Alireza Namazi

Alireza Namazi, Amirreza Dolatpour Fathkouhi, Heman Shakeri

Autoregressive forecasting is central to predictive control in diabetes and hemodynamic management, where different operating zones carry different clinical risks. Standard models trained with teacher forcing suffer from exposure bias, yielding unstable multi-step forecasts for closed-loop use. We introduce Soft-Token Trajectory Forecasting (SoTra), which propagates continuous probability distributions (``soft tokens'') to mitigate exposure bias and learn calibrated, uncertainty-aware trajectories. A risk-aware decoding module then minimizes expected clinical harm. In glucose forecasting, SoTra reduces average zone-based risk by 18\%; in blood-pressure forecasting, it lowers effective clinical risk by approximately 15\%. These improvements support its use in safety-critical predictive control.

Amirreza Dolatpour Fathkouhi, Alireza Namazi, Heman Shakeri

Time-series imputation benchmarks employ uniform random masking and shape-agnostic metrics (MSE, RMSE), implicitly weighting evaluation by regime prevalence. In systems with a dominant attractor -- homeostatic physiology, nominal industrial operation, stable network traffic -- this creates a systematic \emph{Stationarity Bias}: simple methods appear superior because the benchmark predominantly samples the easy, low-entropy regime where they trivially succeed. We formalize this bias and propose a \emph{Stratified Stress-Test} that partitions evaluation into Stationary and Transient regimes. Using Continuous Glucose Monitoring (CGM) as a testbed -- chosen for its rigorous ground-truth forcing functions (meals, insulin) that enable precise regime identification -- we establish three findings with broad implications:(i)~Stationary Efficiency: Linear interpolation achieves state-of-the-art reconstruction during stable intervals, confirming that complex architectures are computationally wasteful in low-entropy regimes.(ii)~Transient Fidelity: During critical transients (post-prandial peaks, hypoglycemic events), linear methods exhibit drastically degraded morphological fidelity (DTW), disproportionate to their RMSE -- a phenomenon we term the \emph{RMSE Mirage}, where low pointwise error masks the destruction of signal shape.(iii)~Regime-Conditional Model Selection: Deep learning models preserve both pointwise accuracy and morphological integrity during transients, making them essential for safety-critical downstream tasks. We further derive empirical missingness distributions from clinical trials and impose them on complete training data, preventing models from exploiting unrealistically clean observations and encouraging robustness under real-world missingness. This framework generalizes to any regulated system where routine stationarity dominates critical transients.

Bruce Rushing, Angela Danquah, Alireza Namazi et al.

Effectively stratifying patient risk in chronic diseases like glaucoma is a major clinical challenge. Clinicians need tools to identify patients at high risk of progression from sparse and irregularly-sampled electronic health records (EHRs). We propose a novel deep kernel learning (DKL) architecture that leverages a Gaussian Process (GP) backend. The GP's kernel is defined by a transformer-based feature extractor applied to clinical-BERT embeddings to model glaucoma patient trajectories from multimodal EHR data. Our method successfully identifies three clinically distinct patient subgroups. Crucially, the model learns to decouple disease progression from current severity, identifying a high-risk group with a worsening trajectory despite having better average visual acuity than a second, stably poor group. This reveals that the model learns to identify progression risk rather than just the current disease state. This ability to stratify patients based on their risk trajectory progression offers a powerful tool for clinical decision support, enabling targeted interventions for high-risk individuals and improving the management of glaucoma care.

Alireza Namazi, Heman Shakeri

Clinical time-series forecasting is increasingly studied for decision support, yet standard aggregate metrics can obscure whether a model is actually useful for the task it is meant to serve. In safety-critical settings, low average error can coexist with dangerous failures in exactly the high-risk regimes that matter most. We present a task-aware evaluation framework for blood glucose forecasting built around two downstream uses: hypoglycemia early warning and insulin dosing decision support. For early warning, we evaluate on real data from three clinical cohorts using event-level recall and false alarms per patient-day, metrics that reflect operational alarm burden rather than aggregate accuracy. We show that models appearing acceptable overall, with recall above 0.9 on the full test set, can fail badly in the post-bolus slice, where insulin-on-board is elevated and missed warnings carry the greatest clinical consequences. Standard forecasting evaluation, however, does not test whether a model can reason about the effects of actions, a requirement for supporting insulin dosing decisions. We therefore add a second, interventional arm using the FDA-accepted UVA/Padova simulator, where we evaluate whether forecasters can predict glucose responses to altered insulin plans in paired factual/counterfactual scenarios. We show that models that look strong on real-data forecasting often fail to predict the direction, magnitude, or ranking of intervention effects, and choose poor insulin doses when evaluated under a clinically motivated cost. Taken together, the two arms reveal a consistent gap between forecasting accuracy and task-relevant usefulness. We release the benchmark, the standardized preprocessing pipeline for public cohorts, and the simulator-based interventional dataset as a reproducible toolkit.