Uncertainty Quantification for Clinical Outcome Predictions with (Large) Language Models

To facilitate healthcare delivery, language models (LMs) have significant potential for clinical prediction tasks using electronic health records (EHRs). However, in these high-stakes applications, unreliable decisions can result in high costs due to compromised patient safety and ethical concerns, thus increasing the need for good uncertainty modeling of automated clinical predictions. To address this, we consider uncertainty quantification of LMs for EHR tasks in both white-box and black-box settings. We first quantify uncertainty in white-box models, where we have access to model parameters and output logits. We show that an effective reduction of model uncertainty can be achieved by using the proposed multi-tasking and ensemble methods in EHRs. Continuing with this idea, we extend our approach to black-box settings, including popular proprietary LMs such as GPT-4. We validate our framework using longitudinal clinical data from over 6,000 patients across ten clinical prediction tasks. Results show that ensembling methods and multi-task prediction prompts reduce uncertainty across different scenarios. These findings increase model transparency in white-box and black-box settings, thereby advancing reliable AI healthcare. Our code is publically available at https://github.com/Cyrus9721/EHR_Uncertainty.