In this paper, we present a real-time implementation of a previously developed offline algorithm for predicting core temperature in humans. The real-time algorithm uses a zero-phase Butterworth digital filter to smooth the data and an autoregressive (AR) model to predict core temperature. The performance of the algorithm is assessed in terms of its prediction accuracy, quantified by the root mean squared error (RMSE), and in terms of prediction uncertainty, quantified by statistically based prediction intervals (PIs). To evaluate the performance of the algorithm, we simulated real-time implementation using core-temperature data collected during two different field studies, involving ten different individuals. One of the studies includes a case of heat illness suffered by one of the participants. The results indicate that although the real-time predictions yielded RMSEs that are larger than those of the offline algorithm, the real-time algorithm does produce sufficiently accurate predictions for practically meaningful prediction horizons (approximately 20 min). The algorithm reached alert (39 degrees C) and alarm (39.5 degrees C) thresholds for the heat-ill individual but did not even attain the alert threshold for the other individuals, demonstrating the algorithm's good sensitivity and specificity. The PIs reflected, in an intuitively expected manner, the uncertainty associated with real-time forecast as a function of prediction horizon and core-temperature variability. The results also corroborate the feasibility of "universal" AR models, where an offline-developed model based on one individual's data could be used to predict any other individual in real time. We conclude that the real-time implementation of the algorithm confirms the attributes observed in the offline version and, hence, could be considered as a warning tool for impending heat illnesses.
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