PaPaGei: Open Foundation Models for Optical Physiological Signals
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Abstract (arXiv)
Photoplethysmography (PPG) is the leading non-invasive technique for monitoring biosignals and cardiovascular health, with widespread adoption in both clinical settings and consumer wearable devices. While machine learning models trained on PPG signals have shown promise, they tend to be task-specific and struggle with generalization. Current research is limited by the use of single-device datasets, insufficient exploration of out-of-domain generalization, and a lack of publicly available models, which hampers reproducibility. To address these limitations, we present PaPaGei, the first open foundation model for PPG signals. The model is pre-trained on over 57,000 hours of data, comprising 20 million unlabeled PPG segments from publicly available datasets. We introduce a novel representation learning approach that leverages domain knowledge of PPG signal morphology across individuals, enabling the capture of richer representations compared to traditional contrastive learning methods. We evaluate PaPaGei against state-of-the-art time-series foundation models and self-supervised learning benchmarks across 20 tasks from 10 diverse datasets, spanning cardiovascular health, sleep disorders, pregnancy monitoring, and wellbeing assessment. Our model demonstrates superior performance, improving classification and regression metrics by 6.3% and 2.9% respectively in at least 14 tasks. Notably, PaPaGei achieves these results while being more data- and parameter-efficient, outperforming models that are 70x larger. Beyond accuracy, we examine model robustness across different skin tones, establishing a benchmark for bias evaluation in future models. PaPaGei can serve as both a feature extractor and an encoder for multimodal models, opening up new opportunities for multimodal health monitoring.
Key facts. Cited by 69 papers in the map (data through 14 Oct 2026). Builds on 27 of its 70 references that are in the map. First posted on arXiv 27 Oct 2024.
Builds on
27 of 70 references.
References · 27
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- 2020Self-supervised ECG Representation Learning for Emotion Recognitioncited by 99
- 2023Large-scale Training of Foundation Models for Wearable Biosignalscited by 95
- 2023AnyMAL: An Efficient and Scalable Any-Modality Augmented Language Modelcited by 93
- 2024ECG-FM: An Open Electrocardiogram Foundation Modelcited by 90
- 2020Subject-Aware Contrastive Learning for Biosignalscited by 76
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- 2022Self-supervised Learning for Human Activity Recognition Using 700,000 Person-days of Wearable Datacited by 75
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- 2021Neighborhood Contrastive Learning Applied to Online Patient Monitoringcited by 32
- 2020Self-supervised transfer learning of physiological representations from free-living wearable datacited by 27
- 2020Continuous PPG-Based Blood Pressure Monitoring Using Multi-Linear Regressioncited by 10
- 2021An Accurate Non-accelerometer-based PPG Motion Artifact Removal Technique using CycleGANcited by 10
- 2021Assessment of deep learning based blood pressure prediction from PPG and rPPG signalscited by 9
- 2023Predicting Cardiovascular Disease Risk using Photoplethysmography and Deep Learningcited by 5
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Citing papers per year: 2024: 1; 2025: 20; 2026: 48.
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- 2025Pulse-PPG: An Open-Source Field-Trained PPG Foundation Model for Wearable Applications Across Lab and Field Settingscited by 37
- 2025LSM-2: Learning from Incomplete Wearable Sensor Datacited by 23
- 2024RelCon: Relative Contrastive Learning for a Motion Foundation Model for Wearable Datacited by 20
- 2025HiMAE: Hierarchical Masked Autoencoders Discover Resolution-Specific Structure in Wearable Time Seriescited by 19
- 2025GPT-PPG: A GPT-based Foundation Model for Photoplethysmography Signalscited by 15
- 2025Generalizable deep learning for photoplethysmography-based blood pressure estimation -- A Benchmarking Studycited by 9
