RECAST: Recent & Context-Aware Sampling for Test-Time Adaptation in Streaming Biosignals

Abstract

Streaming biosignals vary across subjects and drift over time, so population-trained models lose accuracy during long-term monitoring. Test-time adaptation (TTA) enables online personalization by updating the model on incoming samples. But in a stream, a basic question is left open: \emph{which samples should drive each update?} Using all buffered samples blurs the update with irrelevant segments. Using only the latest segment makes the update noisy and unstable. The most useful samples are recent, aligned with the current physiological state, and reliable enough to learn from. We propose \textbf{RECAST} (REcent \& Context-Aware Sampling for TTA), a lightweight sampling module for buffered TTA frameworks. RECAST builds each adaptation batch from three signals: temporal recency, contextual similarity, and predictive reliability. It changes only which samples are used, leaving the model and the training objective unchanged. On two blood-pressure datasets, RECAST improves estimation accuracy and trend tracking over baselines and ablations. The per-patient gains are statistically significant on both datasets, with broad improvement on the regular benchmark and gains concentrated on the hardest patients in the emergency-department setting. RECAST stays practical, adding only sub-second latency per segment on a single GPU and CPU core.