Anran Wang
Anran is a Senior Research Scientist at Google. He is passionate about using technology to improve everyday health and safety. His research focuses on creating real-time sensing systems with signal processing and machine learning algorithms for the mobile and wearable devices we use daily. He aims to build new, reliable ways for our technology to understand our well-being and make life safer and healthier.
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SymptomAI: Toward a Conversational AI Agent for Everyday Symptom Assessment
Joe Breda
Fadi Yousif
Beszel Hawkins
Marinela Cotoi
Miao Liu
Ray Luo
Sam Schmidgall
Girish Narayanswamy
Samuel Solomon
Max Xu
Longfei Shangguan
Bhavna Daryani
Buddy Herkenham
Cara Tan
Mark Malhotra
Shwetak Patel
Zach Wasson
Dimitrios Antos
Bob Lou
Matthew Thompson
Jonathan Richina
Anupam Pathak
Nichole Young-Lin
Jake Sunshine
Daniel McDuff
Arxiv preprint, 2605.040 (2026) (to appear)
Preview abstract
Language models excel at diagnostic assessments on curated medical case-studies and vignettes, performing on par with, or better than, clinical professionals. However, existing studies focus on complex scenarios with rich context making it difficult to draw conclusions about how these systems perform for patients reporting symptoms in everyday life. We deployed SymptomAI, a set of conversational AI agents for end-to-end patient interviewing and differential diagnosis (DDx), via the Fitbit app in a study that randomized participants (N=13,917) to interact with five AI agents. This corpus captures diverse communication and a realistic distribution of illnesses from a real world population. A subset of 1,228 participants reported a clinician-provided diagnosis, and 517 of these were further evaluated by a panel of clinicians during over 250 hours of annotation. SymptomAI DDx were significantly more accurate (OR = 2.56, p < 0.001) than those from independent clinicians given the same dialogue in a blinded randomized comparison. Moreover, agentic strategies which conduct a dedicated symptom interview that elicit additional symptom information before providing a diagnosis, perform substantially better than baseline, user-guided conversations (p < 0.001). An auxiliary analysis on 1,509 conversations from a general US population panel validated that these results generalize beyond wearable device users. We used SymptomAI diagnoses as labels for all 13,917 participants to analyze over 500,000 days of wearable metrics across nearly 400 unique conditions. We identified strong associations between acute infections and physiological shifts (e.g., OR > 7 for influenza). While limited by self-reported ground truth, these results demonstrate the benefits of a dedicated and complete symptom interview compared to a user-guided symptom discussion, which is the default of most consumer LLMs.
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Automated loss of pulse detection on a commercial smartwatch
Kamal Shah
Yiwen Chen
Anthony Stange
Lawrence Cai
Matt Wimmer
Pramod Rudrapatna
Shelten Yuen
Anupam Pathak
Shwetak Patel
Mark Malhotra
Marc Stogaitis
Jeanie Phan
Ali Connell
Jim Taylor
Jacqueline Shreibati
Daniel McDuff
Tajinder Gadh
Jake Sunshine
Nature, 642 (2025), pp. 174-181
Preview abstract
Out-of-hospital cardiac arrest is a time-sensitive emergency that requires prompt identification and intervention: sudden, unwitnessed cardiac arrest is nearly unsurvivable. A cardinal sign of cardiac arrest is sudden loss of pulse. Automated biosensor detection of unwitnessed cardiac arrest, and dispatch of medical assistance, may improve survivability given the substantial prognostic role of time, but only if the false-positive burden on public emergency medical systems is minimized. Here we show that a multimodal, machine learning-based algorithm on a smartwatch can reach performance thresholds making it deployable at a societal scale. First, using photoplethysmography, we show that wearable photoplethysmography measurements of peripheral pulselessness (induced through an arterial occlusion model) manifest similarly to pulselessness caused by a common cardiac arrest arrhythmia, ventricular fibrillation. On the basis of the similarity of the photoplethysmography signal (from ventricular fibrillation or arterial occlusion), we developed and validated a loss of pulse detection algorithm using data from peripheral pulselessness and free-living conditions. Following its development, we evaluated the end-to-end algorithm prospectively: there was 1 unintentional emergency call per 21.67 user-years across two prospective studies; the sensitivity was 67.23% (95% confidence interval of 64.32% to 70.05%) in a prospective arterial occlusion cardiac arrest simulation model. These results indicate an opportunity, deployable at scale, for wearable-based detection of sudden loss of pulse while minimizing societal costs of excess false detections.
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