Improving Sepsis Prediction in the ICU with Explainable Artificial Intelligence: The Promise of Bayesian Networks

Background/Objectives: Sepsis remains one of the leading causes of mortality worldwide, characterized by a complex and heterogeneous clinical presentation. Despite advances in patient monitoring and biomarkers, early detection of sepsis in the intensive care unit (ICU) is often hampered by incomplete data and diagnostic uncertainty. In recent years, machine learning models have been proposed as predictive tools, but many function as opaque "black boxes", meaning that humans are unable to understand algorithmic reasoning, poorly suited to the uncertainty-laden clinical environment of critical care. Even when post-hoc interpretability methods are available for these algorithms, their explanations often remain difficult for non-expert clinicians to understand. Methods: In this clinical perspective, we explore the specific advantages of probabilistic graphical models, particularly Bayesian Networks (BNs) and their dynamic counterparts (DBNs), for sepsis prediction. Results: Recent applications of AI models in sepsis prediction have demonstrated encouraging results, such as DBNs achieving an AUROC of 0.94 in early detection, or causal probabilistic models in hospital admissions (AUROC 0.95). These models explicitly represent clinical reasoning under uncertainty, handle missing data natively, and offer interpretable, transparent decision paths. Drawing on recent studies, including real-time sepsis alert systems and treatment-effect modeling, we highlight concrete clinical applications and their current limitations. Conclusions: We argue that BNs present a great opportunity to bridge the gap between artificial intelligence and bedside care through human-in-the-loop collaboration, transparent inference, and integration into clinical information systems. As critical care continues to move toward data-driven decision-making, Bayesian models may offer not only technical performance but also the epistemic humility needed to support clinicians facing uncertain, high-stakes decisions.