HEARTS: Benchmarking LLM Reasoning on Health Time Series
Authors: Sirui Li, Shuhan Xiao, Mihir Joshi, Ahmed Metwally, Daniel McDuff, Wei Wang, Yuzhe Yang
Organizations: University of California, Los Angeles, 2Google Research · 2Google Research
Abstract
The rise of large language models (LLMs) has shifted time series analysis from narrow analytics to general-purpose reasoning. Yet, existing benchmarks cover only a small set of health time series modalities and tasks, failing to reflect the diverse domains and extensive temporal dependencies inherent in real-world physiological modeling. To bridge these gaps, we introduce HEARTS (Health Reasoning over Time Series), a unified benchmark for evaluating hierarchical reasoning capabilities of LLMs over general health time series. HEARTS integrates 16 real-world datasets across 12 health domains and 20 signal modalities, and defines a comprehensive taxonomy of 110 tasks grouped into four core capabilities: Perception, Inference, Generation, and Deduction. Evaluating 16 state-of-the-art LLMs on more than 20K test samples reveals intriguing findings. First, LLMs substantially underperform specialized models, and their performance is only weakly related to general reasoning scores. Moreover, LLMs often rely on simple heuristics and struggle with multi-step temporal reasoning. Finally, performance declines with increasing temporal complexity, with similar failure modes within model families, indicating that scaling alone is insufficient. By making these gaps measurable, HEARTS provides a standardized testbed and living benchmark for developing next-generation LLM agents capable of reasoning over diverse health signals.
Personalized lifestyle health analysis requires long-horizon, multi-dimensional reasoning over heterogeneous lifestyle signals, and recent advances in mobile sensing and large language models (LLMs) make such support increasingly feasible. However, the capabilities of current LLMs in this setting remain insufficiently understood due to the lack of systematic benchmarks. In this paper, we introduce LifeAgentBench, a large-scale QA benchmark for long-horizon, cross-dimensional, and multi-user lifestyle health reasoning, containing 22,573 questions spanning from basic retrieval to complex reasoning. We release an extensible benchmark construction pipeline and a standardized evaluation protocol, deriving verifiable answers through executable queries and programs to support reliable assessment. We then systematically evaluate 13 representative LLMs on LifeAgentBench and identify key bottlenecks in long-horizon aggregation and cross-dimensional reasoning. Motivated by these findings, we propose LifeAgent, a tool-augmented reasoning baseline that decomposes complex queries, performs multi-step evidence retrieval, and invokes tools for deterministic aggregation. LifeAgent substantially enhances LLMs' capabilities on challenging reasoning tasks, achieving clear improvements over widely used baselines and showing potential for health reasoning in everyday scenarios. The benchmark is publicly available.
Time series data inform critical decisions across many real-world domains. While large language model (LLM) agents can analyze data through natural language and tools, it remains unclear whether they can conduct reliable time series analysis across multi-turn conversations. Existing benchmarks focus on single-step tasks such as forecasting and anomaly detection, overlooking practical workflows where user goals evolve, agents must build on prior analyses, and conclusions emerge from accumulated evidence. In this work, we introduce TimeSage-MT, a multi-turn benchmark for agentic time series reasoning with 240 tasks and 2,680 dialogue turns across 8 real-world domains, spanning basic exploration to decision-oriented analysis. TimeSage-MT is built through a reproducible pipeline that converts real-world time series data into multi-turn conversations with verifiable answers. It provides a unified evaluation protocol and public leaderboard for comparing time series agentic systems. To demonstrate the benchmark's utility, we evaluate frontier LLMs alongside TimeSage, a novel structured agent equipped with a comprehensive time series skill library. The results show sharp performance drops on decision-oriented tasks, driven by failures in memory, uncertainty handling, and domain-based decision making. TimeSage-MT exposes critical gaps in current agentic reasoning and provides a rigorous foundation for future development.
Time series analysis has recently been coupled with Large Language Models (LLMs) to leverage their reasoning and world knowledge capabilities, yet gains remain limited. We attribute this to a fundamental mismatch between existing task formulations and LLM strengths: most settings reduce time series understanding to curve-fitting systems, focusing on low-level prediction while ignoring the semantic, contextual, and reasoning-intensive nature of real-world temporal decision-making.To address these limitations, we introduce TSCognition, a multimodal benchmark for multi-dimensional time series reasoning. It collects real-world time series and textual information from 15 public sources and constructs approximately 41K QA samples around five cognitive reasoning tasks: Decoding, Grounding, Inferring, Extrapolating, and Acting. Building on this, we further propose TSAlign, a unified framework that encodes time series into compact patch-level representations and aligns them with semantic directions in the LLM embedding space via gated residual injection and multivariate fusion.Experiments show that TSAlign outperforms existing LLM, VLM, and time series QA baselines on TSCognition and the publicly available TimerBed benchmark while substantially reducing computational cost.Code is available at: https://github.com/EIT-NLP/CognitiveTSR