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Uncertainty Quantification for Postoperative Delirium Prediction: A Position Paper on Why Bayesian Deep Learning Matters for Elderly Surgical Patients
Postoperative delirium affects 10–60% of elderly surgical patients and is linked to longer hospital stays, cognitive decline, and increased mortality. Although machine learning models have been developed to predict this condition using perioperative data, most rely on point predictions that fail to express uncertainty, limiting their clinical reliability in high-stakes surgical decision-making. These models often report a single risk estimate without indicating whether predictions are supported by strong or sparse evidence, which can lead to overconfidence and potential patient harm in vulnerable populations with heterogeneous frailty and comorbidity profiles. We argue that Bayesian deep learning is essential for postoperative delirium prediction because it provides distributional outputs and uncertainty estimates that allow clinicians to assess prediction reliability. Incorporating uncertainty quantification can transform these models from opaque tools into clinically trustworthy decision aids. We recommend that uncertainty reporting be required in all predictive models for postoperative delirium and that regulatory and publication standards enforce the use of Bayesian approaches. Overall, replacing point estimates with distributional predictions is necessary to improve safety and clinical utility in perioperative care of elderly patients.
Journal of Artificial Intelligence for Healthcare Systems
Original Research | Open access | 20 July 2022 | Article: 62

A Deep Kernel Learning Framework for Probabilistic Spatiotemporal Forecasting of Emergency Medical Services Call Volume
Emergency medical services (EMS) systems face significant challenges in managing fluctuating call volumes, where sudden demand surges can delay response times and worsen outcomes for critical conditions such as cardiac arrest, trauma, and stroke. Accurate forecasting of EMS demand supports proactive ambulance deployment, improving survival rates and resource efficiency, yet traditional methods like ARIMA and exponential smoothing fail to capture nonlinear spatial, temporal, weather, and event-driven effects, and do not provide uncertainty estimates needed for operational decision-making. This paper proposes a conceptual framework based on deep kernel learning with Gaussian processes for spatiotemporal EMS demand forecasting. The model integrates deep neural networks for feature extraction with Gaussian processes for probabilistic inference, enabling both flexible nonlinear representation and uncertainty quantification. It combines temporal, spatial, weather, and event-based kernels to model complex patterns in EMS call volumes. The framework produces predictive mean estimates along with calibrated uncertainty intervals, capturing effects such as weather-driven medical incidents and large public events. This probabilistic output supports risk-aware ambulance allocation strategies that balance over- and under-resourcing. Overall, the proposed approach provides a unified, interpretable, and uncertainty-aware solution for EMS demand forecasting, with future work aimed at validation on real-world datasets and comparison with existing methods.
Journal of Artificial Intelligence for Healthcare Systems
Original Research | Open access | 20 July 2024 | Article: 89

Neural Network with Adaptive Conformal Prediction for Providing Calibrated Uncertainty Intervals around Individualized Chemotherapy Toxicity Risk Predictions
Chemotherapy remains a cornerstone of cancer treatment, but it is frequently associated with severe toxicities, with 30–80% of patients experiencing grade 3–4 adverse events that may require dose reduction, treatment delays, or hospitalization. While machine learning models have shown strong potential in predicting chemotherapy-related toxicities using electronic health records, genomic data, and clinical variables, most existing approaches generate only point estimates (e.g., a single risk probability) without quantifying uncertainty, limiting their clinical reliability. Such miscalibrated predictions can lead to overconfident risk underestimation or excessive caution, both of which may negatively impact treatment decisions and patient outcomes. This manuscript proposes a conceptual framework that integrates neural network-based toxicity prediction with adaptive conformal prediction to produce calibrated, patient-specific prediction intervals with formal coverage guarantees. The framework combines a feedforward neural network for risk estimation, a non-conformity score to measure how atypical a patient is relative to the training data, and an adaptive calibration mechanism that updates interval thresholds over time to reflect shifts in patient populations and clinical practice. This design enables narrower intervals for well-represented, predictable cases and wider intervals for atypical or high-uncertainty patients, thereby making prediction reliability explicit. Importantly, the method provides finite-sample coverage guarantees without requiring distributional assumptions, ensuring that true toxicity outcomes fall within the predicted intervals at a user-specified confidence level. By transforming point predictions into uncertainty-aware, clinically interpretable intervals, the framework supports more robust, risk-stratified decision-making in chemotherapy planning and moves toward safer, more trustworthy AI-assisted oncology care.
Journal of Artificial Intelligence for Healthcare Systems
Original Research | Open access | 20 July 2025 | Article: 114

A Variational Recurrent Neural Network with Stochastic Attention for Imputation of Irregularly Sampled ICU Time Series under Non-Random Missingness
Intensive care unit (ICU) data consist of high-frequency multivariate time series, including vital signs, laboratory results, and hemodynamic variables, which are crucial for clinical decision-making and predictive modeling. However, these data are frequently incomplete due to monitor interruptions, clinical workflows, and selective measurement, with missing rates ranging from 20% to over 80% depending on the variable. Missingness in ICU time series is often not random, as sicker patients tend to be monitored more frequently, creating a missing not at random (MNAR) mechanism. Conventional imputation methods such as mean filling, interpolation, and multiple imputation assume random missingness and therefore introduce bias and distort clinical signals under MNAR conditions. We propose a variational recurrent neural network (VRNN) with stochastic attention to impute ICU time series under MNAR settings. The framework integrates latent state modeling of physiological dynamics, stochastic attention over observed measurements using Gumbel-Softmax sampling, and a missingness pattern encoder that explicitly models the observation process. An imputation decoder generates probabilistic estimates of missing values conditioned on latent states, attention context, and missingness structure. This framework enables uncertainty-aware and potentially unbiased imputation in ICU time series by jointly modeling physiological dynamics and missingness mechanisms. It combines variational inference and stochastic attention to address systematic bias in conventional approaches, with future work needed to validate performance on real-world ICU datasets.
Journal of Artificial Intelligence for Healthcare Systems
Original Research | Open access | 20 January 2026 | Article: 120
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AI-driven Diagnostics Artificial Intelligence in Health Informatics Artificial Intelligence in Healthcare Big Data in Healthcare Clinical Data Mining Clinical Decision Support Systems Clinical Informatics Computer Vision Connected Health Systems Deep Learning Digital Health Digital Healthcare Innovation Digital Transformation in Healthcare Electronic Health Records Ethical AI in Healthcare Explainable AI Health Data Analytics Health Data Privacy Health Informatics Health Information Management Health Information Systems Health System Optimization Health Technology Assessment Healthcare Data Science Healthcare Informatics Healthcare Information Security Healthcare Management Healthcare Management Information Systems Intelligent Medical Systems Internet of Medical Things (IoMT) Interoperability in Healthcare Systems Machine Learning Medical Data Analytics Medical Data Management Medical Imaging Mobile Health (mHealth) Natural Language Processing Precision Medicine Predictive Analytics Remote Patient Monitoring Smart Healthcare Systems Telemedicine Wearable Health Technologies e-Health




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