统一预测重症患者生命体征与化验指标,提升临床预警准确性。
OmniTFT: Omni Target Forecasting for Vital Signs and Laboratory Result Trajectories in Multi Center ICU Data
- 融合多源时序数据,通过分层注意力机制聚焦关键生理特征。
- 在三大数据集上显著提升生命体征与化验结果预测精度。
- 模型可解释性强,适合临床决策支持系统部署。
准确预测重症监护室(ICU)中生命体征与实验室指标的多变量时间序列,对早期干预和精准医疗至关重要。然而,生命体征常伴随噪声和快速波动,而实验室检测存在缺失值、测量延迟及设备偏差,导致整合建模极具挑战。为此,我们提出OmniTFT,一种基于时序融合变换器(TFT)的深度学习框架,联合学习并预测高频生命体征与稀疏采样的实验室结果。具体包含四项创新策略:滑动窗口均衡采样以平衡生理状态分布,频率感知嵌入压缩以稳定罕见类别表征,分层变量选择引导模型关注信息丰富的特征簇,以及影响对齐注意力校准以增强突变生理状态下的鲁棒性。通过减少对目标特定架构和复杂特征工程的依赖,OmniTFT实现多个异构临床目标的统一建模,并保持跨机构泛化能力。在MIMIC-III、MIMIC-IV和eICU数据集上的多项预测任务中,该模型均显著提升生命体征与实验室结果的预测性能。其注意力模式具有可解释性,与已知病理生理学一致,凸显其在临床量化决策支持中的潜力。
原文摘要 · Abstract (English)
Accurate multivariate time-series prediction of vital signs and laboratory results is crucial for early intervention and precision medicine in intensive care units (ICUs). However, vital signs are often noisy and exhibit rapid fluctuations, while laboratory tests suffer from missing values, measurement lags, and device-specific bias, making integrative forecasting highly challenging. To address these issues, we propose OmniTFT, a deep learning framework that jointly learns and forecasts high-frequency vital signs and sparsely sampled laboratory results based on the Temporal Fusion Transformer (TFT). Specifically, OmniTFT implements four novel strategies to enhance performance: sliding window equalized sampling to balance physiological states, frequency-aware embedding shrinkage to stabilize rare-class representations, hierarchical variable selection to guide model attention toward informative feature clusters, and influence-aligned attention calibration to enhance robustness during abrupt physiological changes. By reducing the reliance on target-specific architectures and extensive feature engineering, OmniTFT enables unified modeling of multiple heterogeneous clinical targets while preserving cross-institutional generalizability. Across forecasting tasks, OmniTFT achieves substantial performance improvement for both vital signs and laboratory results on the MIMIC-III, MIMIC-IV, and eICU datasets. Its attention patterns are interpretable and consistent with known pathophysiology, underscoring its potential utility for quantitative decision support in clinical care.
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