progression and recovery.
- 34:13And we're asking our users to give data every couple of days.
- 34:17So we start having samples. And one of the volunteers has given us more than 250 samples and every talk I give.
- 34:25I'm essentially thanking them for this. This is very valuable data at the bottom.
- 34:30Here you see a graph there shows how we could possibly be able to see the progression of someone
- 34:37with the disease before they test negative the Green Party's where they have a negative test.
- 34:43And the other part is where our data and our model starts to decline already in the probability of this prediction.
- 34:50So the ability of and this is not personalised or anything is just using and, you know, sequential modelling technique.
- 34:58But but the idea is to get here and this is possibly not just for COVID.
- 35:03This is something that we're trying to think more generally and scale up to other diseases.
- 35:10Now the last part of this is a reflection of of how, especially in this case, you know,
- 35:19the idea of having this prediction, this one number that gives us COVID non-COVID is is useful.
- 35:27And you know, the the we looked around. And of course, if you look at uncertainty that I found, for example,
- 35:35this paper that says that essentially the computer measure of uncertainty allowed.
- 35:41So this is an example of diabetic retinopathy and images, essentially.
- 35:47And it was it was saying that computing the uncertainty of the prediction allowed them to refer
- 35:53the subset of difficult cases to further inspection to perhaps refer them back to the clinician.
- 35:58So this this is obviously one use of uncertainty.
- 36:03What I would like to highlight and I will go through this complex graph in steps and I have time for that,
- 36:10is the fact that with digital intervention, uncertainty could be used to.
- 36:20You know, being integrated in in the process of not just where the clinician comes in, but also where the need for more samples come in.
- 36:30And so this is even more useful and lowers and has a very low entry point because the data is digital is easily sampled,
- 36:37at least in this particular case. So in this paper that you see at the bottom, we are essentially solving two problems and one at once.
- 36:47The first problem is the generation of uncertainty over the prediction value of the COVID prediction,
- 36:54and we do that by using and single mothers are not just using my models,
- 37:00by using multiple models and aggregating the prediction variance and deciding when you know, there wasn't,
- 37:07let's say, certainty about their prediction, then declaring that that is an uncertain prediction.
- 37:14The fact of using different ensembles also was solving our problem that our data was mainly mainly negative.
- 37:22People declare that have been tested negative. So we use just one positive set and to balance it with multiple negative sets in the
- 37:31different kind of ensembles that we have different instances of the samples that we have.
- 37:39One interesting piece of information is that the graph at the bottom where we noted that the
- 37:46uncertainty tended to be higher when we had the sort of wrong prediction and so indicating that,
- 37:54oh, you know, we don't know if this is in general, but this is certainly an indication that perhaps you know the wrong predictions retaking the data.
- 38:03Perhaps the data was noisy and was therefore predicted in a certain way.
- 38:08And so this is, you know, I will stop here on this. But if you want to read more again and there is a paper there and essentially the last
- 38:17couple of slides for you is related to the privacy argument that I've made before.
- 38:22Now, machine learning device is an open area of work.
- 38:29Many researchers have made strides into compressing the models into using various techniques to make that happen.
- 38:37We're still not there on a number of things, including perhaps training on device,
- 38:42but I think the agreement from the community is that perhaps more than training on device, we are interested in incremental learning.
- 38:48So having a model and then perhaps adopting it on device, that's more interesting.
- 38:53What I found particularly interesting is the bringing this idea of how if we have uncertainty estimation in the models,
- 39:00can we then also bring that on device? And this is again, if you want to read into this area, we are by no means alone in in this quest,
- 39:08but that's one reference of works that we have been doing on this.
- 39:13And as I am, this is my last slide before the questions that, as I said at the beginning,
- 39:19there are other new types of devices on which we can start doing these things and obviously having
- 39:28having sensors around your head in your ear like I'm wearing right now is very interesting.
- 39:33We found the use of microphones to perhaps monitor breathing and heart rate already from with the inner microphone.
- 39:41These things have and again, this is an initial work that just does activity recognition use of that microphone, but that's the direction we're going.
- 39:49So doing all this, you know, data collection and perhaps then analysis on device is the general picture of here.
- 39:58And then here is my slide of things.
- 40:03Obviously, I can't do this. I've done none of this. In fact, all of these people are the people who have done it all.
- 40:09And if you want to contact us, here are the details and thank you very much for listening.
- 40:16Even if just online. Thank you very much. Thank you so much, Cecilia, for really stimulating lecture.
