Filipe Barata

Mesut Ceylan, Alexis Tabin, Patrick Langer et al.

Wearable devices enable continuous, population-scale monitoring of physiological signals, such as photoplethysmography (PPG), creating new opportunities for data-driven clinical assessment. Time-series extrinsic regression (TSER) models increasingly leverage PPG signals to estimate clinically relevant outcomes, including heart rate, respiratory rate, and oxygen saturation. For clinical reasoning and trust, however, single point estimates alone are insufficient: clinicians must also understand whether predictions are stable under physiologically plausible variations and to what extent realistic, attainable changes in physiological signals would meaningfully alter a model's prediction. Counterfactual explanations (CFE) address these "what-if" questions, yet existing time series CFE generation methods are largely restricted to classification, overlook waveform morphology, and often produce physiologically implausible signals, limiting their applicability to continuous biomedical time series. To address these limitations, we introduce EvoMorph, a multi-objective evolutionary framework for generating physiologically plausible and diverse CFE for TSER applications. EvoMorph optimizes morphology-aware objectives defined on interpretable signal descriptors and applies transformations to preserve the waveform structure. We evaluated EvoMorph on three PPG datasets (heart rate, respiratory rate, and oxygen saturation) against a nearest-unlike-neighbor baseline. In addition, in a case study, we evaluated EvoMorph as a tool for uncertainty quantification by relating counterfactual sensitivity to bootstrap-ensemble uncertainty and data-density measures. Overall, EvoMorph enables the generation of physiologically-aware counterfactuals for continuous biomedical signals and supports uncertainty-aware interpretability, advancing trustworthy model analysis for clinical time-series applications.

Fan Wu, Matthias P. Nägele, Daryush D. Mehta et al.

Objective: This study aimed to evaluate which voice features can predict health deterioration in patients with chronic HF. Background: Heart failure (HF) is a chronic condition with progressive deterioration and acute decompensations, often requiring hospitalization and imposing substantial healthcare and economic burdens. Current standard-of-care (SoC) home monitoring, such as weight tracking, lacks predictive accuracy and requires high patient engagement. Voice is a promising non-invasive biomarker, though prior studies have mainly focused on acute HF stages. Methods: In a 2-month longitudinal study, 32 patients with HF collected daily voice recordings and SoC measures of weight and blood pressure at home, with biweekly questionnaires for health status. Acoustic analysis generated detailed vowel and speech features. Time-series features were extracted from aggregated lookback windows (e.g., 7 days) to predict next-day health status. Explainable machine learning with nested cross-validation identified top vocal biomarkers, and a case study illustrated model application. Results: A total of 21,863 recordings were analyzed. Acoustic vowel features showed strong correlations with health status. Time-series voice features within the lookback window outperformed corresponding standard care measures, achieving peak sensitivity and specificity of 0.826 and 0.782 versus 0.783 and 0.567 for SoC metrics. Key prognostic voice features identifying deterioration included delayed energy shift, low energy variability, and higher shimmer variability in vowels, along with reduced speaking and articulation rate, lower phonation ratio, decreased voice quality, and increased formant variability in speech. Conclusion: Voice-based monitoring offers a non-invasive approach to detect early health changes in chronic HF, supporting proactive and personalized care.

Patrick Langer, Thomas Kaar, Max Rosenblattl et al.

LLMs have emerged as powerful tools for interpreting multimodal data. In medicine, they hold particular promise for synthesizing large volumes of clinical information into actionable insights and digital health applications. Yet, a major limitation remains their inability to handle time series. To overcome this gap, we present OpenTSLM, a family of Time Series Language Models (TSLMs) created by integrating time series as a native modality to pretrained LLMs, enabling reasoning over multiple time series of any length. We investigate two architectures for OpenTSLM. The first, OpenTSLM-SoftPrompt, models time series implicitly by concatenating learnable time series tokens with text tokens via soft prompting. Although parameter-efficient, we hypothesize that explicit time series modeling scales better and outperforms implicit approaches. We thus introduce OpenTSLM-Flamingo, which integrates time series with text via cross-attention. We benchmark both variants against baselines that treat time series as text tokens or plots, across a suite of text-time-series Chain-of-Thought (CoT) reasoning tasks. We introduce three datasets: HAR-CoT, Sleep-CoT, and ECG-QA-CoT. Across all, OpenTSLM models outperform baselines, reaching 69.9 F1 in sleep staging and 65.4 in HAR, compared to 9.05 and 52.2 for finetuned text-only models. Notably, even 1B-parameter OpenTSLM models surpass GPT-4o (15.47 and 2.95). OpenTSLM-Flamingo matches OpenTSLM-SoftPrompt in performance and outperforms on longer sequences, while maintaining stable memory requirements. By contrast, SoftPrompt grows exponentially in memory with sequence length, requiring around 110 GB compared to 40 GB VRAM when training on ECG-QA with LLaMA-3B. Expert reviews by clinicians find strong reasoning capabilities exhibited by OpenTSLMs on ECG-QA. To facilitate further research, we provide all code, datasets, and models open-source.

Fan Wu, Kaicheng Zhao, Elgar Fleisch et al.

AI-based voice analysis shows promise for disease diagnostics, but existing classifiers often fail to accurately identify specific pathologies because of gender-related acoustic variations and the scarcity of data for rare diseases. We propose a novel two-stage framework that first identifies gender-specific pathological patterns using ResNet-50 on Mel spectrograms, then performs gender-conditioned disease classification. We address class imbalance through multi-scale resampling and time warping augmentation. Evaluated on a merged dataset from four public repositories, our two-stage architecture with time warping achieves state-of-the-art performance (97.63\% accuracy, 95.25\% MCC), with a 5\% MCC improvement over single-stage baseline. This work advances voice pathology classification while reducing gender bias through hierarchical modeling of vocal characteristics.

Bernhard Gahr, Shu Liu, Kevin Koch et al.

Driver identification has emerged as a vital research field, where both practitioners and researchers investigate the potential of driver identification to enable a personalized driving experience. Within recent years, a selection of studies have reported that individuals could be perfectly identified based on their driving behavior under controlled conditions. However, research investigating the potential of driver identification under naturalistic conditions claim accuracies only marginally higher than random guess. The paper at hand provides a comprehensive summary of the recent work, highlighting the main discrepancies in the design of the machine learning approaches, primarily the window length parameter that was considered. Key findings further indicate that the longitudinal vehicle control information is particularly useful for driver identification, leaving the research gap on the extent to which the lateral vehicle control can be used for reliable identification. Building upon existing work, we provide a novel approach for the design of the window length parameter that provides evidence that reliable driver identification can be achieved with data limited to the steering wheel only. The results and insights in this paper are based on data collected from the largest naturalistic driving study conducted in this field. Overall, a neural network based on GRUs was found to provide better identification performance than traditional methods, increasing the prediction accuracy from under 15\% to over 65\% for 15 drivers. When leveraging the full field study dataset, comprising 72 drivers, the accuracy of identification prediction of the approach improved a random guess approach by a factor of 25.