Personalized Digital Health Modeling with Adaptive Support Users
Authors: Zhongqi Yang, Mahkameh Rasouli, Neda Mohseni, Yong Huang, Iman Azimi, Amir M. Rahmani
Organizations: Department of Computer Science, University of California, Irvine · Sue & Bill Gross School of Nursing, University of California, Irvine · Thrive AI Health · University of California, Irvine
Abstract
Personalized models are essential in digital health because individuals exhibit substantial physiological and behavioral heterogeneity. Yet personalization is limited by scarce and noisy user-specific data. Most existing methods rely on population pretraining or data from similar users only, which can lead to biased transfer and weak generalization. We propose a unified personalization framework that trains a personal model using adaptively weighted support users, including both similar and dissimilar individuals. The objective integrates personal loss, similarity-weighted transfer from similar users, and contrastive regularization from dissimilar users to suppress misleading correlations. An iterative optimization algorithm jointly updates model parameters and user similarity weights. Experiments on six tasks across four real-world digital health datasets show consistent improvements over population and personalized baselines. The method achieves up to 10% lower RMSE on large-scale datasets and approximately 25% lower RMSE in low-data settings. The learned adaptive weights improve data efficiency and provide interpretable guidance for targeted data selection.
Generative AI is reshaping healthcare, yet most existing advances rely on hospital-grade devices, which limits their accessibility and potential for health management outside clinical settings. With the proliferation of portable devices and telemedicine, healthcare is shifting toward home-based Diagnosis-It-Yourself (DIY) care. Despite this promise, several distinctive challenges remain: (i) home-collected data are heterogeneous, exacerbated by the absence of standardized large-scale datasets; (ii) models require adaptation to variable task demands and evolving individual conditions; (iii) the broad spectrum of home care tasks lacks a unified benchmark for systematic evaluation. In this paper, we present DIYHealth Suite, a comprehensive framework designed to address these challenges through a tailored dataset, model, and benchmark. We first curate DIYHealth-900K, a large-scale multimodal dataset capturing diverse real-world home care scenarios. Building on this, we propose DIYHealthGPT, an adaptive foundation model for home-based health management, powered by the novel Hybrid Hyper Low-Rank Adaptation technique. Finally, we establish DIYHealthBench, the first benchmark to evaluate foundation models on home care tasks. Extensive experiments demonstrate that DIYHealthGPT delivers state-of-the-art performance over both general-purpose and medical-specific baselines on 11 home care tasks in both open-QA and closed-QA settings, laying the groundwork for the next generation of personalized health management at home.
Tabular foundation models (TFMs) achieve strong performance on health datasets, but their inference cost and infrastructure requirements limit practical use. We study whether their predictive behavior can be transferred to lightweight tabular models through knowledge distillation. Since in-context TFMs condition on the training set at inference time, naive distillation can introduce context leakage; we address this with stratified out-of-fold teacher labeling. Across 19 healthcare datasets, 6 TFM teachers, 4 student families, and several multi-teacher ensembles, we find that distilled students retain at least 90% of teacher AUC, outperforming teachers in some cases, while running at least 26× faster on CPU and preserving calibration and fairness critical for health applications. Moreover, multi-teacher averaging does not consistently improve over the best single teacher. Leakage-aware distillation is thus a viable route for bringing TFM-quality predictions into inference-constrained health settings.
Federated learning enables collaborative model training across medical institutions without sharing raw data, but its performance is often limited by domain heterogeneity across clients. Existing approaches to address this challenge fall into two main paradigms: model-side personalization, which adapts model parameters to each client, and data-side harmonization, which reduces inter-client variation at the input level. Despite their widespread use, these strategies have not been systematically compared. In this work, we conduct a comprehensive study across six medical imaging settings-colon polyp, skin lesion, and breast tumor segmentation, and tuberculosis CXR, brain tumor, and breast tumor classification-covering diverse types of domain shift. We evaluate a broad set of state-of-the-art harmonization and personalization methods under a unified framework. Our results reveal a conditional trade-off driven by the nature of heterogeneity: harmonization is more effective when variation is primarily appearance-based (e.g., CXR classification), while personalization performs better when differences are structural (e.g., colon polyp segmentation). When inter-client variation is limited, both strategies perform similarly. These findings demonstrate that the effectiveness of adaptation in federated medical imaging depends on the type and magnitude of domain shift rather than the strategy alone. We provide practical guidelines for selecting between harmonization and personalization and highlight directions for future hybrid approaches that combine both paradigms. Code is available at https://github.com/ChamaniS/WhenToAdapt.