Enhancing ALS Progression Tracking with Semi-Supervised ALSFRS-R Scores Estimated from Ambient Home Health Monitoring

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Main Authors: Marchal, Noah, Janes, William E., Popescu, Mihail, Song, Xing
Format: Preprint
Published: 2025
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author Marchal, Noah
Janes, William E.
Popescu, Mihail
Song, Xing
author_facet Marchal, Noah
Janes, William E.
Popescu, Mihail
Song, Xing
contents Clinical monitoring of functional decline in ALS relies on periodic assessments that may miss critical changes occurring between visits. To address this gap, semi-supervised regression models were developed to estimate rates of decline in a case series cohort by targeting ALSFRS- R scale trajectories with continuous in-home sensor monitoring data. Our analysis compared three model paradigms (individual batch learning and cohort-level batch versus incremental fine-tuned transfer learning) across linear slope, cubic polynomial, and ensembled self-attention pseudo-label interpolations. Results revealed cohort homogeneity across functional domains responding to learning methods, with transfer learning improving prediction error for ALSFRS-R subscales in 28 of 32 contrasts (mean RMSE=0.20(0.04)), and individual batch learning for predicting the composite scale (mean RMSE=3.15(1.25)) in 2 of 3. Self-attention interpolation achieved the lowest prediction error for subscale-level models (mean RMSE=0.19(0.06)), capturing complex nonlinear progression patterns, outperforming linear and cubic interpolations in 20 of 32 contrasts, though linear interpolation proved more stable in all ALSFRS-R composite scale models (mean RMSE=0.23(0.10)). We identified distinct homogeneity-heterogeneity profiles across functional domains with respiratory and speech exhibiting patient-specific patterns benefiting from personalized incremental adaptation, while swallowing and dressing functions followed cohort-level trajectories suitable for transfer models. These findings suggest that matching learning and pseudo-labeling techniques to functional domain-specific homogeneity-heterogeneity profiles enhances predictive accuracy in ALS progression tracking. Integrating adaptive model selection within sensor monitoring platforms could enable timely interventions and scalable deployment in future multi-center studies.
format Preprint
id arxiv_https___arxiv_org_abs_2507_09460
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Enhancing ALS Progression Tracking with Semi-Supervised ALSFRS-R Scores Estimated from Ambient Home Health Monitoring
Marchal, Noah
Janes, William E.
Popescu, Mihail
Song, Xing
Machine Learning
Artificial Intelligence
Clinical monitoring of functional decline in ALS relies on periodic assessments that may miss critical changes occurring between visits. To address this gap, semi-supervised regression models were developed to estimate rates of decline in a case series cohort by targeting ALSFRS- R scale trajectories with continuous in-home sensor monitoring data. Our analysis compared three model paradigms (individual batch learning and cohort-level batch versus incremental fine-tuned transfer learning) across linear slope, cubic polynomial, and ensembled self-attention pseudo-label interpolations. Results revealed cohort homogeneity across functional domains responding to learning methods, with transfer learning improving prediction error for ALSFRS-R subscales in 28 of 32 contrasts (mean RMSE=0.20(0.04)), and individual batch learning for predicting the composite scale (mean RMSE=3.15(1.25)) in 2 of 3. Self-attention interpolation achieved the lowest prediction error for subscale-level models (mean RMSE=0.19(0.06)), capturing complex nonlinear progression patterns, outperforming linear and cubic interpolations in 20 of 32 contrasts, though linear interpolation proved more stable in all ALSFRS-R composite scale models (mean RMSE=0.23(0.10)). We identified distinct homogeneity-heterogeneity profiles across functional domains with respiratory and speech exhibiting patient-specific patterns benefiting from personalized incremental adaptation, while swallowing and dressing functions followed cohort-level trajectories suitable for transfer models. These findings suggest that matching learning and pseudo-labeling techniques to functional domain-specific homogeneity-heterogeneity profiles enhances predictive accuracy in ALS progression tracking. Integrating adaptive model selection within sensor monitoring platforms could enable timely interventions and scalable deployment in future multi-center studies.
title Enhancing ALS Progression Tracking with Semi-Supervised ALSFRS-R Scores Estimated from Ambient Home Health Monitoring
topic Machine Learning
Artificial Intelligence
url https://arxiv.org/abs/2507.09460