ABSTRACT
Photoplethysmography (PPG) measured by smartphone has the potential for a large scale, non-invasive, and easy-to-use screening tool. Vascular aging is linked to increased arterial stiffness, which can be measured by PPG. We investigate the feasibility of using PPG to predict healthy vascular aging (HVA) based on two approaches: machine learning (ML) and deep learning (DL). We performed data preprocessing including detrending, demodulating and denoising on the raw PPG signals. For ML, ridge penalized regression has been applied to 38 features extracted from PPG, whereas for DL several convolutional neural networks (CNNs) have been applied to the whole PPG signals as input. The analysis has been conducted using the crowd-sourced Heart for Heart data. The prediction performance of ML using two features (AUC of 94.7%) – the a wave of the second derivative PPG and tpr, including four covariates, sex, height, weight, and smoking – was similar to that of the best performing CNN, 12-layer ResNet (AUC of 95.3%). Without having the heavy computational cost of DL, ML might be advantageous in finding potential biomarkers for HVA prediction. The whole workflow of the procedure is clearly described, and open software has been made available to facilitate replication of the results.
Competing Interest Statement
Yosef Safi Harb is a shareholder at Happitech. The other authors declare that they have no competing interests.
Footnotes
↵* h.w.uh{at}umcutrecht.nl
Specifically, we improved and clarified the technical details and the handling and processing the data and variables in Supplementary Materials (Section 1 and Section 2). We clarified the misunderstanding that the vascular aging prediction was a regression problem. Therefore, we have included a paragraph in the Discussion: introducing the concept of chronological and biological aging and distinguishing regression and classification problems regarding healthy aging. Our main message remains that healthy vascular aging can be monitored by using a smartphone. Moreover, our method is more flexible for extensions, for instance, to detect vascular diseases such as Atrial Fibrillation.