Data-Driven Guided Attention for Analysis of Physiological Waveforms With Deep Learning

Estimating physiological parameters - such as blood pressure (BP) - from raw sensor data captured by noninvasive, wearable devices rely on either burdensome manual feature extraction designed by domain experts to identify key waveform characteristics and phases, or deep learning (DL) models that require extensive data collection. We propose the Data-Driven Guided Attention (DDGA) framework to optimize DL models to learn features supported by the underlying physiology and physics of the captured waveforms, with minimal expert annotation. With only a single template waveform cardiac cycle and its labelled fiducial points, we leverage dynamic time warping (DTW) to annotate all other training samples. DL models are trained to first identify them before estimating BP to inform them which regions of the input represent key phases of the cardiac cycle, yet we still grant the flexibility for DL to determine the optimal feature set from them. In this study, we evaluate DDGA's improvements to a BP estimation task for three prominent DL-based architectures with two datasets: 1) the MIMIC-III waveform dataset with ample training data and 2) a bio-impedance (Bio-Z) dataset with less than abundant training data. Experiments show that DDGA improves personalized BP estimation models by an average 8.14% in root mean square error (RMSE) when there is an imbalanced distribution of target values in a training set and improves model generalizability by an average 4.92% in RMSE when testing estimation of BP value ranges not previously seen in training.