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This research introduces a rigorous statistical framework for triaging ICU cardiac alarms, balancing the reduction of false positives against the critical risk of missing genuine arrhythmias. By certifying suppression policies with bounded error rates, the study addresses the multiplicity costs inherent in optimizing safety-critical AI systems without relying on learned reliability dimensions that failed to improve performance. The findings offer a principled approach to deploying machine learning in high-stakes medical environments where alarm fatigue and patient safety are paramount trade-offs.
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Certified AI Triage of ICU Alarms

arXiv2 min read

arXiv:2609.12365v1 Announce Type: new Abstract: In the VTaC benchmark 71% of ventricular-tachycardia alarms are false, but silencing a real one can delay recognition of a dangerous arrhythmia. We reframe alarm reduction as three-way triage (retain, suppress, or defer) and bound the decision this analysis treats as harmful: among suppressed alarms, the fraction that were genuine stays below a user-set budget with 95% confidence, under i.i.d. event sampling. Alarms sharing a waveform record are dependent, so the clustered analysis is a sensitivity check. On the official split a 5% budget certifies in all three seeds, suppressing 74.8% of false alarms while silencing 1.5% of genuine ones, at AUROC 0.953 and Challenge Score 83.33, numerically comparable to the strongest of the eleven published systems. Our central finding measures what multiplicity costs: the correction charges for every candidate, so a finer grid can certify strictly less. Under held-out calibration the 885-cell grid we declared certifies 1 of 15 fold-runs, while choosing the grid on a separate selection partition certifies 8. We project the calibration volume each budget needs, making an uncertifiable budget a design parameter. Finally, adding a learned reliability dimension to the policy grid did not sharpen the certified frontier.

Abstract:In the VTaC benchmark 71% of ventricular-tachycardia alarms are false, but silencing a real one can delay recognition of a dangerous arrhythmia. We reframe alarm reduction as three-way triage (retain, suppress, or defer) and bound the decision this analysis treats as harmful: among suppressed alarms, the fraction that were genuine stays below a user-set budget with 95% confidence, under i.i.d. event sampling. Alarms sharing a waveform record are dependent, so the clustered analysis is a sensitivity check. On the official split a 5% budget certifies in all three seeds, suppressing 74.8% of false alarms while silencing 1.5% of genuine ones, at AUROC 0.953 and Challenge Score 83.33, numerically comparable to the strongest of the eleven published systems. Our central finding measures what multiplicity costs: the correction charges for every candidate, so a finer grid can certify strictly less. Under held-out calibration the 885-cell grid we declared certifies 1 of 15 fold-runs, while choosing the grid on a separate selection partition certifies 8. We project the calibration volume each budget needs, making an uncertifiable budget a design parameter. Finally, adding a learned reliability dimension to the policy grid did not sharpen the certified frontier.

Machine Learning (cs.LG)

arXiv:2609.12365 [cs.LG]

(or arXiv:2609.12365v1 [cs.LG] for this version)

https://doi.org/10.48550/arXiv.2609.12365 Focus to learn more arXiv-issued DOI via DataCite (pending registration)

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Full text under the publisher's open licence · 287 words

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