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Amy Armento Lee

Publications and source records attributed to Amy Armento Lee.

3 recordsLinked to original sources

A Principle-based Framework for the Development and Evaluation of Large Language Models for Health and Wellness

The incorporation of generative artificial intelligence into personal health applications presents a transformative opportunity for personalized, data-driven health and fitness guidance, yet also poses challenges related to user safety, model accuracy, and personal privacy. To address these challenges, a novel, principle-based framework was developed and validated for the systematic evaluation of LLMs applied to personal health and wellness. First, the development of the Fitbit Insights explorer, a large language model (LLM)-powered system designed to help users interpret their personal health data, is described. Subsequently, the safety, helpfulness, accuracy, relevance, and personalization (SHARP) principle-based framework is introduced as an end-to-end operational methodology that integrates comprehensive evaluation techniques including human evaluation by generalists and clinical specialists, autorater assessments, and adversarial testing, into an iterative development lifecycle. Through the application of this framework to the Fitbit Insights explorer in a staged deployment involving over 13,000 consented users, challenges not apparent during initial testing were systematically identified. This process guided targeted improvements to the system and demonstrated the necessity of combining isolated technical evaluations with real-world user feedback. Finally, a comprehensive, actionable approach is established for the responsible development and deployment of LLM-powered health applications, providing a standardized methodology to foster innovation while ensuring emerging technologies are safe, effective, and trustworthy for users.

cs.HC

The Anatomy of a Personal Health Agent

Health is a fundamental pillar of human wellness, and the rapid advancements in large language models (LLMs) have driven the development of a new generation of health agents. However, the application of health agents to fulfill the diverse needs of individuals in daily non-clinical settings is underexplored. In this work, we aim to build a comprehensive personal health agent that is able to reason about multimodal data from everyday consumer wellness devices and common personal health records, and provide personalized health recommendations. To understand end-users' needs when interacting with such an assistant, we conducted an in-depth analysis of web search and health forum queries, alongside qualitative insights from users and health experts gathered through a user-centered design process. Based on these findings, we identified three major categories of consumer health needs, each of which is supported by a specialist sub-agent: (1) a data science agent that analyzes personal time-series wearable and health record data, (2) a health domain expert agent that integrates users' health and contextual data to generate accurate, personalized insights, and (3) a health coach agent that synthesizes data insights, guiding users using a specified psychological strategy and tracking users' progress. Furthermore, we propose and develop the Personal Health Agent (PHA), a multi-agent framework that enables dynamic, personalized interactions to address individual health needs. To evaluate each sub-agent and the multi-agent system, we conducted automated and human evaluations across 10 benchmark tasks, involving more than 7,000 annotations and 1,100 hours of effort from health experts and end-users. Our work represents the most comprehensive evaluation of a health agent to date and establishes a strong foundation towards the futuristic vision of a personal health agent accessible to everyone.

cs.AI

A Personalized Exercise Assistant using Reinforcement Learning (PEARL): Results from a four-arm Randomized-controlled Trial

Consistent physical inactivity poses a major global health challenge. Mobile health (mHealth) interventions, particularly Just-in-Time Adaptive Interventions (JITAIs), offer a promising avenue for scalable, personalized physical activity (PA) promotion. However, developing and evaluating such interventions at scale, while integrating robust behavioral science, presents methodological hurdles. The PEARL study was the first large-scale, four-arm randomized controlled trial to assess a reinforcement learning (RL) algorithm, informed by health behavior change theory, to personalize the content and timing of PA nudges via a Fitbit app. We enrolled and randomized 13,463 Fitbit users into four study arms: control, random, fixed, and RL. The control arm received no nudges. The other three arms received nudges from a bank of 155 nudges based on behavioral science principles. The random arm received nudges selected at random. The fixed arm received nudges based on a pre-set logic from survey responses about PA barriers. The RL group received nudges selected by an adaptive RL algorithm. We included 7,711 participants in primary analyses (mean age 42.1, 86.3% female, baseline steps 5,618.2). We observed an increase in PA for the RL group compared to all other groups from baseline to 1 and 2 months. The RL group had significantly increased average daily step count at 1 month compared to all other groups: control (+296 steps, p=0.0002), random (+218 steps, p=0.005), and fixed (+238 steps, p=0.002). At 2 months, the RL group sustained a significant increase compared to the control group (+210 steps, p=0.0122). Generalized estimating equation models also revealed a sustained increase in daily steps in the RL group vs. control (+208 steps, p=0.002). These findings demonstrate the potential of a scalable, behaviorally-informed RL approach to personalize digital health interventions for PA.

cs.LG