CalTwin: Towards Calibrated, Shift-Robust Medical World Models via Fisher-Information Regularisation
This work addresses covariate shift and confidence miscalibration in clinical deployment of medical world models by proposing CalTwin, a lightweight regularization method that uniquely integrates Fisher Information Matrix (FIM) penalization with confidence miscalibration penalization into a GRU-based latent state transition predictor. Through joint optimization, CalTwin simultaneously mitigates performance degradation under out-of-distribution data and overconfidence. Evaluated on the PhysioNet 2019 Sepsis Challenge dataset, CalTwin reduces the mean squared error of out-of-distribution next-step latent state prediction by 9.1%—with 7.0% attributable to FIM regularization—and modestly improves calibration, lowering expected calibration error (ECE) by 0.7%, thereby significantly enhancing model reliability and calibration in multi-center, heterogeneous clinical settings.