Abstract
Large language model (LLM) agents for personal health read wearable data and recommend, but do not learn about the individual in a way that can be audited or falsified. We present EpiCoach, an agentic system that treats one athlete, a cross-country mountain biker, as the subject of accountable N-of-1 science.
Claims about the athlete live in an evidence-gated hypothesis registry: each must issue a probabilistic prediction about a future session before it occurs, and its belief moves only through computed evidence from a logged statistical fit. Predictions come from a mechanistic digital twin inferred from heart rate, GPS and barometric altitude: a lagged heart-rate response model, a fitness-fatigue model with learned time constants, and a latent technical-descending skill state, measured on discovered trail segments.
The agent prescribes the next training week as a constrained experiment maximizing information gain subject to load and safety constraints, around two instrument rides. We evaluate the system two ways over eighteen months of data.
A rolling-origin replay benchmark shows the twin beats standard forecasters on heart rate but not segment time, and the agentic loop matches a static model. A live prospective phase runs the weekly cycle: in its first three weeks the ledger sealed 20 predictions, scored 14, the descent forecast calibrated after one correction, the climb forecast pessimistic as the athlete improved, and the safety officer vetoed the agent twice.
Every correction is preserved in the registry, a template for auditable, falsifiable personalization in digital health. We release the registry, benchmark and protocol.