Age-Conditioned Evaluation of Handcrafted Polysomnography Models for Cognitive-Impairment Prediction

Raghavendra Satwik Kapavarapu1, Nathan Hoang2, Andrei V Malagusan2
1University of Washington Seattle, 2Georgia Institute of Technology


Abstract

Sleep disturbances have been associated with cognitive decline, but generalizable prediction from routine polysomnography remains difficult. As team gdub, we developed a CPU-oriented system that represented each study with 830 handcrafted demographic, physiological, and annotation-derived features. Training-cohort preprocessing removed configured BMI and coverage/missingness fields, excluded the 30\% of candidate features with the largest cross-site Kolmogorov--Smirnov statistics, and applied median imputation. ExtraTrees, CatBoost, and LightGBM probabilities were averaged and calibrated with out-of-fold isotonic regression; the submitted system also included an age-binned LambdaRank score and an age-local prevalence rule for binary predictions. In strict public three-site leave-one-site-out (LOSO) evaluation of the classifier path with LambdaRank disabled, the submitted KS setting achieved a macro age-conditioned AUROC of 0.654. Official hidden validation of submission 2163 produced an age-conditioned AUROC of 0.486 despite an ordinary AUROC of 0.746. This discrepancy indicates that all-pair discrimination did not persist among age-comparable participants and identifies age-conditioned cross-source generalization as the principal limitation of the submitted approach.