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Overcoming Data Loss in Wearable Disease Detection with GAN-Based Imputation
Jürgen Wallner1, Sarah Berbuir2, Lukas Birner2
1Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.
NPJ Digital Medicine
|March 28, 2026
Summary
A new generative adversarial network (GAN) framework effectively imputes missing heart rate data from wearables, enabling earlier infectious disease detection. This technology significantly improves early warning systems, especially in resource-limited areas with data gaps.
Area of Science:
- Digital Health
- Infectious Disease Surveillance
- Machine Learning
Background:
- High rates of missing data in wearable sensor streams impede early detection of infectious diseases.
- Low-resource settings face challenges with device adherence and connectivity, exacerbating data loss.
- Existing methods struggle to reliably impute physiological data for timely disease surveillance.
Purpose of the Study:
- To develop and evaluate a lightweight generative adversarial network (GAN) framework for imputing missing heart rate data.
- To integrate the GAN imputation with an anomaly detection algorithm for early identification of infections.
- To assess the system's effectiveness in a real-world setting with significant data loss.
Main Methods:
- Developed a lightweight generative adversarial network (GAN) framework for heart rate data imputation.
- Integrated the GAN with a rule-based anomaly detection algorithm for infection alerts.
- Validated the system on a cohort in rural Kenya (n=300) with high rates of missing data.
Main Results:
- The system triggered early alerts in 100 cases, with 42 alerts solely due to imputation.
- Alerts preceded symptom onset by an average of 11.9 days.
- Despite 50% data coverage, early detection improved by 35%, with alerts occurring during the infection window.
- The GAN, trained on COVID-19 data, generalized to malaria, reducing reconstruction error by 58%.
Conclusions:
- The developed GAN framework offers a scalable solution for physiological monitoring despite high wearable data loss.
- This approach enhances early infectious disease detection and provides a robust tool for disease surveillance in challenging environments.
- The cross-pathogen generalization capability of the GAN highlights its potential for broad public health applications.

