Stable Prediction of Adverse Events in Medical Time-Series Data
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Abstract (arXiv)
Early event prediction (EEP) systems continuously estimate a patient's imminent risk to support clinical decision-making. For bedside trust, risk trajectories must be accurate and temporally stable, shifting only with new, relevant evidence. However, current benchmarks (a) ignore stability of risk scores and (b) evaluate mainly on tabular inputs, leaving trajectory behavior untested. To address this gap, we introduce CAREBench, an EEP benchmark that evaluates deployability using multi-modal inputs-tabular EHR, ECG waveforms, and clinical text-and assesses temporal stability alongside predictive accuracy. We propose a stability metric that quantifies short-term variability in per-patient risk and penalizes abrupt oscillations based on local-Lipschitz constants. CAREBench spans six prediction tasks such as sepsis onset and compares classical learners, deep sequence models, and zero-shot LLMs. Across tasks, existing methods, especially LLMs, struggle to jointly optimize accuracy and stability, with notably poor recall at high-precision operating points. These results highlight the need for models that produce evidence-aligned, stable trajectories to earn clinician trust in continuous monitoring settings. (Code: https://github.com/SeewonChoi/CAREBench.)
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References · 14
- 2023Can LLMs Express Their Uncertainty? An Empirical Evaluation of Confidence Elicitation in LLMscited by 974
- 2017Interpretation of Neural Networks is Fragilecited by 444
- 2017Multitask learning and benchmarking with clinical time series datacited by 290
- 2021Multi-Time Attention Networks for Irregularly Sampled Time Seriescited by 238
- 2023EHRSHOT: An EHR Benchmark for Few-Shot Evaluation of Foundation Modelscited by 105
- 2024Zero Shot Health Trajectory Prediction Using Transformercited by 77
- 2024Context Clues: Evaluating Long Context Models for Clinical Prediction Tasks on EHRscited by 39
- 2021Benchmarking emergency department triage prediction models with machine learning and large public electronic health recordscited by 31
- 2023Multimodal Clinical Benchmark for Emergency Care (MC-BEC): A Comprehensive Benchmark for Evaluating Foundation Models in Emergency Medicinecited by 24
- 2022Temporal Label Smoothing for Early Event Predictioncited by 12
- 2025Memorize and Rank: Elevating Large Language Models for Clinical Diagnosis Predictioncited by 8
- 2025Building the EHR Foundation Model via Next Event Predictioncited by 6
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