- 2025Machine-learning for photoplethysmography analysis: Benchmarking feature, image, and signal-based approachescited by 8
- 2026SIGMA-PPG: Statistical-prior Informed Generative Masking Architecture for PPG Foundation Modelcited by 8
- 2025Time2Lang: Bridging Time-Series Foundation Models and Large Language Models for Health Sensing Beyond Promptingcited by 7
- 2025PPGFlowECG: Latent Rectified Flow with Cross-Modal Encoding for PPG-Guided ECG Generation and Cardiovascular Disease Detectioncited by 7
- 2025PPG-Distill: Efficient Photoplethysmography Signals Analysis via Foundation Model Distillationcited by 6
- 2026Wavelet-Driven Masked Multiscale Reconstruction for PPG Foundation Modelscited by 5
38 more
- 2026Physiology-Aware Masked Cross-Modal Reconstruction for Biosignal Representation Learningcited by 5
- 2026sleep2vec: Unified Cross-Modal Alignment for Heterogeneous Nocturnal Biosignalscited by 4
- 2026Learning Transferable Sensor Models via Language-Informed Pretrainingcited by 4
- 2026PulseLM: A Foundation Dataset and Benchmark for PPG-Text Learningcited by 3
- 2026Wearable Foundation Models Should Go Beyond Static Encoderscited by 3
- 2026A robust PPG foundation model using multimodal physiological supervisioncited by 3
- 2026CardioState-JEPA: Delay-Aware Cross-Modal Learning of a Shared Cardiac Representationcited by 3
- 2025Continuous Cardiac Arrest Prediction in ICU using PPG Foundation Modelcited by 2
- 2025Sensing Cardiac Health Across Scenarios and Devices: A Multi-Modal Foundation Model Pretrained on Heterogeneous Data from 1.7 Million Individualscited by 2
- 2025Estimating Clinical Lab Test Result Trajectories from PPG using Physiological Foundation Model and Patient-Aware State Space Model -- a UNIPHY+ Approachcited by 2
- 2025A Unified AI Approach for Continuous Monitoring of Human Health and Diseases from Intensive Care Unit to Home with Physiological Foundation Models (UNIPHY+)cited by 2
- 2025SlotFM: A Motion Foundation Model with Slot Attention for Diverse Downstream Taskscited by 2
- 2025Generalist vs Specialist Time Series Foundation Models: Investigating Potential Emergent Behaviors in Assessing Human Health Using PPG Signalscited by 2
- 2026PENGUIN: General Vital Sign Reconstruction from PPG with Flow Matching State Space Modelcited by 2
- 2026CAP: Towards PPG Universal Representation Learning with Patient-level Supervisioncited by 2
- 2025Wav2Arrest 2.0: Long-Horizon Cardiac Arrest Prediction with Time-to-Event Modeling, Identity-Invariance, and Pseudo-Lab Alignmentcited by 1
- 2025BioX-Bridge: Model Bridging for Unsupervised Cross-Modal Knowledge Transfer across Biosignalscited by 1
- 2026Learning Longitudinal Health Representations from EHR and Wearable Datacited by 1
- 2026SignalMC-MED: A Multimodal Benchmark for Evaluating Biosignal Foundation Models on Single-Lead ECG and PPGcited by 1
- 2026A foundation model for electrodermal activity datacited by 1
- 2026Next-Token Prediction Learns Generalisable Representations of Sleep Physiologycited by 1
- 2026Retrieval-Augmented Personalization with Foundation Models for Wearable Stress Detectioncited by 1
- 2026P2E-VQ: ECG-linked representation augmentation for PPG via discrete patch retrievalcited by 1
- 2026SOTER: A Generative Time-Series Foundation Model for Wearable Human Physiological Signalscited by 1
- 2025Prototype-based Self-Supervised Multimodal Learning for PPG and Accelerometry Signalscited by 0
- 2025Towards Characterizing Knowledge Distillation of PPG Heart Rate Estimation Modelscited by 0
- 2025FMTK: A Modular Toolkit for Composable Time Series Foundation Model Pipelinescited by 0
- 2026DomusFM: A Foundation Model for Event-Based Behavioral Monitoring in Smart-Homescited by 0
- 2026Weighted Temporal Decay Loss for Learning Wearable PPG Data with Sparse Clinical Labelscited by 0
- 2026Benchmarking Open-Source PPG Foundation Models for Biological Age Predictioncited by 0
- 2026PanLUNA: An Efficient and Robust Query-Unified Multimodal Model for Edge Biosignal Intelligencecited by 0
- 2026Sense Less, Infer More: Agentic Multimodal Transformers for Edge Medical Intelligencecited by 0
