Sepsis is a leading cause of ICU mortality, and early detection is critical for improving patient outcomes. However, existing machine learning models often rely on hourly aggregated data, limiting their ability to capture rapid physiological changes, and frequently lack interpretability, reducing clinical trust and usability. This paper proposes a conceptual framework that integrates Temporal Convolutional Networks (TCNs) with an attention mechanism to analyze high-frequency, minute-level vital sign data for early sepsis prediction. The architecture includes a data input layer, a TCN-based feature extractor with causal dilated convolutions and residual connections, an attention module for identifying clinically relevant time points and variables, and a prediction head that estimates the risk of sepsis within a 6-hour horizon. The proposed approach enables efficient parallel processing, improved temporal sensitivity, and enhanced interpretability compared to recurrent models. While offering advantages in real-time prediction and explainability, challenges remain in handling missing data, ensuring generalizability across ICUs, and minimizing false alarms for clinical deployment.
Sepsis remains a major cause of mortality in intensive care units worldwide, with an estimated 49 million cases and over 11 million deaths annually, highlighting the need for earlier detection to improve outcomes. This systematic review synthesizes evidence on machine learning models for early sepsis prediction in adult ICU patients from 2017 to 2021, focusing on prediction horizons, data modalities, and validation approaches. A comprehensive search of PubMed, Embase, IEEE Xplore, ACM Digital Library, and arXiv identified studies meeting criteria for ICU-based sepsis prediction with at least a 4-hour forecast window, following PRISMA guidelines. Of 1,478 records screened, 35 studies were included, with prediction horizons ranging from 4 to 24 hours and most relying on hourly vital sign data and internal validation. Reported performance varied widely depending on horizon length, data sampling, and validation rigor, with external validation generally producing lower but more realistic results. Overall, while machine learning models show promising predictive ability, limitations in generalizability and standardization remain, emphasizing the need for stronger validation frameworks and reporting practices to support clinical translation.
Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide, accounting for 25–30% of deaths, particularly in low-resource settings, and early identification of high-risk patients during labor could enable timely interventions such as uterotonic administration, blood preparation, and escalation of care; however, current risk stratification models rely mainly on static antepartum factors and fail to incorporate dynamic intrapartum physiological changes. Existing tools, including those from the California Maternal Quality Care Collaborative, use baseline maternal characteristics such as prior PPH, BMI, parity, and comorbidities, but do not capture continuously evolving labor data, despite intrapartum signals like fetal heart rate patterns, maternal vital sign trends, and labor progression metrics containing rich predictive information that remains underused in real-time decision-making, while clinical judgment is limited by inter-observer variability and inability to integrate complex temporal trends. To address this gap, we propose an explainable gradient boosting machine framework for real-time PPH risk prediction that integrates electronic fetal monitoring parameters (baseline rate, variability, decelerations), maternal vital signs (heart rate, blood pressure, temperature, oxygen saturation), and labor progression features (cervical dilation, contraction frequency, stage duration, and oxytocin use), producing continuously updated risk scores throughout labor. The system combines a gradient boosting model (XGBoost or LightGBM), a SHAP-based explainability module, a real-time feature extraction pipeline, and a clinician-facing dashboard that displays risk scores and key contributing factors, where SHAP provides both global and patient-specific interpretability by identifying how features such as tachysystole or prolonged labor stages influence predictions, thereby improving transparency and clinical trust. Overall, this framework enables dynamic, interpretable PPH risk assessment using routinely collected intrapartum data, combining predictive accuracy with explainability to support earlier detection of hemorrhage risk and more timely, targeted interventions.
This article proposes a conceptual framework for a diagnostic support system in emergency departments that leverages large language models, retrieval-augmented generation, and chain-of-thought reasoning. By combining triage notes and vital signs, the system generates a ranked differential diagnosis list to assist clinicians without replacing their judgment. The framework includes components like a triage note encoder, a vital sign encoder, a retrieval module, and a diagnosis ranker, using evidence from clinical guidelines, curated references, and de-identified prior cases. The approach grounds the model in authoritative knowledge while ensuring transparency and explainability in the diagnostic process. However, prospective validation, integration into workflows, and clinician oversight are crucial before implementation to ensure safety and effectiveness.