# Curriculum-Aware Interpolate-then-Refine: Learned Physiological Time-Series Imputation under Realistic Missingness

arXiv: https://arxiv.org/abs/2608.21207 · HTML: https://mlsanity.com/paper/2608.21207/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 16 of its 48 references that are in the map.
- First posted on arXiv 21 Aug 2026.

## Builds on (most cited first, 16 of 16)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Learning Phrase Representations using RNN Encoder-Decoder for Statistical Machine Translation](https://mlsanity.com/paper/1406.1078/) (2014)
- [Simple and Scalable Predictive Uncertainty Estimation using Deep Ensembles](https://mlsanity.com/paper/1612.01474/) (2016)
- [Averaging Weights Leads to Wider Optima and Better Generalization](https://mlsanity.com/paper/1803.05407/) (2018)
- [TimesNet: Temporal 2D-Variation Modeling for General Time Series Analysis](https://mlsanity.com/paper/2210.02186/) (2022)
- [CSDI: Conditional Score-based Diffusion Models for Probabilistic Time Series Imputation](https://mlsanity.com/paper/2107.03502/) (2021)
- [Recurrent Neural Networks for Multivariate Time Series with Missing Values](https://mlsanity.com/paper/1606.01865/) (2016)
- [BRITS: Bidirectional Recurrent Imputation for Time Series](https://mlsanity.com/paper/1805.10572/) (2018)
- [Multi-Time Attention Networks for Irregularly Sampled Time Series](https://mlsanity.com/paper/2101.10318/) (2021)
- [GP-VAE: Deep Probabilistic Time Series Imputation](https://mlsanity.com/paper/1907.04155/) (2019)
- [SAITS: Self-Attention-based Imputation for Time Series](https://mlsanity.com/paper/2202.08516/) (2022)
- [Interpolation-Prediction Networks for Irregularly Sampled Time Series](https://mlsanity.com/paper/1909.07782/) (2019)
- [Estimating Missing Data in Temporal Data Streams Using Multi-directional Recurrent Neural Networks](https://mlsanity.com/paper/1711.08742/) (2017)
- [GlucoBench: Curated List of Continuous Glucose Monitoring Datasets with Prediction Benchmarks](https://mlsanity.com/paper/2410.05780/) (2024)
- [Beyond Random Missingness: Clinically Rethinking for Healthcare Time Series Imputation](https://mlsanity.com/paper/2405.17508/) (2024)
- [Indicators of retention in remote digital health studies: A cross-study evaluation of 100,000 participants](https://mlsanity.com/paper/1910.01165/) (2019)

## Abstract (arXiv)

Imputing physiological time series (arterial blood pressure, blood glucose, etc.) is essential for addressing the missingness that pervades clinical data. Yet modern imputation methods perform poorly in this domain: a recent benchmark found that simple linear interpolation outperformed every learned imputer on real-world clinical signals with realistic gaps. We show that this reflects two properties of physiological missingness that generic imputers ignore: gaps may occur when the signal is clinically extreme rather than typical, and gap lengths can easily span orders of magnitude. To this end, we introduce Curriculum-Aware Interpolate-then-Refine (CAIR), a two-stage framework for physiological time-series imputation. Our key motivation is to learn a coarse base curve and then repeatedly correct it toward physiological realism, rather than predict a gap in a single pass. Consequently, CAIR couples a bidirectional-GRU interpolator with a Transformer refiner that corrects its own estimate over three successive passes, trained jointly under a broad, signal-agnostic random-gap curriculum. We evaluate imputers stratified by gap length and missingness mechanism (MCAR, MAR, NMAR) rather than by a single average, and CAIR is the most accurate under every mechanism on continuous glucose monitoring (AI-READI) and arterial pressure in intensive care (MIMIC-III). Its margin over the strongest baseline grows with difficulty, from 9% under MCAR to 19% under value-dependent dropout, where generic learned imputers are weakest. We further show low reconstruction error alone does not recover the burden metrics clinicians act on: interpolants matching CAIR's error fail to preserve those metrics, imputers that recover them are far less accurate, and CAIR alone ranks among the best on both axes.