Remote patient monitoring depends on patient-reported data to capture the subjective dimension of recovery that devices cannot measure. The Quality of Recovery (QoR-15) survey is the gold-standard instrument for this purpose. It was designed and validated for occasional in-hospital assessment, yet remote monitoring now administers it to patients daily. In our own post-surgical deployment, only 55% of patients submitted the survey more than 14 days of 30 monitoring days. We developed QoR-compact, a five-item daily input for the RPM prediction pathway. Setting a deployment-driven target of one-third of the daily items, we exhaustively evaluated all 3,003 five-question subsets of the QoR-15 and tested whether the best of them matches the full instrument in predicting near-term postoperative recovery severity. QoR-compact achieves a mean AUC-ROC of 0.968 (95% CI 0.915-0.988), statistically comparable to the 0.964 baseline obtained with one-third of the items. Patient-level backtesting indicates that it tracks readmission events as faithfully as the full form. Its five items span the physical and psychological axes of recovery: Q3 (feeling rested), Q9 (feeling comfortable and in control), Q10 (general well-being), Q12 (severe pain), and Q14 (feeling worried or anxious). The QoR-15 remains the gold-standard measure of recovery; QoR-compact complements it as a shorter daily input designed for prediction. This parity provides the basis for a prospective study of whether a lighter daily input is, in turn, completed more consistently. External validation on larger cohorts is required before clinical use.
Many clinical prediction models treat post-intervention outcomes as a one-step mapping from baseline measurements to a future endpoint. However, recovery after a procedure often unfolds as an irregular trajectory: clinical observations, medication changes, repeat interventions, and physiological measurements are recorded asynchronously and can change risk assessment over time. We propose an intervention-aware clinical world model that represents each patient with a structured latent state and evolves it through time-ordered post-intervention events. The model first encodes baseline imaging into a 3D spatial latent state. It then updates this state using procedural context, static covariates, elapsed time, and peri-event physiological embeddings. Follow-up imaging provides training-only supervision through a latent forecasting objective. We apply the framework to atrial fibrillation ablation. During the 90-day recovery window, irregular post-procedure records provide clinically meaningful evidence for long-term recurrence risk. In repeated internal cross-validation on DECAAF-II, our model achieves AUROC 0.756 and AUPRC 0.777 for recurrence prediction. It also achieves a scar-extent MAE of 2.971 percentage points without requiring follow-up MRI intensities at inference. The learned state supports recurrence-risk queries at different horizons and retrospective input editing of blanking-period records.
Electronic health records (EHRs) may incompletely capture patient-reported factors associated with opioid use disorder (OUD). We evaluated whether survey data improve prediction of a first recorded OUD diagnosis among 267,747 All of Us participants with documented opioid exposure, including 15,287 OUD cases. We compared EHR-only and EHR+survey models across 6-, 12-, and 24-month look-back windows using logistic regression, random forest, XGBoost, LightGBM, multilayer perceptron, LSTM, GRU, and Transformer. Survey augmentation improved PR-AUC across all 24 model-window combinations by 0.0087-0.0505; the best 24-month LightGBM model improved from 0.6219 to 0.6603. Survey coverage increased with longer windows and differed by OUD status (24 months: 21.7% OUD-positive vs. 60.7% OUD-negative). Permutation analysis ranked survey features as the second most important information domain at 24 months in both evaluated models. Patient-reported data provide complementary predictive signals beyond structured EHRs while highlighting the importance of survey availability.
Cardiac arrest remains one of the most lethal conditions encountered in intensive care units. Despite the growing availability of electronic health record data, existing mortality prediction studies in this population largely depend on static summaries derived from early admission. Such approaches ignore the temporal progression of physiological deterioration and recovery that unfolds throughout a patient's ICU stay. To address this limitation, we introduce QuanTiMedAI, a quantum-agentic framework developed for cardiac arrest mortality prediction using agentic AI guided quantum enhancement time series model. The proposed system combines an agentic large language model (LLM) for clinically informed feature discovery with a compact quantum recurrent network for temporality aware mortality prediction. Our findings demonstrate that agentic LLM-guided feature selection consistently outperforms conventional feature selection approaches, and the proposed quantum architecture achieves competitive predictive performance through nonlinear feature enhancement while keeping the number of parameters very low. Through extensive experimentation on a MIMIC-IV cohort of cardiac arrest patients, QuanTiMedAI's quantum-enhanced architecture attains an AUROC of 0.852 using only 605 parameters, an improvement of approximately 2.9% over a current state-of-the-art baseline for this task. A structured ablation study systematically validates the contribution of each architectural design choice. These results show that quantum-enhanced sequential modeling can exceed classical recurrent networks while using substantially fewer parameters.
Mutasim Fuad Sarker, Adiba Rahman Namira, Wafa Binte Alam +3