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Hugh Logan Ellis

Publications and source records attributed to Hugh Logan Ellis.

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Physical Activity Trajectories Preceding Incident Major Depressive Disorder Diagnosis Using Consumer Wearable Devices in the All of Us Research Program: Case-Control Study

Low physical activity is a known risk factor for major depressive disorder (MDD), but changes in activity before a first clinical diagnosis remain unclear, especially using long-term objective measurements. This study characterized trajectories of wearable-measured physical activity during the year preceding incident MDD diagnosis. We conducted a retrospective nested case-control study using linked electronic health record and Fitbit data from the All of Us Research Program. Adults with at least 6 months of valid wearable data in the year before diagnosis were eligible. Incident MDD cases were matched to controls on age, sex, body mass index, and index time (up to four controls per case). Daily step counts and moderate-to-vigorous physical activity (MVPA) were aggregated into monthly averages. Linear mixed-effects models compared trajectories from 12 months before diagnosis to diagnosis. Within cases, contrasts identified when activity first significantly deviated from levels 12 months prior. The cohort included 4,104 participants (829 cases and 3,275 controls; 81.7% women; median age 48.4 years). Compared with controls, cases showed consistently lower activity and significant downward trajectories in both step counts and MVPA during the year before diagnosis (P < 0.001). Significant declines appeared about 4 months before diagnosis for step counts and 5 months for MVPA. Exploratory analyses suggested subgroup differences, including steeper declines in men, greater intensity reductions at older ages, and persistently low activity among individuals with obesity. Sustained within-person declines in physical activity emerged months before incident MDD diagnosis. Longitudinal wearable monitoring may provide early signals to support risk stratification and earlier intervention.

stat.AP

CSAI: Conditional Self-Attention Imputation for Healthcare Time-series

We introduce the Conditional Self-Attention Imputation (CSAI) model, a novel recurrent neural network architecture designed to address the challenges of complex missing data patterns in multivariate time series derived from hospital electronic health records (EHRs). CSAI extends state-of-the-art neural network-based imputation by introducing key modifications specific to EHR data: a) attention-based hidden state initialisation to capture both long- and short-range temporal dependencies prevalent in EHRs, b) domain-informed temporal decay to mimic clinical data recording patterns, and c) a non-uniform masking strategy that models non-random missingness by calibrating weights according to both temporal and cross-sectional data characteristics. Comprehensive evaluation across four EHR benchmark datasets demonstrates CSAI's effectiveness compared to state-of-the-art architectures in data restoration and downstream tasks. CSAI is integrated into PyPOTS, an open-source Python toolbox designed for machine learning tasks on partially observed time series. This work significantly advances the state of neural network imputation applied to EHRs by more closely aligning algorithmic imputation with clinical realities.

cs.LG

How Deep is your Guess? A Fresh Perspective on Deep Learning for Medical Time-Series Imputation

We present a comprehensive analysis of deep learning approaches for Electronic Health Record (EHR) time-series imputation, examining how architectural and framework biases combine to influence model performance. Our investigation reveals varying capabilities of deep imputers in capturing complex spatiotemporal dependencies within EHRs, and that model effectiveness depends on how its combined biases align with medical time-series characteristics. Our experimental evaluation challenges common assumptions about model complexity, demonstrating that larger models do not necessarily improve performance. Rather, carefully designed architectures can better capture the complex patterns inherent in clinical data. The study highlights the need for imputation approaches that prioritise clinically meaningful data reconstruction over statistical accuracy. Our experiments show imputation performance variations of up to 20\% based on preprocessing and implementation choices, emphasising the need for standardised benchmarking methodologies. Finally, we identify critical gaps between current deep imputation methods and medical requirements, highlighting the importance of integrating clinical insights to achieve more reliable imputation approaches for healthcare applications.

cs.LG