Weighted Temporal Decay Loss for Learning Wearable PPG Data with Sparse Clinical Labels

Advances in wearable computing and AI have increased interest in leveraging PPG for health monitoring over the past decade. One of the biggest challenges in developing health algorithms based on such biosignals is the sparsity of clinical labels, which makes biosignals temporally distant from lab draws less reliable for supervision. To address this problem, we introduce a simple training strategy that learns a biomarker-specific decay of sample weight over the time gap between a segment and its ground truth label and uses this weight in the loss with a regularizer to prevent trivial solutions. On smartwatch PPG from 450 participants across 10 biomarkers, the approach improves over baselines. In the subject-wise setting, the proposed approach averages 0.715 AUPRC, compared to 0.674 for a fine-tuned self-supervised baseline and 0.626 for a feature-based Random Forest. A comparison of four decay families shows that a simple linear decay function is most robust on average. Beyond accuracy, the learned decay rates summarize how quickly each biomarker's PPG evidence becomes stale, providing an interpretable view of temporal sensitivity.

Wavelet-Driven Masked Multiscale Reconstruction for PPG Foundation Models

Wearable foundation models have the potential to transform digital health by learning transferable representations from large-scale biosignals collected in everyday settings. While recent progress has been made in large-scale pretraining, most approaches overlook the spectral structure of photoplethysmography (PPG) signals, wherein physiological rhythms unfold across multiple frequency bands. Motivated by the insight that many downstream health-related tasks depend on multi-resolution features spanning fine-grained waveform morphology to global rhythmic dynamics, we introduce Masked Multiscale Reconstruction (MMR) for PPG representation learning - a self-supervised pretraining framework that explicitly learns from hierarchical time-frequency scales of PPG data. The pretraining task is designed to reconstruct randomly masked out coefficients obtained from a wavelet-based multiresolution decomposition of PPG signals, forcing the transformer encoder to integrate information across temporal and spectral scales. We pretrain our model with MMR using ~17 million unlabeled 10-second PPG segments from ~32,000 smartwatch users. On 17 of 19 diverse health-related tasks, MMR trained on large-scale wearable PPG data improves over or matches state-of-the-art open-source PPG foundation models, time-series foundation models, and other self-supervised baselines. Extensive analysis of our learned embeddings and systematic ablations underscores the value of wavelet-based representations, showing that they capture robust and physiologically-grounded features. Together, these results highlight the potential of MMR as a step toward generalizable PPG foundation models.