Health & Bioscience
Research in health and biomedical sciences has a unique potential to improve peoples’ lives, and includes work ranging from basic science that aims to understand biology, to diagnosing individuals’ diseases, to epidemiological studies of whole populations. We recognize that our strengths in machine learning, large-scale computing, and human-computer interaction can help accelerate the progress of research in this space. By collaborating with world-class institutions and researchers and engaging in both early-stage research and late-stage work, we hope to help people live healthier, longer, and more productive lives.
Recent Publications
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As artificial intelligence (AI) is rapidly integrated into healthcare, ensuring that this innovation helps to combat health inequities requires engaging marginalized communities in health AI futuring. However, little research has examined Black populations’ perspectives on the use of AI in health contexts, despite the widespread health inequities they experience–inequities that are already perpetuated by AI. Addressing this research gap, through qualitative workshops with 18 Black adults, we characterize participants’ cautious optimism for health AI addressing structural well-being barriers (e.g., by providing second opinions that introduce fairness into an unjust healthcare system), and their concerns that AI will worsen health inequities (e.g., through health AI biases they deemed inevitable and the problematic reality of having to trust healthcare providers to use AI equitably). We advance health AI research by articulating previously-unreported health AI perspectives from a population experiencing significant health inequities, and presenting key considerations for future work.
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Performance analysis of updated Sleep Tracking algorithms across Google and Fitbit wearable devices
Arno Charton
Linda Lei
Siddhant Swaroop
Marius Guerard
Michael Dixon
Logan Niehaus
Shao-Po Ma
Logan Schneider
Ross Wilkinson
Ryan Gillard
Conor Heneghan
Pramod Rudrapatna
Mark Malhotra
Shwetak Patel
Google, Google, 1600 Amphitheatre Parkway
Mountain View, CA 94043 (2026) (to appear)
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Background: The general public has increasingly adopted consumer wearables for sleep tracking over the past 15 years, but reports on performance versus gold standards such as polysomnogram (PSG), high quality sleep diaries and at-home portable EEG systems still show potential for improved performance. Two aspects in particular are worthy of consideration: (a) improved recognition of sleep sessions (times when a person is in bed and has attempted to sleep), and (b) improved accuracy on recognizing sleep stages relative to an accepted standard such as PSG.
Aims: This study aimed to: 1) provide an update on the methodology and performance of a system for correctly recognizing valid sleep sessions, and 2) detail an updated description of how sleep stages are calculated using accelerometer and inter-beat intervals
Methods: Novel machine learning algorithms were developed to recognize sleep sessions and sleep stages using accelerometer sensors and inter-beat intervals derived from the watch or tracker photoplethysmogram. Algorithms were developed on over 3000 nights of human-scored free-living sleep sessions from a representative population of 122 subjects, and then tested on an independent validation set of 47 users. Within sleep sessions, an algorithm was developed to recognize periods when the user was attempting to sleep (Time-Attempting-To-Sleep = TATS). For sleep stage estimation, an algorithm was trained on human expert-scored polysomnograms, and then tested on 50 withheld subject nights for its ability to recognize Wake, Light (N1/N2), Deep (N3) and REM sleep relative to expert scored labels.
Results: For sleep session estimation, the algorithm had at least 95% overlap on TATS with human consensus scoring for 94% of nights from healthy sleepers. For sleep stage estimation, comparing with the current Fitbit algorithm, Cohen’s kappa for four-class determination of sleep stage increased from an average of 0.56 (std 0.13) to 0.63 (std 0.12), and average accuracy increased from 71% (std 0.10) to 77% (std 0.078)
Conclusion: A set of new algorithms has been developed and tested on Fitbit and Pixel Watches and is capable of providing robust and accurate measurement of sleep in free-living environments.
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Participatory AI Considerations for Advancing Racial Health Equity
Jatin Alla
Proceedings of the 2025 CHI Conference on Human Factors in Computing Systems (CHI) (2025)
Mitigating Clinician Information Overload: Generative AI for Integrated EHR and RPM Data Analysis
Aman Raj
IEEE Compsac 2025 (2025)
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Generative AI (GenAI), particularly Large Language Models (LLMs), offer powerful capabilities for interpreting the complex data landscape in healthcare. In this paper, we present a comprehensive overview of the capabilities, requirements and applications of GenAI for deriving clinical insights and improving clinical efficiency. We first provide some background on the forms and sources of patient data, namely real-time Remote Patient Monitoring (RPM) streams and traditional Electronic Health Records (EHR). The sheer volume and heterogeneity of this combined data present significant challenges to clinicians and contribute to information overload.
