Uncertainty-Calibrated Prediction of Randomly-Timed Biomarker Trajectories with Conformal Bands

Vasiliki Tassopoulou, Charis Stamouli, Haochang Shou, George J. Pappas, Christos Davatzikos

Advances in Neural Information Processing Systems 38 (NeurIPS 2025) Main Conference Track

We introduce a novel conformal prediction framework for constructing conformal prediction bands with high probability around biomarker trajectories observed at subject-specific, randomly-timed follow-up visits. Existing conformal methods typically assume fixed time grids, limiting their applicability in longitudinal clinical studies. Our approach addresses this limitation by defining a time-varying nonconformity score that normalizes prediction errors using model-derived uncertainty estimates, enabling conformal inference at arbitrary time points. We evaluate our method on two well-established brain biomarkers—hippocampal and ventricular volume—using a range of standard and state-of-the-art predictors. Across models, our conformalized predictors consistently achieve nominal coverage with tighter prediction intervals compared to baseline uncertainty estimates. To further account for population heterogeneity, we develop group-conditional conformal bands with formal coverage guarantees across clinically relevant and high-risk subgroups. Finally, we demonstrate the clinical utility of our approach in identifying subjects at risk of progression to Alzheimer’s disease. We introduce an uncertainty-aware progression metric based on the lower conformal bound and show that it enables the identification of 17.5\% more high-risk subjects compared to standard slope-based methods, highlighting the value of uncertainty calibration in real-world clinical decision making. We make the code available at \href{https://github.com/vatass/ConformalBiomarkerTrajectories}{\texttt{github.com/vatass/ConformalBiomarkerTrajectories}}.