Foundation Artificial Intelligence Models for Health Recognition Using Face Photographs (FAHR-Face)

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Auteurs principaux: Haugg, Fridolin, Lee, Grace, He, John, Nürnberg, Leonard, Bontempi, Dennis, Bitterman, Danielle S., Catalano, Paul, Prudente, Vasco, Glubokov, Dmitrii, Warrington, Andrew, Pai, Suraj, De Ruysscher, Dirk, Guthier, Christian, Kann, Benjamin H., Gladyshev, Vadim N., Aerts, Hugo JWL, Mak, Raymond H.
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Publié: 2025
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author Haugg, Fridolin
Lee, Grace
He, John
Nürnberg, Leonard
Bontempi, Dennis
Bitterman, Danielle S.
Catalano, Paul
Prudente, Vasco
Glubokov, Dmitrii
Warrington, Andrew
Pai, Suraj
De Ruysscher, Dirk
Guthier, Christian
Kann, Benjamin H.
Gladyshev, Vadim N.
Aerts, Hugo JWL
Mak, Raymond H.
author_facet Haugg, Fridolin
Lee, Grace
He, John
Nürnberg, Leonard
Bontempi, Dennis
Bitterman, Danielle S.
Catalano, Paul
Prudente, Vasco
Glubokov, Dmitrii
Warrington, Andrew
Pai, Suraj
De Ruysscher, Dirk
Guthier, Christian
Kann, Benjamin H.
Gladyshev, Vadim N.
Aerts, Hugo JWL
Mak, Raymond H.
contents Background: Facial appearance offers a noninvasive window into health. We built FAHR-Face, a foundation model trained on >40 million facial images and fine-tuned it for two distinct tasks: biological age estimation (FAHR-FaceAge) and survival risk prediction (FAHR-FaceSurvival). Methods: FAHR-FaceAge underwent a two-stage, age-balanced fine-tuning on 749,935 public images; FAHR-FaceSurvival was fine-tuned on 34,389 photos of cancer patients. Model robustness (cosmetic surgery, makeup, pose, lighting) and independence (saliency mapping) was tested extensively. Both models were clinically tested in two independent cancer patient datasets with survival analyzed by multivariable Cox models and adjusted for clinical prognostic factors. Findings: For age estimation, FAHR-FaceAge had the lowest mean absolute error of 5.1 years on public datasets, outperforming benchmark models and maintaining accuracy across the full human lifespan. In cancer patients, FAHR-FaceAge outperformed a prior facial age estimation model in survival prognostication. FAHR-FaceSurvival demonstrated robust prediction of mortality, and the highest-risk quartile had more than triple the mortality of the lowest (adjusted hazard ratio 3.22; P<0.001). These findings were validated in the independent cohort and both models showed generalizability across age, sex, race and cancer subgroups. The two algorithms provided distinct, complementary prognostic information; saliency mapping revealed each model relied on distinct facial regions. The combination of FAHR-FaceAge and FAHR-FaceSurvival improved prognostic accuracy. Interpretation: A single foundation model can generate inexpensive, scalable facial biomarkers that capture both biological ageing and disease-related mortality risk. The foundation model enabled effective training using relatively small clinical datasets.
format Preprint
id arxiv_https___arxiv_org_abs_2506_14909
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Foundation Artificial Intelligence Models for Health Recognition Using Face Photographs (FAHR-Face)
Haugg, Fridolin
Lee, Grace
He, John
Nürnberg, Leonard
Bontempi, Dennis
Bitterman, Danielle S.
Catalano, Paul
Prudente, Vasco
Glubokov, Dmitrii
Warrington, Andrew
Pai, Suraj
De Ruysscher, Dirk
Guthier, Christian
Kann, Benjamin H.
Gladyshev, Vadim N.
Aerts, Hugo JWL
Mak, Raymond H.
Image and Video Processing
Artificial Intelligence
Computer Vision and Pattern Recognition
Background: Facial appearance offers a noninvasive window into health. We built FAHR-Face, a foundation model trained on >40 million facial images and fine-tuned it for two distinct tasks: biological age estimation (FAHR-FaceAge) and survival risk prediction (FAHR-FaceSurvival). Methods: FAHR-FaceAge underwent a two-stage, age-balanced fine-tuning on 749,935 public images; FAHR-FaceSurvival was fine-tuned on 34,389 photos of cancer patients. Model robustness (cosmetic surgery, makeup, pose, lighting) and independence (saliency mapping) was tested extensively. Both models were clinically tested in two independent cancer patient datasets with survival analyzed by multivariable Cox models and adjusted for clinical prognostic factors. Findings: For age estimation, FAHR-FaceAge had the lowest mean absolute error of 5.1 years on public datasets, outperforming benchmark models and maintaining accuracy across the full human lifespan. In cancer patients, FAHR-FaceAge outperformed a prior facial age estimation model in survival prognostication. FAHR-FaceSurvival demonstrated robust prediction of mortality, and the highest-risk quartile had more than triple the mortality of the lowest (adjusted hazard ratio 3.22; P<0.001). These findings were validated in the independent cohort and both models showed generalizability across age, sex, race and cancer subgroups. The two algorithms provided distinct, complementary prognostic information; saliency mapping revealed each model relied on distinct facial regions. The combination of FAHR-FaceAge and FAHR-FaceSurvival improved prognostic accuracy. Interpretation: A single foundation model can generate inexpensive, scalable facial biomarkers that capture both biological ageing and disease-related mortality risk. The foundation model enabled effective training using relatively small clinical datasets.
title Foundation Artificial Intelligence Models for Health Recognition Using Face Photographs (FAHR-Face)
topic Image and Video Processing
Artificial Intelligence
Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2506.14909