用不确定性自适应的预测区间,提升帕金森病用药剂量预测的可靠性。
CASCADE Conformal Prediction: Uncertainty-Adaptive Prediction Intervals for Two-Stage Clinical Decision Support

- 基于筛查分类器的信念不确定度,动态调整用药量预测区间的大小。
- 对信心高的患者区间窄了38.9%,对不确定病例自动扩大以保证覆盖。
- 适合需要精准、可解释医疗决策支持的临床场景。
帕金森病药物管理因疾病进展异质性、患者反应差异和药物副作用而困难重重。尽管人工智能模型可预测左旋多巴等效每日剂量(LEDD)以衡量用药需求,但传统不确定性量化无法区分高低置信度决策,导致结果不可靠。本文提出CASCADE(Calibrated Adaptive Scaling via Conformal And Distributional Estimation),一种新型合符预测框架,将主分类任务(判断是否需调整用药)的内生不确定性传递至次级回归任务(预测调整幅度),通过直接映射Venn-Abers多概率不确定性为非符合度得分,实现连续风险调节。实验表明,该‘级联效应’使高信心患者的预测区间比标准合符基线窄38.9%,同时自动扩展以保障低信心情况下的稳健覆盖,弥合了离散临床决策与连续剂量预测之间的鸿沟。
原文摘要 · Abstract (English)
Effective medication management in Parkinson's Disease (PD) is challenging due to heterogeneous disease progression, variable patient response, and medication side effects. While AI models can forecast levodopa equivalent daily dose (LEDD) as a measure of medication needs, standard uncertainty quantification often fails to communicate the reliability of these predictions, treating high and low confidence clinical decisions identically. We introduce CASCADE (Calibrated Adaptive Scaling via Conformal And Distributional Estimation), a novel conformal prediction framework that propagates epistemic uncertainty from a screening classifier to adapt downstream predictions. Unlike standard conformal methods that rely on auxiliary residual regression, we leverage epistemic uncertainty from a primary classification task (identifying whether a medication change is needed) to dynamically scale the prediction intervals of a secondary regression task (predicting how much change). By mapping Venn-Abers multi-probabilistic uncertainty directly to non-conformity scores, our framework achieves continuous risk adaptation. We demonstrate that this ``cascade effect'' produces highly efficient intervals for confident patients (38.9% narrower than standard conformal baselines) while automatically expanding intervals to ensure robust coverage for uncertain cases, bridging the gap between discrete clinical decision-making and continuous dose forecasting in PD.
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