Medical time series, such as electrocardiograms (ECG) and electroencephalograms (EEG), exhibit complex temporal dynamics and structured cross-channel dependencies, posing fundamental challenges for automated analysis. Conventional convolutional and recurrent models struggle to capture long-range dependencies, while Transformer-based approaches incur quadratic complexity and often introduce redundant interactions that are misaligned with the intrinsic structure of physiological signals. To address these limitations, we propose MedMamba, a principle-driven multi-scale bidirectional state space architecture tailored for medical time series classification. Our design is guided by three key inductive biases of physiological signals: spatial centralization, multi-timescale temporal composition, and non-causal contextual dependency. These principles are instantiated through a lightweight channel-mixing module for cross-channel reparameterization, multi-scale convolutional tokenization for temporal decomposition, and bidirectional Mamba blocks for efficient global context modeling with linear complexity. Extensive experiments on six benchmark datasets spanning EEG, ECG, and human activity signals demonstrate that MedMamba consistently outperforms state-of-the-art methods across diverse modalities. Notably, it achieves 85.97% accuracy on PTB and establishes new state-of-the-art performance on the challenging ADFTD dataset (54.72% accuracy and 52.01% F1-score). Strong results on long-sequence benchmarks, such as SleepEDF, further validate its capability in modeling long-range dependencies. Moreover, MedMamba achieves a speedup of 4.6x in inference, highlighting its practicality for real-time clinical deployment. These results suggest that principle-guided state space modeling offers an effective and scalable alternative to Transformer-based approaches for medical time series analysis.
Medical time series are central to healthcare, enabling continuous monitoring and supporting timely clinical decisions. Despite recent progress, existing methods struggle to jointly model local-global dynamics and handle nonstationarities like baseline drift, while often failing to capture latent channel interactions. To address these challenges, we propose MedMamba, an end-to-end architecture that integrates state space models with domain-specific inductive biases. Specifically, MedMamba first employs multi-scale convolutional embeddings to capture discriminative local morphology. Second, to mitigate nonstationarity, we introduce a tri-branch differential state space encoder that processes raw, temporal-difference, and frequency-domain views, fusing them to emphasize informative patterns while suppressing drift. Furthermore, to uncover latent channel correlations, we design a spatial graph Mamba module that learns a directed dependency structure regularized toward sparsity and acyclicity, which obviates the need for predefined graphs. Extensive experiments on five real-world datasets demonstrate that MedMamba achieves state-of-the-art performance while maintaining linear computational complexity, and ablation studies validate each component's contribution.Code is available at https://github.com/zhangda1018/MedMamba.
Medical time series (MedTS) signals such as electroencephalography (EEG) and electrocardiography (ECG) support many clinical applications. However, substantial subject-level heterogeneity often induces subject-level distribution shift, causing a fixed parameter set to generalize poorly to unseen individuals. Compared with domain adaptation methods that often depend on extra adaptation components or target-batch statistics, Test-Time Training (TTT) provides a more practical solution for sequential clinical data by enabling online adaptation from unlabeled test samples. However, many representative TTT methods require iterative inner-loop optimization, increasing test-time overhead. In this paper, we propose MedTS-TTT, a test-time training framework for medical time series modeling. MedTS-TTT is built upon Closed-Loop Self-Alignment Test-Time Training (CLSA-TTT) and a Gated Convolutional Backbone (GCB). CLSA-TTT constructs a token-level self-supervised target and performs a single-step fast-weight update for intra-layer closed-loop alignment, enabling rapid sample-wise adaptation without iterative inner-loop optimization. GCB combines CLSA-TTT-based fast adaptation and token-level fusion with a gated convolutional branch to balance local dynamic modeling and information-flow control. On 4 public datasets (2 EEG and 2 ECG) with subject-independent splits, MedTS-TTT achieves 11 top-1 rankings out of 12 evaluations across 9 baselines and 3 metrics. The code is publicly available at https://github.com/mingzhi-c/MedTS-TTT.
Electronic health Records (EHRs) have become a cornerstone in modern-day healthcare. They are a crucial part for analyzing the progression of patient health; however, their complexity, characterized by long, multivariate sequences, sparsity, and missing values poses significant challenges in traditional deep learning modeling. While Transformer-based models have demonstrated success in modeling EHR data and predicting clinical outcomes, their quadratic computational complexity and limited context length hinder their efficiency and practical applications. On the other hand, State Space Models (SSMs) like Mamba present a promising alternative offering linear-time sequence modeling and improved efficiency for handling long sequences, but focus mostly on mixing sequence-level information rather than channel-level data. To overcome these challenges, we propose HyMaTE (A Hybrid Mamba and Transformer Model for EHR Representation Learning), a novel hybrid model tailored for representing longitudinal data, combining the strengths of SSMs with advanced attention mechanisms. By testing the model on predictive tasks on multiple clinical datasets, we demonstrate HyMaTE's ability to capture an effective, richer, and more nuanced unified representation of EHR data. Additionally, the interpretability of the outcomes achieved by self-attention illustrates the effectiveness of our model as a scalable and generalizable solution for real-world healthcare applications. Codes are available at: https://github.com/healthylaife/HyMaTE.
Md Mozaharul Mottalib, Thao-Ly T. Phan, Rahmatollah Beheshti