Simultaneous forecasting of vital sign trajectories in the ICU

Individual health trajectory forecasting is a major opportunity for computational methods to integrate with precision healthcare. Recently developed generative AI models have demonstrated promising results in capturing short and long range dependencies in time series data. While these models have also been applied in healthcare, most state-of-the-art are local models, i.e. one model per feature, which is unrealistic in a clinical setting where multiple measures are taken at once. In this work, we extend the framework temporal fusion transformer (TFT), a multi-horizon time series prediction tool, and propose TFT-multi, a global model that can predict multiple vital trajectories simultaneously. We apply TFT-multi to forecast 5 vital signs recorded in the intensive care unit: blood pressure, pulse, SpO2, temperature and respiratory rate. We hypothesize that by jointly predicting these measures, which are often correlated with one another, we can make more accurate predictions, especially in variables with large missingness. We validate our model on the public MIMIC dataset and an independent institutional dataset, and demonstrate our model's competitive performance and computational efficiency compared to state-of-the-art prediction tools. Furthermore, we perform a study case analysis by applying our pipeline to forecast blood pressure changes in response to actual and hypothetical pressor administration.