Early detection of infectious diseases using wearable sensor data through personalized baseline deviation modelling.

OBJECTIVE: Early detection of infectious diseases using physiological and behavioural signals from wearable devices could enable earlier intervention and help reduce disease transmission. This study proposes and evaluates a framework specifically designed for sequential early-warning aimed at detecting infectious disease episodes prior to clinical diagnosis. METHODS: In this retrospective observational cohort study, we used the Evidation 2019-2020 Fitbit dataset to formulate infection detection as an episode-level prediction problem. We designed augmented features that capture short-term deviations from each individual's healthy baseline over sliding windows and evaluated several machine learning models. The framework incorporates probability calibration, validation-based threshold selection, and an optional persistent two-day alarm rule to reduce false-positive alerts. RESULTS: Experiments on data from 435 participants showed that personalized deviation-based features substantially outperformed basic wearable features. The best-performing configuration achieved an episode-level F1-score of 0.784 with an Average Earliness (AE) of 0.555, corresponding to approximately 5.5 days before diagnosis. Additionally, combining step and sleep features provided a favourable trade-off between timeliness (AE = 0.69) and accuracy (F1 = 0.75). CONCLUSIONS: Personalized baseline-deviation features, combined with calibrated probabilities and persistent alarm mechanisms, enable accurate and timely early detection of infectious disease episodes from wearable data. The results indicate that recent individualized baselines and step-derived signals provide the most robust predictive information, supporting the potential of wearable devices as scalable tools for population-level infectious disease surveillance.