Guy Lutsker
Publications
Simulating clinical interventions with a generative multimodal model of human physiology
Understanding how human health changes over time, and why responses to interventions vary between individuals, remains a central challenge in medicine. Here we present HealthFormer, a decoder-only transformer that models the human physiological trajectory generatively, by training on data from the Human Phenotype Project, a multi-visit cohort of over 15,000 deeply phenotyped individuals. We tokenise each participant's health trajectory across 667 measurements spanning seven domains: blood biomarkers, body composition, sleep physiology, continuous glucose monitoring, gut microbiome, wearable-derived physiology, and behaviour and medication exposure. We train HealthFormer to forecast individual physiological trajectories across these domains, and from this single generative objective a range of clinically relevant tasks can be expressed as queries on the model. We show that, without task-specific training, HealthFormer transfers to four independent cohorts and improves prediction for 27 of 30 incident-disease and mortality endpoints, exceeding established clinical risk scores in every comparison. We further show that the model can simulate interventions in silico: in a held-out personalised-nutrition trial, intervention-conditioned predictions recover individual six-month biomarker changes (e.g., Pearson r = 0.78 for diastolic blood pressure). Across 41 randomised intervention-outcome comparisons drawn from published trials, our results show that the predicted direction of effect agrees in every case, and the predicted mean falls within the reported 95% confidence interval in 30 cases. We position HealthFormer as an initial health world model, from which forecasting, risk stratification, and intervention-conditioned simulation arise as queries, providing a basis for clinical digital twins.
A Gait Foundation Model Predicts Multi-System Health Phenotypes from 3D Skeletal Motion
Gait is increasingly recognized as a vital sign, yet current approaches treat it as a symptom of specific pathologies rather than a systemic biomarker. We developed a gait foundation model for 3D skeletal motion from 3,414 deeply phenotyped adults, recorded via a depth camera during five motor tasks. Learned embeddings outperformed engineered features, predicting age (Pearson r = 0.69), BMI (r = 0.90), and visceral adipose tissue area (r = 0.82). Embeddings significantly predicted 1,980 of 3,210 phenotypic targets; after adjustment for age, BMI, VAT, and height, gait provided independent gains in all 18 body systems in males and 17 of 18 in females, and improved prediction of clinical diagnoses and medication use. Anatomical ablation revealed that legs dominated metabolic and frailty predictions while torso encoded sleep and lifestyle phenotypes. These findings establish gait as an independent multi-system biosignal, motivating translation to consumer-grade video and its integration as a scalable, passive vital sign.
MoHETS: Long-term Time Series Forecasting with Mixture-of-Heterogeneous-Experts
Real-world multivariate time series can exhibit intricate multi-scale structures, including global trends, local periodicities, and non-stationary regimes, which makes long-horizon forecasting challenging. Although sparse Mixture-of-Experts (MoE) approaches improve scalability and specialization, they typically rely on homogeneous MLP experts that poorly capture the diverse temporal dynamics of time series data. We address these limitations with MoHETS, an encoder-only Transformer that integrates sparse Mixture-of-Heterogeneous-Experts (MoHE) layers. MoHE routes temporal patches to a small subset of expert networks, combining a shared depthwise-convolution expert for sequence-level continuity with routed Fourier-based experts for patch-level periodic structures. MoHETS further improves robustness to non-stationary dynamics by incorporating exogenous information via cross-attention over covariate patch embeddings. Finally, we replace parameter-heavy linear projection heads with a lightweight convolutional patch decoder, improving parameter efficiency, reducing training instability, and allowing a single model to generalize across arbitrary forecast horizons. We validate across seven multivariate benchmarks and multiple horizons, with MoHETS consistently achieving state-of-the-art performance, reducing the average MSE by $12\%$ compared to strong recent baselines, demonstrating effective heterogeneous specialization for long-term forecasting.