- 40:27I've got some questions that people have been asking here, so I'm going to read those out.
- 40:31Also, people can feel free to send more in as we're going so well.
- 40:36Actually, the first one I want to read is not a question, but a comment. It just says, thanks for the lecture.
- 40:41Your work is so interesting. So I think that many people wanted to write this comment, so I thought I'd read it first.
- 40:49Thank you. OK, so then some more technical questions.
- 40:52The first one asks about the work for measuring heart rate, and it said, Why are we predicting heart rate rather than measuring it so?
- 41:02So what's going on there? OK, so so it's a it's a very good question, and we are also working on trying to measure it.
- 41:11But as a researcher, you know, we're also interested in trying to see what is the right proxy.
- 41:16There are cases where at the moment, measuring heart rate is not precise.
- 41:23So we have PPC sensors on these devices that have been proven to have all sorts of biases movement on the wrist.
- 41:30I heard the talk from from an expert well, in Google, in fact.
- 41:35And you were saying the breast is really the fun place to have a heart rate sensor because we move it so much for many other reasons.
- 41:44So we are trying to see what else so you can measure it from here.
- 41:49You can measure from the places. But another line of research and you know, I'm I'm big on the question why not?
- 41:57And I guess this I would like to answer this question is why not?
- 42:01So this challenge that one sensor is always the best. It's something I like to do this.
- 42:07I hope that that answers the question. Great, thanks.
- 42:12We have another person who's interested in well, and actually I'm sure many people interested in what what types of neural nets
- 42:18did you find more effective for making the predictions from the wearable data?
- 42:24That's that's a very good question. I mean, it depends in the sense that if you see the two presented and one of them is using a CNN plus Joe use,
- 42:35the other one is using just two dense layers. And so in in the in the ones using the twins layer, we actually were using it.
- 42:44We're essentially condensing the features. We're using features instead of the raw accelerometer input because that was essentially too much data.
- 42:54So I'm sure I'm not answering this question. If you're looking for, but I can point you to literature, of course I was teaching, in fact,
- 43:02where I know people in Georgia Tech have looked at the best techniques for accelerometer activity recognition data.
- 43:11And I think there were big on Elysium's, for example.
- 43:16So, yeah, but I think the jury's out and it really depends how much data you have and
- 43:20what you're trying to do if you're trying to combine multiple sensors or not. I'm probably not even the right person to ask this.
- 43:26I will ask one of my students, maybe you can send me an e-mail and I put you in touch with the people on the ground with this way.
- 43:34OK. So another person's asking about the COVID predictions, and the question is,
- 43:41you've got a model that's trained on a kind of population and what the accuracy?
- 43:47How would the accuracy increase if you had a model that was trained per user and actually also is that even feasible?
- 43:53I mean, could you do that over time? Well, that that is, I think the next step, the problem is that we're missing data.
- 44:01So so the moment we use the the general model, because that's where the data is, you only have mainly one sample per user.
- 44:09But if you were to start collecting personalised sample day after day, I even had people that said, we are so different.
- 44:18Our voices are so different that I don't expect this model to be more precise.
- 44:21The next, because you know what you sound is different from what I saw.
- 44:27And then you found mass MOCA is even more true. So, yeah, personalised models are really the way to go.
- 44:33And I think this is even more important for progression when you're trying to monitor progression,
- 44:37knowing the baseline of yourself is where we're going. And I think the lack of data is stopping all of this research at the moment.
- 44:47OK, actually, these questions are coming at a huge rate, you've obviously stimulated loads of people.
- 44:52Let me try another so faster than I can even read them, which is excellent.
- 44:57The one I want to ask you next is about the difference between in-ear sensors and wrist sensors in terms of if in terms of noise.
- 45:06So what's more noisy? And actually then the question ask, you know, is this more sound based or yeah, OK.
- 45:12Basically, that's the question which is more noisy.
- 45:15OK, so the device is essentially virtually there's virtually no research on your able heart rate and respiratory sensing, and we will look into it.
- 45:26We have nothing published. At the moment, we only have the paper that they refer to the most,
- 45:31especially if at the at the bottom where we do activity recognition, we are now monitoring heart rate.
- 45:40What I can say is that the head is a much more stable place to monitor, you know, activity and possibly even physiological things.
- 45:55So, you know, the wrist might not be the best place.
- 45:59There are very few comparisons for heart rate monitor on average ear durable at the moment.