In addition, we explore the potential of LLM-powered applications for improving clinical efficiency. These applications can enhance navigation of longitudinal patient data and provide actionable clinical decision support through natural language dialogue. We discuss the opportunities this presents for streamlining clinician workflows and personalizing care, alongside critical challenges such as data integration complexity, ensuring data quality and RPM data reliability, maintaining patient privacy, validating AI outputs for clinical safety, mitigating bias, and ensuring clinical acceptance. We believe this work represents the first summarization of GenAI techniques for managing clinician data overload due to combined RPM / EHR data complexities.
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Capturing Real-World Habitual Sleep Patterns with a Novel User-centric Algorithm to Pre-Process Fitbit Data in the All of Us Research Program: Retrospective observational longitudinal study
Hiral Master
Jeffrey Annis
Karla Gleichauf
Lide Han
Peyton Coleman
Kelsie Full
Neil Zheng
Doug Ruderfer
Logan Schneider
Evan Brittain
Journal of Medical Internet Research (2025)
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Background:
Commercial wearables such as Fitbit quantify sleep metrics using fixed calendar times as default measurement periods, which may not adequately account for individual variations in sleep patterns. To address this limitation, experts in sleep medicine and wearable technology developed a user-centric algorithm designed to more accurately reflect actual sleep behaviors and improve the validity of wearable-derived sleep metrics.
Objective:
This study aims to describe the development of a new user-centric algorithm, compare its performance with the default calendar-relative algorithm, and provide a practical guide for analyzing All of Us Fitbit sleep data on a cloud-based platform.
Methods:
The default and user-centric algorithms were implemented to preprocess and compute sleep metrics related to schedule, duration, and disturbances using high-resolution Fitbit sleep data from 8563 participants (median age 58.1 years, 6002/8341, 71.96%, female) in the All of Us Research Program (version 7 Controlled Tier). Variations in typical sleep patterns were calculated by examining the differences in the mean number of primary sleep logs classified by each algorithm. Linear mixed-effects models were used to compare differences in sleep metrics across quartiles of variation in typical sleep patterns.
Results:
Out of 8,452,630 total sleep logs collected over a median of 4.2 years of Fitbit monitoring, 401,777 (4.75%) nonprimary sleep logs identified by the default algorithm were reclassified as primary sleep by the user-centric algorithm. Variation in typical sleep patterns ranged from –0.08 to 1. Among participants with the greatest variation in typical sleep patterns, the user-centric algorithm identified significantly more total sleep time (by 17.6 minutes; P<.001), more wake after sleep onset (by 13.9 minutes; P<.001), and lower sleep efficiency (by 2.0%; P<.001), on average. Differences in sleep stage metrics between the 2 algorithms were modest.
Conclusions:
The user-centric algorithm captures the natural variability in sleep schedules, providing an alternative approach to preprocess and evaluate sleep metrics related to schedule, duration, and disturbances. A publicly available R package facilitates the implementation of this algorithm for clinical and translational research.
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A Scalable Framework for Evaluating Health Language Models
Neil Mallinar
Tony Faranesh
Brent Winslow
Nova Hammerquist
Ben Graef
Cathy Speed
Mark Malhotra
Shwetak Patel
Xavi Prieto
Daniel McDuff
Ahmed Metwally
(2025)
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Large language models (LLMs) have emerged as powerful tools for analyzing complex datasets. Recent studies demonstrate their potential to generate useful, personalized responses when provided with patient-specific health information that encompasses lifestyle, biomarkers, and context. As LLM-driven health applications are increasingly adopted, rigorous and efficient one-sided evaluation methodologies are crucial to ensure response quality across multiple dimensions, including accuracy, personalization and safety. Current evaluation practices for open-ended text responses heavily rely on human experts. This approach introduces human factors and is often cost-prohibitive, labor-intensive, and hinders scalability, especially in complex domains like healthcare where response assessment necessitates domain expertise and considers multifaceted patient data. In this work, we introduce Adaptive Precise Boolean rubrics: an evaluation framework that streamlines human and automated evaluation of open-ended questions by identifying gaps in model responses using a minimal set of targeted rubrics questions. Our approach is based on recent work in more general evaluation settings that contrasts a smaller set of complex evaluation targets with a larger set of more precise, granular targets answerable with simple boolean responses. We validate this approach in metabolic health, a domain encompassing diabetes, cardiovascular disease, and obesity. Our results demonstrate that Adaptive Precise Boolean rubrics yield higher inter-rater agreement among expert and non-expert human evaluators, and in automated assessments, compared to traditional Likert scales, while requiring approximately half the evaluation time of Likert-based methods. This enhanced efficiency, particularly in automated evaluation and non-expert contributions, paves the way for more extensive and cost-effective evaluation of LLMs in health.
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