Organizations: School of Electronic and Electrical Engineering, Shanghai University of Engineering Science, Shanghai 200438, China · Tencent Youtu Lab, Shanghai 200233, China · ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital of Fudan University, Shanghai 200031, China · National University of Singapore, 9 Engineering Drive 1, Singapore 117575, Singapore
Effective pre-polysomnography screening for obstructive sleep apnea-hypopnea syndrome (OSAHS) requires combining clinical risk factors with visible craniofacial and neck cues. Directly prompting general-purpose multimodal foundation models for medical yes/no decisions can yield unstable, poorly calibrated outputs. We propose EviOSAHS, an evidence-grounded multimodal reasoning framework that separates image-only anatomical evidence acquisition from final clinical adjudication. Each frontal facial image is decomposed into seven fixed anatomical queries covering the neck, chin, mouth, face/neck fat, lower jaw, midface, and nose. Visual responses are converted into structured evidence cards recording target anatomy, visibility, risk direction, evidence strength, confidence, and a concise summary. These cards are combined with a cleaned clinical profile only in the final stage, where a large language model performs balanced binary screening adjudication. We evaluated EviOSAHS on a 642-subject cohort, mapping normal subjects to screening-negative and mild, moderate, or severe OSAHS subjects to screening-positive. EviOSAHS achieved 88.47% accuracy, 94.86% sensitivity, 93.74% F1-score, and a 5.14% false-negative rate, outperforming clinical-only prompting, direct multimodal prompting, and naive two-stage pipelines under a unified protocol. Ablations showed that seven-question visual decomposition and balanced final adjudication were critical to the high-sensitivity operating point. A question-level audit of 4,494 visual outputs showed a 100% structured parse rate and 93.88% high-visibility rate. EviOSAHS provides an auditable, high-sensitivity workflow for binary pre-polysomnography OSAHS screening, but should be viewed as a triage assistant rather than a diagnostic system. Prospective validation, external testing, and calibrated operating-point control are needed before clinical deployment.
Pneumonia remains a leading global cause of morbidity and mortality, particularly in low-resource settings where access to imaging, laboratory testing, and specialist care is limited. Clinical assessment relies on heterogeneous evidence, including symptoms, respiratory patterns, spoken descriptions, and chest imaging, making frontline screening inherently multimodal. However, many existing computational approaches remain unimodal and focus primarily on radiographs. In this work, we present MultiSense-Pneumo, a multimodal research prototype for pneumonia-oriented screening and triage support that integrates structured symptom descriptors, cough audio, spoken language, and chest radiographs. The system combines deterministic symptom triage, LightGBM-based acoustic classification, domain-adversarial radiograph analysis using ResNet-18, transformer-based speech recognition, and an interpretable late-fusion operator. Each modality is transformed into a normalized concern signal and aggregated into a unified screening estimate. The fusion weights are hand-specified and are treated as heuristic, interpretable parameters rather than learned or clinically optimized values. MultiSense-Pneumo is implemented with offline execution in mind on standard laptop-class hardware, but it is not presented as a deployment-validated or clinically validated diagnostic system. Experimental results demonstrate strong component-level performance of the radiograph pathway under synthetic domain shifts, while also highlighting important limitations, especially reduced abnormal-class recall for cough acoustics and the absence of paired end-to-end multimodal patient evaluation. MultiSense-Pneumo is therefore intended as a framework and component-level prototype for screening and triage research.
Sleep is essential for health, yet studying its dynamics requires manual sleep staging, a labor-intensive step in research and clinical care. Across centers, polysomnography (PSG) recordings are traditionally scored in 30-s epochs for pragmatic, not physiological, reasons and vary in electrode count, montage, and subject characteristics. These constraints challenge harmonized multi-center studies and the discovery of robust biomarkers on shorter timescales. We present AnySleep, a deep neural network that scores sleep from any electroencephalography (EEG) or electrooculography (EOG) data at adjustable temporal resolutions. We trained and validated the model on over 20,000 overnight recordings (> 200,000 hours of EEG and EOG) from 28 datasets across multiple clinics to promote robust generalization across sites. The model attains state-of-the-art performance and surpasses or equals established baselines at 30-s epochs. Performance improves with more channels, yet remains strong when EOG is absent or only EOG or single EEG derivations (frontal, central, or occipital) are available. On sub-30-s timescales, the model captures short wake intrusions consistent with arousals and improves prediction of pathophysiological conditions (obstructive sleep apnea, narcolepsy type 1, insomnia) over 30-s scoring. We make the model publicly available to facilitate large-scale studies with heterogeneous electrode setups and accelerate biomarker discovery in sleep.
Objective sleep assessment relies on polysomnography (PSG), yet clinical impact is often better reflected in patient-reported outcomes (PROs) such as sleepiness and fatigue. Existing summary indices, including the Apnea-Hypopnea Index (AHI), provide limited insight into the multidomain physiology underlying functional recovery. We propose an interpretable, causal-discovery-guided framework for deriving a hierarchical Sleep Recovery Score (SRS) from multimodal PSG. Using two large population cohorts (MESA: n=1,540; MrOS: n=825), we apply directed acyclic graph (DAG) learning to identify candidate physiological drivers spanning respiratory burden, hypoxic burden, sleep fragmentation, sleep architecture, and autonomic regulation. Although derived from clinical PSG, these domains map naturally to sensing streams increasingly available in connected health technologies, including wearable ECG, oximetry, and sleep-stage estimation devices. To preserve mechanistic plausibility, we introduce a two-stage screening process that combines physiology-based constraints with constrained LLM-assisted auditing to identify and remove structural confounders and construct-overlapping variables. Across cohorts, these five domains emerge as recurrent physiological domains associated with recovery, and the resulting SRS shows up to 3.4× stronger alignment with perceived recovery than AHI. By linking multimodal sleep physiology to patient-centered outcomes through an interpretable, bias-aware, and domain-structured framework, this work provides a practical foundation for recovery modeling across both clinical sleep studies and emerging smart and connected health settings.
Saba A. Farahani, Elahe Khatibi, Manoj Vishwanath +2