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A Comprehensive Inference-Time Augmentation Framework in Physiological Signals: Application to PPG-Based AF

Davood Fattahi, Runze Yan, Saurabh Kataria

    Arxiv
    |June 24, 2026
    PubMed
    Summary

    Inference-time augmentation (ITA) enhances physiological signal classification by applying optimized transformations during real-time analysis. This model-agnostic approach improves accuracy for conditions like atrial fibrillation detection, even without retraining.

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    Area of Science:

    • Biomedical Engineering
    • Signal Processing
    • Machine Learning

    Background:

    • Physiological signal classification faces challenges from noise, artifacts, and data shifts in real-world applications.
    • Inference-time augmentation (ITA) offers a model-agnostic solution to improve robustness without retraining.
    • Current ITA methods for physiological signals are limited in scope and parameter optimization.

    Purpose of the Study:

    • To introduce a unified framework for inference-time augmentation (ITA) tailored for physiological signals.
    • To address the limitations of existing ITA methods by incorporating diverse transformations and optimized parameters.
    • To enhance the reliability of physiological signal classification in deployment settings.

    Main Methods:

    • Developed a framework integrating 13 augmentation techniques across time, amplitude, and frequency domains, plus artifact injection.

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  • Utilized Bayesian optimization to fine-tune hyperparameters for these augmentation methods.
  • Evaluated the framework on atrial fibrillation (AF) detection using photoplethysmography (PPG) signals with GPT-PPG and ResNet models across multiple datasets.

    • Main Results:

    • Standard ITA consistently improved Area Under the Receiver Operating Characteristic Curve (AUROC) and Area Under the Precision-Recall Curve (AUPRC) for AF detection.
    • GPT-PPG and ResNet models showed significant improvements in AUROC (up to 8.5% and 0.7%) and AUPRC (up to 10.6% and 0.8%).
    • Selective ITA further reduced the False Positive Rate (FPR) by up to 4.4% on non-AF datasets.

    Conclusions:

    • Inference-time augmentation (ITA) is a practical, model-agnostic strategy for enhancing PPG-based AF classification reliability.
    • The proposed framework effectively improves classification performance in deployment scenarios where retraining is impractical.
    • ITA demonstrates broad applicability for improving the robustness of various physiological signal analyses.