Supplemental Metrics for ECG Reading (#47)

# Supplemental Metrics for ECG Reading

## ♻️ Current situation & Problem
Building on top of #40, this pull request seeks to package ECG readings
with supplemental information like VO2 max and pulse rate in a way that
is sensitive to the possible limitations of current recording
capabilities.


## ⚙️ Release Notes 
- Measures most recent VO2 max known at the time of ECG recording.
- Captures pulse rate via optical sensor at T-minus five minutes and
T-plus five minutes.
- Captures activity metrics at T-minus five minutes and T-plus five
minutes, inlcuding:
  - Active calories.
  - Step count.
  - Standing minutes.
- Collects readings of heart rate from optical sensor at intervals of 10
minutes for first two days of the study.
- Estimates amount of time watch has been worn each day.


## 📚 Documentation
In-line documentation will be written in relevant files in conformance
to the [Spezi Documentation
Guide](https://github.com/StanfordSpezi/.github/blob/main/DOCUMENTATIONGUIDE.md).


## ✅ Testing
Tests may be added for ensuring that data is correctly serialized and
properly handled.


### Code of Conduct & Contributing Guidelines 

By submitting creating this pull request, you agree to follow our [Code
of
Conduct](https://github.com/StanfordBDHG/.github/blob/main/CODE_OF_CONDUCT.md)
and [Contributing
Guidelines](https://github.com/StanfordBDHG/.github/blob/main/CONTRIBUTING.md):
- [x] I agree to follow the [Code of
Conduct](https://github.com/StanfordBDHG/.github/blob/main/CODE_OF_CONDUCT.md)
and [Contributing
Guidelines](https://github.com/StanfordBDHG/.github/blob/main/CONTRIBUTING.md).

PAWS/ECGRecordings/ECGRecording.swift

@@ -40,3 +40,110 @@ struct ECGRecording: View {
  }
  }
 }
+
+extension HKElectrocardiogram {
+ private var oneDayPredicate: NSPredicate {
+ HKQuery.predicateForSamples(
+ withStart: Calendar.current.date(byAdding: .day, value: -1, to: self.startDate), // 24 hours before recording.
+ end: self.startDate,
+ options: .strictStartDate
+ )
+ }
+
+ private var fiveMinutePredicate: NSPredicate {
+ HKQuery.predicateForSamples(
+ withStart: Calendar.current.date(byAdding: .minute, value: -5, to: self.startDate), // 5 minutes before recording.
+ end: self.startDate,
+ options: .strictStartDate
+ )
+ }
+
+ var precedingPulseRates: [HKQuantitySample] {
+ get async throws {
+ try await precedingSamples(forType: HKQuantityType(.heartRate))
+ }
+ }
+
+ var precedingVo2Max: HKQuantitySample? {
+ get async throws {
+ try await precedingSamples(
+ forType: HKQuantityType(.vo2Max),
+ sortDescriptors: [SortDescriptor(\.startDate, order: .reverse)],
+ limit: 1
+ )
+ .first
+ }
+ }
+
+ var precedingPhysicalEffort: [HKQuantitySample] {
+ get async throws {
+ try await precedingSamples(forType: HKQuantityType(.physicalEffort))
+ }
+ }
+
+ var precedingStepCount: [HKQuantitySample] {
+ get async throws {
+ try await precedingSamples(forType: HKQuantityType(.stepCount))
+ }
+ }
+
+ var precedingActiveEnergy: [HKQuantitySample] {
+ get async throws {
+ try await precedingSamples(forType: HKQuantityType(.activeEnergyBurned))
+ }
+ }
+
+ private func precedingSamples(
+ forType type: HKSampleType,
+ sortDescriptors: [SortDescriptor<HKSample>] = [SortDescriptor(\.startDate)],
+ limit: Int? = nil
+ ) async throws -> [HKSample] {
+ let store = HKHealthStore()
+ let queryDescriptor = HKSampleQueryDescriptor(
+ predicates: [.sample(type: type, predicate: self.fiveMinutePredicate)],
+ sortDescriptors: sortDescriptors,
+ limit: limit
+ )
+
+ // If something is available in last 5 minutes since recording, return those samples.
+ if let result = try? await queryDescriptor.result(for: store), !result.isEmpty {
+ return result
+ }
+
+ // Otherwise, request the last 24 hours of samples.
+ let extendedQueryDescriptor = HKSampleQueryDescriptor(
+ predicates: [.sample(type: type, predicate: self.oneDayPredicate)],
+ sortDescriptors: sortDescriptors,
+ limit: limit
+ )
+
+ return try await extendedQueryDescriptor.result(for: store)
+ }
+
+ private func precedingSamples(
+ forType type: HKQuantityType,
+ sortDescriptors: [SortDescriptor<HKQuantitySample>] = [SortDescriptor(\.startDate)],
+ limit: Int? = nil
+ ) async throws -> [HKQuantitySample] {
+ let store = HKHealthStore()
+ let queryDescriptor = HKSampleQueryDescriptor(
+ predicates: [.quantitySample(type: type, predicate: self.fiveMinutePredicate)],
+ sortDescriptors: sortDescriptors,
+ limit: limit
+ )
+
+ // If something is available in last 5 minutes since recording, return those samples.
+ if let result = try? await queryDescriptor.result(for: store), !result.isEmpty {
+ return result
+ }
+
+ // Otherwise, request the last 24 hours of samples.
+ let extendedQueryDescriptor = HKSampleQueryDescriptor(
+ predicates: [.quantitySample(type: type, predicate: self.oneDayPredicate)],
+ sortDescriptors: sortDescriptors,
+ limit: limit
+ )
+
+ return try await extendedQueryDescriptor.result(for: store)
+ }
+}

