Introduction: There is increasing interest in developing mathematical and computational models to forecast adverse events in physiological systems. Examples include falls, the onset of fatal cardiac arrhythmias, and adverse surgical outcomes. However, the dynamics of physiological systems are known to be exceedingly complex and perhaps even chaotic. Since no model can be perfect, it becomes important to understand how forecasting can be improved, especially when training data is limited. An adverse event that can be readily studied in the laboratory is the occurrence of stick falls when humans attempt to balance a stick on their fingertips. Over the last 20 years, this task has been extensively investigated experimentally, and presently detailed mathematical models are available. Methods: Here we use a long short-term memory (LTSM) deep learning network to forecast stick falls. We train this model to forecast stick falls in three ways: 1) using only data generated by the mathematical model (synthetic data), 2) using only stick balancing recordings of stick falls measured using high-speed motion capture measurements (human data), and 3) using transfer learning which combines a model trained using synthetic data plus a small amount of human balancing data. Results: We observe that the LTSM model is much more successful in forecasting a fall using synthetic data than it is in forecasting falls for models trained with limited available human data. However, with transfer learning, i.e., the LTSM model pre-trained with synthetic data and re-trained with a small amount of real human balancing data, the ability to forecast impending falls in human data is vastly improved. Indeed, it becomes possible to correctly forecast 60%-70% of real human stick falls up to 2.35 s in advance. Conclusion: These observations support the use of model-generated data and transfer learning techniques to improve the ability of computational models to forecast adverse physiological events.
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