A Comparative Study of Stress and Anxiety Estimation in Ecological Settings Using a Smart-shirt and a Smart-bracelet

Wearable Artificial Intelligence for Detecting Anxiety: Systematic Review and Meta-Analysis

BACKGROUND

Anxiety disorders rank among the most prevalent mental disorders worldwide. Anxiety symptoms are typically evaluated using self-assessment surveys or interview-based assessment methods conducted by clinicians, which can be subjective, time-consuming, and challenging to repeat. Therefore, there is an increasing demand for using technologies capable of providing objective and early detection of anxiety. Wearable artificial intelligence (AI), the combination of AI technology and wearable devices, has been widely used to detect and predict anxiety disorders automatically, objectively, and more efficiently.

OBJECTIVE

This systematic review and meta-analysis aims to assess the performance of wearable AI in detecting and predicting anxiety.

METHODS

Relevant studies were retrieved by searching 8 electronic databases and backward and forward reference list checking. In total, 2 reviewers independently carried out study selection, data extraction, and risk-of-bias assessment. The included studies were assessed for risk of bias using a modified version of the Quality Assessment of Diagnostic Accuracy Studies-Revised. Evidence was synthesized using a narrative (ie, text and tables) and statistical (ie, meta-analysis) approach as appropriate.

RESULTS

Of the 918 records identified, 21 (2.3%) were included in this review. A meta-analysis of results from 81% (17/21) of the studies revealed a pooled mean accuracy of 0.82 (95% CI 0.71-0.89). Meta-analyses of results from 48% (10/21) of the studies showed a pooled mean sensitivity of 0.79 (95% CI 0.57-0.91) and a pooled mean specificity of 0.92 (95% CI 0.68-0.98). Subgroup analyses demonstrated that the performance of wearable AI was not moderated by algorithms, aims of AI, wearable devices used, status of wearable devices, data types, data sources, reference standards, and validation methods.

CONCLUSIONS

Although wearable AI has the potential to detect anxiety, it is not yet advanced enough for clinical use. Until further evidence shows an ideal performance of wearable AI, it should be used along with other clinical assessments. Wearable device companies need to develop devices that can promptly detect anxiety and identify specific time points during the day when anxiety levels are high. Further research is needed to differentiate types of anxiety, compare the performance of different wearable devices, and investigate the impact of the combination of wearable device data and neuroimaging data on the performance of wearable AI.

TRIAL REGISTRATION

PROSPERO CRD42023387560; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=387560.

Self-Management of Subclinical Common Mental Health Disorders (Anxiety, Depression and Sleep Disorders) Using Wearable Devices

RATIONALE

Common mental health disorders (CMD) (anxiety, depression, and sleep disorders) are among the leading causes of disease burden globally. The economic burden associated with such disorders is estimated at $2.4 trillion as of 2010 and is expected to reach $16 trillion by 2030. The UK has observed a 21-fold increase in the economic burden associated with CMD over the past decade. The recent COVID-19 pandemic was a catalyst for adopting technologies for mental health support and services, thereby increasing the reception of personal health data and wearables. Wearables hold considerable promise to empower users concerning the management of subclinical common mental health disorders. However, there are significant challenges to adopting wearables as a tool for the self-management of the symptoms of common mental health disorders.

AIMS

This review aims to evaluate the potential utility of wearables for the self-management of sub-clinical anxiety and depressive mental health disorders. Furthermore, we seek to understand the potential of wearables to reduce the burden on the healthcare system.

METHODOLOGY

a systematic review of research papers was conducted, focusing on wearable devices for the self-management of CMD released between 2018-2022, focusing primarily on mental health management using technology.

RESULTS

We screened 445 papers and analysed the reports from 12 wearable devices concerning their device type, year, biometrics used, and machine learning algorithm deployed. Electrodermal activity (EDA/GSR/SC/Skin Temperature), physical activity, and heart rate (HR) are the most common biometrics with nine, six and six reference counts, respectively. Additionally, while smartwatches have greater penetration and integration within the marketplace, fitness trackers have the most significant public value benefit of £513.9 M, likely due to greater retention.

Dataset of Psychological Scales and Physiological Signals Collected for Anxiety Assessment Using a Portable Device

Portable and wearable devices are becoming increasingly common in our daily lives. In this study, we examined the impact of anxiety-inducing videos on biosignals, particularly electrocardiogram (ECG) and respiration (RES) signals, that were collected using a portable device. Two psychological scales (Beck Anxiety Inventory and Hamilton Anxiety Rating Scale) were used to assess overall anxiety before induction. The data were collected at Simon Fraser University from participants aged 18–56, all of whom were healthy at the time. The ECG and RES signals were collected simultaneously while participants continuously watched video clips that stimulated anxiety-inducing (negative experience) and non-anxiety-inducing events (positive experience). The ECG and RES signals were recorded simultaneously at 500 Hz. The final dataset consisted of psychological scores and physiological signals from 19 participants (14 males and 5 females) who watched eight video clips. This dataset can be used to explore the instantaneous relationship between ECG and RES waveforms and anxiety-inducing video clips to uncover and evaluate the latent characteristic information contained in these biosignals.