- 2026Membership Inference Attacks Expose Participation Privacy in ECG Foundation Encoderscited by 0
- 2026PRISM-CTG: A Foundation Model for Cardiotocography Analysis with Multi-View SSLcited by 0
- 2026Emergent Symbolic Structure in Health Foundation Models: Extraction, Alignment, and Cross-Modal Transfercited by 0
- 2026WavesFM: Hierarchical Representation Learning for Longitudinal Wearable Sensor Waveformscited by 0
- 2026VCR: Learning Valid Contextual Representation for Incomplete Wearable Signalscited by 0
- 2026VitalAgent: A Tool-Augmented Agent for Reactive and Proactive Physiological Monitoring over Wearable Health Datacited by 0
50 most cited of 69 All 69 (JSON)
- 2026TEX-MEX: Similarity-Guided Temporal Contrastive Learning for Time Series14 Oct 2026
- 2026HiPPT: Physiology-Grounded Wearable PPG Representation Learning via Multi-Scope Text Alignment10 Oct 2026
- 2026PPG-Bench: A Unified Benchmark for PPG Foundation Models9 Oct 2026
- 2026EMG-FM-Bench: A Comprehensive Benchmark for Foundation Model Transfer and Adaptation on Electromyography5 Oct 2026
- 2026Training and Scaling Compute-Optimal Physiological Waveform Foundation Models5 Oct 2026
- 2026RAE-PPG: Duration-Grounded Retain-and-Extend Pretraining for PPG Foundation Models29 Sep 2026
- 2026PPG-LM: A Photoplethysmography-Language Model with Multi-Level Clinical Alignment27 Sep 2026
- 2026Pulseflow: PPG Counterfactual Generation Via Latent Transport27 Sep 2026
- 2026Learning Where to Look: A Shared Relative-Alignment Module for Time-Series Forecasting and PPG-to-Vital-Sign Reconstruction23 Sep 2026
- 2026Detecting Agitation Before Behavioral Escalation in Autistic Youth Through Multimodal Wearable Sensing21 Sep 2026
- 2026SOTER: A Generative Time-Series Foundation Model for Wearable Human Physiological Signals15 Sep 2026
- 2026Change Point--Aware Evaluation and Re-Calibration of PPG-Based Blood Pressure Estimation19 Aug 2026
38 more
- 2026Attributing Preprocessing Invariance in Spectral Foundation Models14 Aug 2026
- 2026CardioState-JEPA: Delay-Aware Cross-Modal Learning of a Shared Cardiac Representation13 Aug 2026
- 2026HIPNO: Symmetry-Aware Physics-Informed Neural Operators for Noninvasive Hemodynamic Inference8 Aug 2026
- 2026FemWear: A Parameter-Efficient Wearable Foundation Model for Women's Health8 Aug 2026
- 2026P2E-VQ: ECG-linked representation augmentation for PPG via discrete patch retrieval31 Jul 2026
- 2026When Derived Measurements Mislead: Quantifying and Mitigating LLM Over-Trust with Privileged-Modality Reliability Evidence30 Jul 2026
- 2026PhysioBench: A Unified Benchmark for Physiological Signal Question Answering29 Jul 2026
- 2026Retrieval-Augmented Personalization with Foundation Models for Wearable Stress Detection23 Jun 2026
- 2026SPOTR: Spatio-temporal Pooling One-Token Reconstruction for Universal Physiological Signal Self-supervised Learning20 Jun 2026
- 2026CAP: Towards PPG Universal Representation Learning with Patient-level Supervision13 Jun 2026
- 2026FMplex: Model Virtualization for Serving Extensible Foundation Models8 Jun 2026
- 2026Next-Token Prediction Learns Generalisable Representations of Sleep Physiology8 Jun 2026
- 2026BCG-FM: A Foundation Model for Ambient Cardiac Health Sensing5 Jun 2026
- 2026A robust PPG foundation model using multimodal physiological supervision5 Jun 2026
- 2026VitalAgent: A Tool-Augmented Agent for Reactive and Proactive Physiological Monitoring over Wearable Health Data28 May 2026
- 2026VCR: Learning Valid Contextual Representation for Incomplete Wearable Signals13 May 2026
- 2026WavesFM: Hierarchical Representation Learning for Longitudinal Wearable Sensor Waveforms9 May 2026
- 2026Emergent Symbolic Structure in Health Foundation Models: Extraction, Alignment, and Cross-Modal Transfer8 May 2026
- 2026Physiology-Aware Masked Cross-Modal Reconstruction for Biosignal Representation Learning1 May 2026
- 2026Membership Inference Attacks Expose Participation Privacy in ECG Foundation Encoders12 Apr 2026
- 2026Sense Less, Infer More: Agentic Multimodal Transformers for Edge Medical Intelligence12 Apr 2026
- 2026PRISM-CTG: A Foundation Model for Cardiotocography Analysis with Multi-View SSL9 Apr 2026
