arXiv:2607.25864cs.LGeess.SP2026-07

通过直接+递归结合,提升重症监护生理数据预测精度。

DRIFT: Direct-Recursive Intervention-Conditioned Forecasting of ICU Physiological Trajectories

论文配图:DRIFT: Direct-Recursive Intervention-Conditioned Forecasting of ICU Physiological Trajectories
图 1 · 摘自论文原文
  • 直接模型主预测,递归模型依治疗动作修正,减少误差积累。
  • 在MIMIC-IV和eICU-CRD上,平均动脉压预测误差降低0.673%。
  • 治疗方案变化时仍表现更优,适合临床决策支持场景。

许多时间序列预测不仅依赖历史观测,还受预测期内施加的治疗措施影响。在重症监护室(ICU),未来的生命体征和实验室指标受血管活性药物等治疗措施影响。然而,一次性预测全序列的模型对治疗信息利用不足,而自回归模型易累积误差。我们提出DRIFT,一种混合框架:直接模型生成主预测,递归、治疗条件模型提供约束性修正。在MIMIC-IV(6,046例)和eICU-CRD(8,345例)上评估。在8、24、48小时预测终点上,相对于治疗条件化的时序融合变换器(TFT-action),DRIFT在MIMIC-IV上将平均动脉压(MAP)均方误差降低0.673%,在eICU-CRD上达到最低误差。尽管整体提升有限,但在治疗序列被更改的窗口中,DRIFT在8和24小时的观测-目标MAP误差低于TFT-action。治疗序列变更使DRIFT的MAP误差上升0.21–0.26 mmHg,高于TFT-action,且预测变化主要出现在路径分歧后。在三种强调整体终点误差、MAP误差或二者均衡的检查点选择规则下,其MAP优势依然保持。

原文摘要 · Abstract (English)

Many time-series forecasts depend not only on prior observations but also on actions specified during the forecast period. In intensive care units (ICUs), future vital signs and laboratory values are influenced by treatments such as vasopressors. However, models that predict the full future sequence all at once make little use of these treatments, whereas autoregressive models can accumulate errors. We introduce DRIFT, a hybrid framework in which a direct model produces the primary forecast and a recursive, action-conditioned model contributes constrained corrections. We evaluate DRIFT on 6,046 admissions from MIMIC-IV and 8,345 admissions from eICU-CRD. Averaged across the 8-, 24-, and 48-hour forecast endpoints, DRIFT reduces mean absolute error for mean arterial pressure (MAP) by 0.673% relative to an action-conditioned Temporal Fusion Transformer (TFT-action) on MIMIC-IV and achieves the lowest corresponding error among the compared models on eICU-CRD. Although the overall accuracy improvement is modest, a MIMIC-IV audit restricted to windows in which the supplied treatment sequence was altered showed that DRIFT achieved lower observed-target MAP error than TFT-action at 8 and 24 hours. Treatment-sequence alteration increased DRIFT's MAP error by 0.21-0.26 mmHg more than it increased TFT-action's error, with prediction changes occurring primarily after the supplied paths diverged. In a separate robustness experiment, the MAP advantage persisted under three shared checkpoint-selection rules emphasizing overall endpoint error, MAP error, or both equally.

ICU预测治疗干预时序建模医疗AI

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