A scoping review on monitoring mental health using smart wearable devices

With the continuous development of the times, social competition is becoming increasingly fierce, people are facing enormous pressure and mental health problems have become common. Long-term and persistent mental health problems can lead to severe mental disorders and even death in individuals. The real-time and accurate prediction of individual mental health has become an effective method to prevent the occurrence of mental health disorders. In recent years, smart wearable devices have been widely used for monitoring mental health and have played an important role. This paper provides a comprehensive review of the application fields, application mechanisms, common signals, common techniques and results of smart wearable devices for the detection of mental health problems, aiming to achieve more efficient and accurate prediction for individual mental health, and to achieve early identification, early prevention and early intervention to provide a reference for improving the level of individual mental health.

Predicting Driver Stress Levels with a Sensor-Equipped Steering Wheel and a Quality-Aware Heart Rate Measurement Algorithm

Unobtrusive monitoring of driver mental states has been regarded as an important element in improving the safety of existing transportation systems. While many solutions exist relying on camera-based systems for e.g., drowsiness detection, these can be sensitive to varying lighting conditions and to driver facial accessories, such as eye/sunglasses. In this work, we evaluate the use of physiological signals derived from sensors embedded directly into the steering wheel. In particular, we are interested in monitoring driver stress levels. To achieve this goal, we first propose a modulation spectral signal representation to reliably extract electrocardiogram (ECG) signals from the steering wheel sensors, thus allowing for heart rate and heart rate variability features to be computed. When input to a simple logistic regression classifier, we show that up to 72% accuracy can be achieved when discriminating between stressful and non-stressful driving conditions. In particular, the proposed modulation spectral signal representation allows for direct quality assessment of the obtained heart rate information, thus can provide additional intelligence to autonomous driver monitoring systems.

Remote COPD Severity and Exacerbation Detection Using Heart Rate and Activity Data Measured from a Wearable Device

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of human mortality worldwide. Traditionally, estimating COPD severity has been done in controlled clinical conditions using cough sounds, respiration, and heart rate variability, with the latter reporting insights on the autonomic dysfunction caused by the disease. Advancements in remote monitoring and wearable device technologies, in turn, have allowed for remote COPD monitoring in daily life conditions. In this study, we explore the potential for predicting COPD severity and exacerbation using a low-cost wearable device that measures heart rate and activity data. We collected smartwatch sensor data from 35 COPD patients over a period of three months. Our evaluation shows that future trajectory of the disease can be predicted using only the first few days of continuous unobtrusive wearable data collected from COPD patients. Using features extracted from wearable device an Isolation Forest was able to predict exacerbation with an area under curve (AUC) 0.69 thus showing improvement over a random choice classifier.

Features of wearable devices used for Anxiety & Depression: A scoping review (Preprint).. [DOI: 10.2196/preprints.33287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

BACKGROUND

The rates of mental health disorders such as anxiety and depression are at an all time high and the need for readily available digital health care solutions has never been greater. Wearable devices (WD) have seen a steady rise in the usage of sensors previously reserved for hospital settings. The availibity of features that make use of WDs for anxiety and depression is in its infancy, but we are seeing the potential for consumers to self monitor moods and behaviours with everyday commercially available devices and the ability to self-regulate their health needs.

OBJECTIVE

This study aims to explore features of wearable devices (WDs) used for anxiety and depression

METHODS

We have searched the following six bibliographic databases while conducting this review: MEDLINE, EMBASE, PsycINFO, IEEE Xplore, ACM Digital Library, and Google Scholar. Two reviewers independently performed study selection and data extraction; two other individual reviewers justified cross-checking of extracted data. We utilized a narrative approach for synthesizing the data.

RESULTS

From an initial 2,408 studies we assess and report the features in 58 studies that were highlighted according to our inclusion criteria. Wrist worn devices were identified in the bulk of our studies (n=42 or 71%). Depression was assessed in most of the studies (n=27 or 47%), whereas anxiety was assessed in n=15 or 25% of studies. More than a quarter (n=16 or 27%) of the included studies assessed both mental disorders. Finally n=26 or 46% of studies highlighted the wearable device host device as a smartphone.

CONCLUSIONS

The emergence of affordable, consumer-grade biosensors offers the potential for new approaches to support mental health therapies such as anxiety and depression. We see WDs having real potential in aiding with self-care and with purposefully designed WDs that combine the expertise of technologists and clinical experts WDs could play a key role in self-care monitoring and diagnosis.

