WEQA: Wearable hEalth Question Answering with Query-Adaptive Agentic Reasoning

Language models are remarkably capable at medical question answering, in some cases surpassing the accuracy of general physicians. However, answering questions about wearable health data remains challenging and understudied, as these ubiquitous sensors produce continuous, high-dimensional, and longitudinal data, which is non-trivial to align with text-centric distributions in LLM pretraining. The diversity of sensor modalities and user intents cannot be effectively handled by a fixed reasoning workflow or a single pretrained foundation model. To address these challenges, we propose WEQA, a query-adaptive agent framework that unifies LLM reasoning with specialized wearable analytical and modeling tools. An LLM controller is employed to synthesize execution plans and dynamically route each query to the appropriate combination of sensor analysis and pretrained models, and perform grounded response auditing with external knowledge. We also curate a benchmark spanning four open wearable datasets comprising analytic and predictive tasks in three different health domains. Experiments show that our framework is 24% more accurate than LLM and agentic baselines, and a blinded study with 12 medical experts and 8 users shows substantial gains in usefulness and clinical soundness.

ADAPTOOD: Uncertainty-Aware Fine-Tuning for Out-of-Distribution ECG Time Series Models

Data samples used for training often differ from those encountered during fine-tuning and deployment, and while ML models show promise, their performance remains limited when only small annotated datasets are available. Performance often degrades under distribution shifts caused by diverse sensors, populations, and application settings. Although pre-training helps, models frequently encounter out-of-distribution (OOD) data in real-world settings, leading to reduced robustness. Existing adaptation methods usually assume fixed distribution shifts and struggle when multiple types or severities occur. In particular, they overlook shift severity, for example treating adaptation to a large familiar dataset the same as adaptation to a small dataset with a new task, which limits generalisation. To address this, we propose ADAPTOOD, a novel framework that leverages data uncertainty to quantify distribution shift severity and guide fine-tuning for time series. This uncertainty measures how strongly samples from the target deployment distribution deviate from the pre-training distribution, providing a direct signal of OOD severity. Our framework combines this uncertainty with low-rank model updates and adaptive hyperparameter optimisation to improve adaptation. We show that ADAPTOOD achieves up to 7% higher accuracy and 12.9% higher precision than existing methods in OOD tasks, maintaining strong performance as distribution shift severity increases.

VitalAgent: A Tool-Augmented Agent for Reactive and Proactive Physiological Monitoring over Wearable Health Data

Wearable devices enable continuous monitoring of physiological signals such as ECG and PPG, but existing mHealth systems are largely limited to task-specific prediction pipelines or reactive question answering over static summaries. They lack the ability to support temporal reasoning, persistent physiological context, and proactive monitoring over long-term signal streams. We propose VitalAgent, a tool-augmented agentic framework for ECG/PPG-based mHealth that supports both reactive question answering and proactive monitoring. VitalAgent is built on a longitudinal physiological memory and a tool-augmented reasoning interface that enables dynamic computation over raw signals. We further introduce VitalBench, a longitudinal physiological monitoring benchmark dataset comprising 1,862 QA pairs for reactive question answering and 90.2 hours of continuous ECG/PPG recordings for proactive monitoring, covering cardiac, physical activity, and stress-related tasks. Experiments demonstrate that VitalAgent achieves over 30% improvement over prompt-based and ReAct baselines in reactive evaluation and supports proactive alert monitoring over long-term physiological signals, highlighting the importance of dynamic tool use and long-term physiological monitoring.

Wearable Foundation Models Should Go Beyond Static Encoders

Wearable foundation models (WFMs), trained on large volumes of data collected by affordable, always-on devices, have demonstrated strong performance on short-term, well-defined health monitoring tasks, including activity recognition, fitness tracking, and cardiovascular signal assessment. However, most existing WFMs primarily map short temporal windows to predefined labels via static encoders, emphasizing retrospective prediction rather than reasoning over evolving personal history, context, and future risk trajectories. As a result, they are poorly suited for modeling chronic, progressive, or episodic health conditions that unfold over weeks, months or years. Hence, we argue that WFMs must move beyond static encoders and be explicitly designed for longitudinal, anticipatory health reasoning. We identify three foundational shifts required to enable this transition: (1) Structurally rich data, which goes beyond isolated datasets or outcome-conditioned collection to integrated multimodal, long-term personal trajectories, and contextual metadata, ideally supported by open and interoperable data ecosystems; (2) Longitudinal-aware multimodal modeling, which prioritizes long-context inference, temporal abstraction, and personalization over cross-sectional or population-level prediction; and (3) Agentic inference systems, which move beyond static prediction to support planning, decision-making, and clinically grounded intervention under uncertainty. Together, these shifts reframe wearable health monitoring from retrospective signal interpretation toward continuous, anticipatory, and human-aligned health support.

Learning Transferable Sensor Models via Language-Informed Pretraining

Modern sensing systems generate large volumes of unlabeled multivariate time-series data. This abundance of unlabeled data makes self-supervised learning (SSL) a natural approach for learning transferable representations. However, most existing approaches are optimized for reconstruction or forecasting objectives and often fail to capture the semantic structure required for downstream classification and reasoning tasks. While recent sensor-language alignment methods improve semantic generalization through captioning and zero-shot transfer, they are limited to fixed sensor configurations, such as predefined channel sets, signal lengths, or temporal resolutions, which hinders cross-domain applicability. To address these gaps, we introduce \textbf{SLIP} (\textbf{S}ensor \textbf{L}anguage-\textbf{I}nformed \textbf{P}retraining), an open-source framework for learning language-aligned representations that generalize across diverse sensor setups. SLIP integrates contrastive alignment with sensor-conditioned captioning, facilitating both discriminative understanding and generative reasoning. By repurposing a pretrained decoder-only language model via cross-attention and introducing an elegant, flexible patch-embedder, SLIP supports different temporal resolutions and variable-length input at inference time without additional retraining. Across 11 datasets, SLIP demonstrates superior performance in zero-shot transfer, signal captioning, and question answering. It achieves a 77.14% average linear-probing accuracy, a 5.93% relative improvement over strong baselines, and reaches 64.83% accuracy in sensor-based question answering.