- 46:06So I guess I'm not. Yeah. Maybe next year we can talk about this with more data.
- 46:14Certainly promising. And here's somebody who's asking about the difficulty that in the real world,
- 46:21you don't have labelled data and what are some of the effective methods that you can use to try to get around the lack of labels?
- 46:30That's a very good question. So this is something that the community is really looking very much into.
- 46:41Obviously, transfer learning has been tried, so supervision has been tried and transformation.
- 46:48People are trying to use ancillary tasks as well as in the way that we've also tried to to.
- 46:54And I think there are techniques that have been applied to other data that can be tried here.
- 47:01But the problem of labelling in wearable is really perhaps bigger than in other domains.
- 47:07So, yeah, I think I mentioned the techniques that we've been using,
- 47:11but it's an if you if you're not working on that and you want to work on that, it's definitely, I think, interesting.
- 47:18OK, OK. And there's someone asking about something that you alluded to, but maybe didn't quite have time to tell us enough.
- 47:25So this person was saying that what were the biggest challenges with the app deployment and converting the data into results?
- 47:32You said you had some thoughts on how the process could be improved. What are they?
- 47:37So our problem was that we were blacklisted for about a month from Google and Apple because the app
- 47:49had the Corvette in the title and it was considered kind of an exploitation of a large scale event.
- 47:56And so we had to I had to plead to the head of public health in Cambridge to send the letter through.
- 48:05So we through the normal forms that Google has and and to send this letter, we are not we are not playing around.
- 48:13We are trying to do a research study on this and the day we have all the ethics, we have all the data transfer agreement in place.
- 48:21And so there is the seemed to be a missing pass to connect academic research and this sort of large scale deployment for this sort of, I would say,
- 48:33maybe excluding mine, but generally very important studies that can happen through the deployment and the large scale collection of this data.
- 48:41Obviously, you know, privacy is up there as as a big banner, but it is already finding application that is published in.
- 48:51And temps. Well, yeah, I was alluding to this when I mentioned that,
- 48:56but definitely another another important lesson is people have asked about our data why you not only coughs,
- 49:03why you're not releasing this data publicly to everyone in some groups have and in consultation with experts in the university,
- 49:11we have decided that this data is actually more dangerous than people think.
- 49:15And we also had this conversation with the chairs of the new reps, data and data track where we released our data because their good for paper.
- 49:27The beginning was this was asking us to release the data public if we were to submit to that track.
- 49:33And I wrote to them and said, Well,
- 49:36it is wrong to release this data publicly because someone could reengineered the identity of someone's voice or even cost,
- 49:46in fact, just by correlating it with something else, public and publicly available data.
- 49:51So this process have taken time, but I think we got that right.
- 49:59Thank you, sir.
- 50:00I'm just going to ask one more question, and then I'm just expressing because we can't do it live so much thanks from all of us listening.
- 50:09But let me ask one more question.
- 50:10So this person says, could you say a couple of things on current research on mental health analysis using wearable data?
- 50:17Do you have any general thoughts or directions that you might find interesting? So we have worked on collecting data for mental health.
- 50:28Five, six, seven years ago, in fact, the one of the papers that got the the pen name,
- 50:34but your award was in fact the one that was doing emotion detection from voice on device on a very old Nokia phone that had wonderful battery.
- 50:46That's why we could do it. We Gucci mixture models. So that was on the voice.
- 50:52We also collected data from accelerometer and, you know, questionnaires and then tried to correlate those with mood.
- 51:01We had mood reports, so we have a large dataset that had the sort of information.
- 51:05So I think these days these things are still ongoing.
- 51:10I think the finding that the finding of the phone was striking at the time was that someone having a light.
- 51:19So having this syndrome with on their phone, having some sort of activity that didn't mean exercise,
- 51:23it just meant that they were going somewhere all the time where they were using the phone was actually positively correlated with mood.
- 51:31So, so definitely I mean, this this is really important, but there are various aspects of mental health the expanding to Alzheimer.
- 51:39I have a project on monitoring memory and Alzheimer correlation with the ability to navigate,
- 51:50which is apparently one of the first thing that disappears with your assignment is also another area where these devices could make a difference.
- 51:56I could go on given our talk, but Leslie would stop me. Okay, thank you so much, Cecilia, for a marvellous talk and thanks again to our sponsors,
- 52:05Oxford Asset Management, and thanks to all of you for attending online.
- 52:10So, so that's a day lecture. Thank you very much. Keep.