TILES-2018, a longitudinal physiologic and behavioral data set of hospital workers

We present a novel longitudinal multimodal corpus of physiological and behavioral data collected from direct clinical providers in a hospital workplace. We designed the study to investigate the use of off-the-shelf wearable and environmental sensors to understand individual-specific constructs such as job performance, interpersonal interaction, and well-being of hospital workers over time in their natural day-to-day job settings. We collected behavioral and physiological data from n = 212 participants through Internet-of-Things Bluetooth data hubs, wearable sensors (including a wristband, a biometrics-tracking garment, a smartphone, and an audio-feature recorder), together with a battery of surveys to assess personality traits, behavioral states, job performance, and well-being over time. Besides the default use of the data set, we envision several novel research opportunities and potential applications, including multi-modal and multi-task behavioral modeling, authentication through biometrics, and privacy-aware and privacy-preserving machine learning.

Measurement(s)	Overall Sleep Quality Rating • Step Unit of Distance • Speech • Mean Heart Rate • Proximity • Electrocardiogram Sequence • heart rate variability measurement • Respiratory Rate • physical activity measurement • light • door motion • Changes in Ambient Temperature in Medical Device Environment • humidity • Overall Emotional Well-Being • Stress • psychological flexibility • work-related acceptance • work engagement • psychological capital • intelligence • job performance • organizational citizenship behavior • counter-productive work behavior • personality trait measurement • Negative affectivity • positive affectivity • anxiety-related behavior trait • Alcohol Use History • Overall Health Rating During Past Week
Technology Type(s)	photoplethysmography • Accelerometer • Microphone Device • Bluetooth-enabled Activity Monitor • electrocardiogram • Sensor Device • Photodetector Device • Temperature Sensor Device • questionnaire • Multidimensional Psychological Flexibility Inventory (MPFI) • Utrecht work engagement scale • survey method • individual task proficiency • Search Results Web results Organizational Citizenship Behavior Checklist • big five inventory • Positive and Negative Affect Schedule (PANAS-X) • State-Trait Anxiety Inventory
Sample Characteristic - Organism	Homo sapiens
Sample Characteristic - Environment	hospital

Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.12465101

Optimal filter characterization for photoplethysmography-based pulse rate and pulse power spectrum estimation

Photoplethysmography (PPG) is a non-invasive, low-cost optical technique used to assess the cardiovascular system. In recent years, PPG-based heart rate measurement has gained significant attention due to its popularity in wearable devices, as well as its practicality relative to electrocardiography (ECG). Studies comparing the dynamics of ECG- and PPG-based heart rate measures have found small differences between these two modalities; differences related to the physiological processes behind each technique. In this work, we analyzed the spectral coherence and the signal-to-noise ratio between isolated PPG pulses and the raw PPG signal in order to: (i) determine the optimal filter to enhance pulse detection from raw PPG for improved heart rate estimation, and (ii) characterize the spectral content of the PPG pulse. The proposed methods were evaluated on 27000 pulses from a PPG database acquired from 42 participants (adults and children). The results showed that the optimal bandpass filter to enhance PPG from the adult group was 0.6-3.3 Hz, while for the children group it was 1.0-2.7 Hz. The spectral analysis on the pulse signal showed that similar bandwidths were found for the adult (0.8-2.4 Hz) and children (0.9-2.7 Hz) groups. We hope that the results presented herein serve as a baseline for pulse detection algorithms and assist with the development of more sophisticated PPG processing algorithms.

Transtheoretical Model Is Better Predictor of Physiological Stress than Perceived Stress Scale and Work Ability Index among Office Workers

Physical activity impacts positively on stress and anxiety. Working conditions affect the quality of life by increasing stress levels, which can affect job performance and work absence. The Perceived Stress Scale (PSS), Work Ability Index (WAI), Transtheoretical Model (TTM), as well as heart rate variability (HRV) have been applied to monitor the state of workers in their job. The aim of this study was to analyze PSS, WAI, and TTM classifications, and to find out how are they linked to physiological stress (HRV). One hundred and thirteen office workers responded to the three questionnaires and their HRV was monitored for at least two full days. Groups were set up according to TTM (Stage 1, Stage 2, Stage 3-4, Stage 5), WAI (weak WAI, medium WAI, good WAI), and PSS (low PSS, medium PSS, high PSS). Results obtained from the test were related to stress values measured by HRV with a Bodyguard2 device. The Stage 5 group from TTM had better HVR and stress levels than the other groups for both women and men (p < 0.05). Participants in the good WAI group and low PSS group had better results than weak WAI and high PSS, but the differences with respect to medium WAI and medium PSS were less clear. Finally, TTM seemed to be the best tool to discriminate physiological stress in office workers with regard to other questionnaires.