Towards Trustworthy Vital Sign Forecasting: Leveraging Uncertainty for Prediction Intervals

Abstract

Vital signs, such as heart rate and blood pressure, are critical indicators of patient health and are widely used in clinical monitoring and decision-making. While deep learning models have shown promise in forecasting these signals, their deployment in healthcare remains limited in part because clinicians must be able to trust and interpret model outputs. Without reliable uncertainty quantification -- particularly calibrated prediction intervals (PIs) -- it is unclear whether a forecasted abnormality constitutes a meaningful warning or merely reflects model noise, hindering clinical decision-making. To address this, we present two methods for deriving PIs from the Reconstruction Uncertainty Estimate (RUE), an uncertainty measure well-suited to vital-sign forecasting due to its sensitivity to data shifts and support for label-free calibration. Our parametric approach assumes that prediction errors and uncertainty estimates follow a Gaussian copula distribution, enabling closed-form PI computation. Our non-parametric approach, based on k-nearest neighbours (KNN), empirically estimates the conditional error distribution using similar validation instances. We evaluate these methods on two large public datasets with minute- and hour-level sampling, representing high- and low-frequency health signals. Experiments demonstrate that the Gaussian copula method consistently outperforms conformal prediction baselines on low-frequency data, while the KNN approach performs best on high-frequency data. These results underscore the clinical promise of RUE-derived PIs for delivering interpretable, uncertainty-aware vital sign forecasts.