- 2026PanLUNA: An Efficient and Robust Query-Unified Multimodal Model for Edge Biosignal Intelligence5 Apr 2026
- 2026Wearable Foundation Models Should Go Beyond Static Encoders20 Mar 2026
- 2026Benchmarking Open-Source PPG Foundation Models for Biological Age Prediction14 Mar 2026
- 2026Learning Transferable Sensor Models via Language-Informed Pretraining12 Mar 2026
- 2026SignalMC-MED: A Multimodal Benchmark for Evaluating Biosignal Foundation Models on Single-Lead ECG and PPG10 Mar 2026
- 2026A foundation model for electrodermal activity data20 Feb 2026
- 2026sleep2vec: Unified Cross-Modal Alignment for Heterogeneous Nocturnal Biosignals14 Feb 2026
- 2026PulseLM: A Foundation Dataset and Benchmark for PPG-Text Learning10 Feb 2026
- 2026Weighted Temporal Decay Loss for Learning Wearable PPG Data with Sparse Clinical Labels2 Feb 2026
- 2026DomusFM: A Foundation Model for Event-Based Behavioral Monitoring in Smart-Homes2 Feb 2026
- 2026SIGMA-PPG: Statistical-prior Informed Generative Masking Architecture for PPG Foundation Model28 Jan 2026
- 2026PENGUIN: General Vital Sign Reconstruction from PPG with Flow Matching State Space Model23 Jan 2026
- 2026Learning Longitudinal Health Representations from EHR and Wearable Data18 Jan 2026
- 2026Wavelet-Driven Masked Multiscale Reconstruction for PPG Foundation Models18 Jan 2026
- 2025FMTK: A Modular Toolkit for Composable Time Series Foundation Model Pipelines30 Nov 2025
- 2025Towards Characterizing Knowledge Distillation of PPG Heart Rate Estimation Models24 Nov 2025
50 newest of 69 All 69 (JSON)
- 2025Pulse-PPG: An Open-Source Field-Trained PPG Foundation Model for Wearable Applications Across Lab and Field Settingscited by 37
- 2025LSM-2: Learning from Incomplete Wearable Sensor Datacited by 23
- 2024RelCon: Relative Contrastive Learning for a Motion Foundation Model for Wearable Datacited by 20
- 2025HiMAE: Hierarchical Masked Autoencoders Discover Resolution-Specific Structure in Wearable Time Seriescited by 19
- 2025GPT-PPG: A GPT-based Foundation Model for Photoplethysmography Signalscited by 15
- 2025Generalizable deep learning for photoplethysmography-based blood pressure estimation -- A Benchmarking Studycited by 9
- 2025Machine-learning for photoplethysmography analysis: Benchmarking feature, image, and signal-based approachescited by 8
- 2026SIGMA-PPG: Statistical-prior Informed Generative Masking Architecture for PPG Foundation Modelcited by 8
- 2025Time2Lang: Bridging Time-Series Foundation Models and Large Language Models for Health Sensing Beyond Promptingcited by 7
- 2025PPGFlowECG: Latent Rectified Flow with Cross-Modal Encoding for PPG-Guided ECG Generation and Cardiovascular Disease Detectioncited by 7
- 2026Wavelet-Driven Masked Multiscale Reconstruction for PPG Foundation Modelscited by 5
- 2026Physiology-Aware Masked Cross-Modal Reconstruction for Biosignal Representation Learningcited by 5
12 most cited of 65 All 65 (JSON)
- 2026TEX-MEX: Similarity-Guided Temporal Contrastive Learning for Time Series14 Oct 2026
- 2026HiPPT: Physiology-Grounded Wearable PPG Representation Learning via Multi-Scope Text Alignment10 Oct 2026
- 2026PPG-Bench: A Unified Benchmark for PPG Foundation Models9 Oct 2026
- 2026EMG-FM-Bench: A Comprehensive Benchmark for Foundation Model Transfer and Adaptation on Electromyography5 Oct 2026
- 2026Training and Scaling Compute-Optimal Physiological Waveform Foundation Models5 Oct 2026
- 2026RAE-PPG: Duration-Grounded Retain-and-Extend Pretraining for PPG Foundation Models29 Sep 2026
- 2026PPG-LM: A Photoplethysmography-Language Model with Multi-Level Clinical Alignment27 Sep 2026
- 2026Pulseflow: PPG Counterfactual Generation Via Latent Transport27 Sep 2026
- 2026Learning Where to Look: A Shared Relative-Alignment Module for Time-Series Forecasting and PPG-to-Vital-Sign Reconstruction23 Sep 2026
- 2026Detecting Agitation Before Behavioral Escalation in Autistic Youth Through Multimodal Wearable Sensing21 Sep 2026
- 2026SOTER: A Generative Time-Series Foundation Model for Wearable Human Physiological Signals15 Sep 2026
- 2026Change Point--Aware Evaluation and Re-Calibration of PPG-Based Blood Pressure Estimation19 Aug 2026
12 newest of 65 All 65 (JSON)