An Evolving AI-Driven Ensemble Learning Framework for Sickle Cell Crisis Prediction Using MIMIC-III Data

State-level health resource systems need precise and timely prediction models, but they are plagued by the ongoing problem of deteriorating model performance because of constantly shifting data distributions (data drift). Predicting uncommon but important events like sickle cell crisis is a classification task where this problem is most noticeable. This paper presents the Evolving AI-Driven Ensemble Learning Framework, which blends novelty detection using the F1-score with sophisticated ensemble approaches (stacking XGBoost, Deep Neural Network, and Random Forest with a meta-learner). Complex, high-dimensional health data are handled using sophisticated feature engineering techniques, such as automated feature selection via evolutionary algorithms and meta-learning (MAML). We empirically assessed a reactive retraining technique that was improved by ensemble stacking and simulated real-time data drift. After five retraining cycles, the improved ensemble and feature engineering showed significant performance improvements over the initial model, achieving substantial improvements: F1-score improved from 0.1250 to 0.9734 (an absolute increase of 0.8484, representing a 678.7% relative improvement), recall from 0.0714 to 0.9767 (an absolute increase of 0.9053), and precision from 0.5000 to 0.9702 (an absolute increase of 0.4702). The framework maintained high specificity (0.9700) and demonstrated outstanding discriminative performance with an AUC-ROC of 0.9909 (an 8.5% improvement). The model’s strong predictive capacity was confirmed by improvements in the Matthews Correlation Coefficient from 0.1000 to 0.9467 (846.7% improvement) and Cohen’s Kappa from 0.0800 to 0.9467 (1083.3% improvement). Model transparency in pipeline development is now made possible by a fixed runtime issued in the SHAP explainability layer. The efficiency of the framework is empirically validated by this study, showing that automated feature engineering and optimized ensemble learning greatly increase model stability and preserve remarkable accuracy for minority classes in complicated data contexts.