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We investigated performance of a non-invasive wearable utilising photoplethysmography (PPG), to provide real-time risk prediction in hospitalised individuals. We performed a prospective observational clinical study in Vietnam between January 2020 and October 2022: 153 patients were included in analyses, providing 1353\u2009h of PPG data. Using a multi-modal transformer approach, 10-min PPG waveform segments and basic clinical data (age, sex, clinical features on admission) were used as features to continuously forecast clinical state 2\u2009h ahead. Prediction of low-risk states (17,939\/80,843; 22.1%), defined by NEWS2 and mSOFA\u2009&lt;\u20096, was associated with an area under the precision-recall curve of 0.67 and an area under the receiver operator curve of 0.83. Implementation of such interventions could provide cost-effective triage and clinical care in dengue, offering opportunities for safe ambulatory patient management.<\/jats:p>","DOI":"10.1038\/s41746-024-01304-4","type":"journal-article","created":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T05:02:56Z","timestamp":1730523776000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Predicting deterioration in dengue using a low cost wearable for continuous clinical monitoring"],"prefix":"10.1038","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3125-6378","authenticated-orcid":false,"given":"Damien Keng","family":"Ming","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4464-2625","authenticated-orcid":false,"given":"John","family":"Daniels","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1840-0868","authenticated-orcid":false,"given":"Ho Quang","family":"Chanh","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3638-0741","authenticated-orcid":false,"given":"Stefan","family":"Karolcik","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1010-3559","authenticated-orcid":false,"given":"Bernard","family":"Hernandez","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9145-9328","authenticated-orcid":false,"given":"Vasileios","family":"Manginas","sequence":"additional","affiliation":[]},{"given":"Van Hao","family":"Nguyen","sequence":"additional","affiliation":[]},{"given":"Quang Huy","family":"Nguyen","sequence":"additional","affiliation":[]},{"given":"Tu Qui","family":"Phan","sequence":"additional","affiliation":[]},{"given":"Thi Hue Tai","family":"Luong","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4922-6548","authenticated-orcid":false,"given":"Huynh Trung","family":"Trieu","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5554-5743","authenticated-orcid":false,"given":"Alison Helen","family":"Holmes","sequence":"additional","affiliation":[]},{"given":"Vinh Tho","family":"Phan","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2476-3857","authenticated-orcid":false,"given":"Pantelis","family":"Georgiou","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2910-7819","authenticated-orcid":false,"given":"Sophie","family":"Yacoub","sequence":"additional","affiliation":[]},{"name":"On behalf of the VITAL consortium","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2024,11,2]]},"reference":[{"key":"1304_CR1","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1016\/S0140-6736(18)32560-1","volume":"393","author":"A Wilder-Smith","year":"2019","unstructured":"Wilder-Smith, A., Ooi, E.-E., Horstick, O., & Wills, B. 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