Resident physicians (residents) experiencing prolonged workplace stress are at risk of developing mental health symptoms. Creating novel, unobtrusive measures of resilience would provide an accessible approach to evaluate symptom susceptibility without the perceived stigma of formal mental health assessments. In this work, we created a system to find indicators of resilience using passive wearable sensors and smartphone-delivered ecological momentary assessment (EMA). This system identified indicators of resilience during a medical internship, the high stress first-year of a residency program. We then created density estimation approaches to predict these indicators before mental health changes occurred, and validated whether the predicted indicators were also associated with resilience. Our system identified resilience indicators associated with physical activity (step count), sleeping behavior, reduced heart rate, increased mood, and reduced mood variability. Density estimation models were able to replicate a subset of the associations between sleeping behavior, heart rate, and resilience. To the best of our knowledge, this work provides the first methodology to identify and predict indicators of resilience using passive sensing and EMA. Researchers studying resident mental health can apply this approach to design resilience-building interventions and prevent mental health symptom development.

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Time-to-event analysis is an important statistical tool for allocating clinical resources such as ICU beds. However, classical techniques like the Cox model cannot directly incorporate images due to their high dimensionality. We propose a deep learning approach that naturally incorporates multiple, time-dependent imaging studies as well as non-imaging data into time-to-event analysis. Our techniques are benchmarked on a clinical dataset of 1,894 COVID-19 patients, and show that image sequences significantly improve predictions. For example, classical time-to-event methods produce a concordance error of around 30-40% for predicting hospital admission, while our error is 25% without images and 20% with multiple X-rays included. Ablation studies suggest that our models are not learning spurious features such as scanner artifacts and that models which use multiple images tend to perform better than those which only use one. While our focus and evaluation is on COVID-19, the methods we develop are broadly applicable.