Uncertainty-Aware Prediction of Parkinson's Disease Medication Needs: A Two-Stage Conformal Prediction Approach

Fuente: arXiv
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Main Authors: Diaz-Rincon, Ricardo, Liang, Muxuan, Ramirez-Zamora, Adolfo, Shickel, Benjamin
Format: Preprint
Published: 2025
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author Diaz-Rincon, Ricardo
Liang, Muxuan
Ramirez-Zamora, Adolfo
Shickel, Benjamin
author_facet Diaz-Rincon, Ricardo
Liang, Muxuan
Ramirez-Zamora, Adolfo
Shickel, Benjamin
contents Parkinson's Disease (PD) medication management presents unique challenges due to heterogeneous disease progression and treatment response. Neurologists must balance symptom control with optimal dopaminergic dosing based on functional disability while minimizing side effects. This balance is crucial as inadequate or abrupt changes can cause levodopa-induced dyskinesia, wearing off, and neuropsychiatric effects, significantly reducing quality of life. Current approaches rely on trial-and-error decisions without systematic predictive methods. Despite machine learning advances, clinical adoption remains limited due to reliance on point predictions that do not account for prediction uncertainty, undermining clinical trust and utility. Clinicians require not only predictions of future medication needs but also reliable confidence measures. Without quantified uncertainty, adjustments risk premature escalation to maximum doses or prolonged inadequate symptom control. We developed a conformal prediction framework anticipating medication needs up to two years in advance with reliable prediction intervals and statistical guarantees. Our approach addresses zero-inflation in PD inpatient data, where patients maintain stable medication regimens between visits. Using electronic health records from 631 inpatient admissions at University of Florida Health (2011-2021), our two-stage approach identifies patients likely to need medication changes, then predicts required levodopa equivalent daily dose adjustments. Our framework achieved marginal coverage while reducing prediction interval lengths compared to traditional approaches, providing precise predictions for short-term planning and wider ranges for long-term forecasting. By quantifying uncertainty, our approach enables evidence-based decisions about levodopa dosing, optimizing symptom control while minimizing side effects and improving life quality.
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id arxiv_https___arxiv_org_abs_2508_10284
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Uncertainty-Aware Prediction of Parkinson's Disease Medication Needs: A Two-Stage Conformal Prediction Approach
Diaz-Rincon, Ricardo
Liang, Muxuan
Ramirez-Zamora, Adolfo
Shickel, Benjamin
Machine Learning
Methodology
Parkinson's Disease (PD) medication management presents unique challenges due to heterogeneous disease progression and treatment response. Neurologists must balance symptom control with optimal dopaminergic dosing based on functional disability while minimizing side effects. This balance is crucial as inadequate or abrupt changes can cause levodopa-induced dyskinesia, wearing off, and neuropsychiatric effects, significantly reducing quality of life. Current approaches rely on trial-and-error decisions without systematic predictive methods. Despite machine learning advances, clinical adoption remains limited due to reliance on point predictions that do not account for prediction uncertainty, undermining clinical trust and utility. Clinicians require not only predictions of future medication needs but also reliable confidence measures. Without quantified uncertainty, adjustments risk premature escalation to maximum doses or prolonged inadequate symptom control. We developed a conformal prediction framework anticipating medication needs up to two years in advance with reliable prediction intervals and statistical guarantees. Our approach addresses zero-inflation in PD inpatient data, where patients maintain stable medication regimens between visits. Using electronic health records from 631 inpatient admissions at University of Florida Health (2011-2021), our two-stage approach identifies patients likely to need medication changes, then predicts required levodopa equivalent daily dose adjustments. Our framework achieved marginal coverage while reducing prediction interval lengths compared to traditional approaches, providing precise predictions for short-term planning and wider ranges for long-term forecasting. By quantifying uncertainty, our approach enables evidence-based decisions about levodopa dosing, optimizing symptom control while minimizing side effects and improving life quality.
title Uncertainty-Aware Prediction of Parkinson's Disease Medication Needs: A Two-Stage Conformal Prediction Approach
topic Machine Learning
Methodology
url https://arxiv.org/abs/2508.10284