PAWS/PAWSDelegate.swift

@@ -77,7 +77,7 @@ class PAWSDelegate: SpeziAppDelegate {
  // Collection starts at the time the user consents and lasts for 1 month.
  let sharedPredicate = HKQuery.predicateForSamples(
  withStart: healthKitStartDate,
- end: Calendar.current.date(byAdding: DateComponents(month: 1), to: healthKitStartDate),
+ end: Calendar.current.date(byAdding: DateComponents(month: 6), to: healthKitStartDate),
  options: .strictEndDate
  )
 
@@ -90,7 +90,32 @@ class PAWSDelegate: SpeziAppDelegate {
  CollectSamples(
  Set(HKElectrocardiogram.correlatedSymptomTypes),
  predicate: sharedPredicate,
- deliverySetting: .background(saveAnchor: false)
+ deliverySetting: .background(saveAnchor: true)
+ )
+ CollectSample(
+ HKQuantityType(.heartRate),
+ predicate: sharedPredicate,
+ deliverySetting: .background(saveAnchor: true)
+ )
+ CollectSample(
+ HKQuantityType(.vo2Max),
+ predicate: sharedPredicate,
+ deliverySetting: .manual(safeAnchor: false)
+ )
+ CollectSample(
+ HKQuantityType(.physicalEffort),
+ predicate: sharedPredicate,
+ deliverySetting: .manual(safeAnchor: false)
+ )
+ CollectSample(
+ HKQuantityType(.stepCount),
+ predicate: sharedPredicate,
+ deliverySetting: .manual(safeAnchor: false)
+ )
+ CollectSample(
+ HKQuantityType(.activeEnergyBurned),
+ predicate: sharedPredicate,
+ deliverySetting: .manual(safeAnchor: false)
  )
  }
  }

PAWS/PAWSStandard.swift

@@ -68,20 +68,43 @@ actor PAWSStandard: Standard, EnvironmentAccessible, HealthKitConstraint, Onboar
 
 
  func add(sample: HKSample) async {
+ var supplementalMetrics: [HKSample] = []
+
  if let hkElectrocardiogram = sample as? HKElectrocardiogram {
  ecgStorage.hkElectrocardiograms.append(hkElectrocardiogram)
+
+ do {
+ supplementalMetrics.append(contentsOf: try await hkElectrocardiogram.precedingPulseRates)
+ supplementalMetrics.append(contentsOf: try await hkElectrocardiogram.precedingPhysicalEffort)
+ supplementalMetrics.append(contentsOf: try await hkElectrocardiogram.precedingStepCount)
+ supplementalMetrics.append(contentsOf: try await hkElectrocardiogram.precedingActiveEnergy)
+
+ if let precedingVo2Max = try await hkElectrocardiogram.precedingVo2Max {
+ supplementalMetrics.append(precedingVo2Max)
+ }
+ } catch {
+ logger.log("Could not access HealthKit sample: \(error)")
+ }
  }
 
  if let mockWebService {
  let encoder = JSONEncoder()
  encoder.outputFormatting = [.prettyPrinted, .sortedKeys, .withoutEscapingSlashes]
  let jsonRepresentation = (try? String(data: encoder.encode(sample.resource), encoding: .utf8)) ?? ""
  try? await mockWebService.upload(path: "healthkit/\(sample.uuid.uuidString)", body: jsonRepresentation)
+
+ for metric in supplementalMetrics {
+ try? await mockWebService.upload(path: "healthkit/\(metric.uuid.uuidString)", body: (try? String(data: encoder.encode(metric.resource), encoding: .utf8)) ?? "")
+ }
+
  return
  }
 
  do {
  try await healthKitDocument(id: sample.id).setData(from: sample.resource)
+ for metric in supplementalMetrics {
+ try await healthKitDocument(id: sample.id).setData(from: metric.resource)
+ }
  } catch {
  logger.error("Could not store HealthKit sample: \(error)")
  }