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  <front>
    <journal-meta><journal-id journal-id-type="publisher">NHESS</journal-id><journal-title-group>
    <journal-title>Natural Hazards and Earth System Sciences</journal-title>
    <abbrev-journal-title abbrev-type="publisher">NHESS</abbrev-journal-title><abbrev-journal-title abbrev-type="nlm-ta">Nat. Hazards Earth Syst. Sci.</abbrev-journal-title>
  </journal-title-group><issn pub-type="epub">1684-9981</issn><publisher>
    <publisher-name>Copernicus Publications</publisher-name>
    <publisher-loc>Göttingen, Germany</publisher-loc>
  </publisher></journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.5194/nhess-26-4825-2026</article-id><title-group><article-title>Forecasting European temperature-related mortality in Summer 2024: data-driven vs. physics-based forecast approaches</article-title><alt-title>AI- vs. physics-based forecasting of European temperature-related mortality</alt-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author" corresp="yes" rid="aff1 aff2 aff3 aff4 aff5">
          <name><surname>Holmberg</surname><given-names>Emma</given-names></name>
          <email>emma.holmberg@unibe.ch</email>
        <ext-link>https://orcid.org/0000-0003-4908-4113</ext-link></contrib>
        <contrib contrib-type="author" corresp="no" rid="aff1 aff2 aff3">
          <name><surname>Olivetti</surname><given-names>Leonardo</given-names></name>
          
        <ext-link>https://orcid.org/0009-0003-4904-4362</ext-link></contrib>
        <aff id="aff1"><label>1</label><institution>Department of Earth Sciences, Uppsala University, Uppsala, Sweden</institution>
        </aff>
        <aff id="aff2"><label>2</label><institution>Centre for Natural Hazards and Disaster Science (CNDS), Uppsala University, Uppsala, Sweden</institution>
        </aff>
        <aff id="aff3"><label>3</label><institution>Swedish Centre for Impacts of Climate Extremes (climes), Uppsala University, Uppsala, Sweden</institution>
        </aff>
        <aff id="aff4"><label>4</label><institution>Institute of Social and Preventative Medicine, University of Bern, Bern, Switzerland</institution>
        </aff>
        <aff id="aff5"><label>5</label><institution>Oeschger Centre for Climate Change Research, University of Bern, Bern, Switzerland</institution>
        </aff>
      </contrib-group>
      <author-notes><corresp id="corr1">Emma Holmberg (emma.holmberg@unibe.ch)</corresp></author-notes><pub-date><day>6</day><month>October</month><year>2026</year></pub-date>
      
      <volume>26</volume>
      <issue>10</issue>
      <fpage>4825</fpage><lpage>4842</lpage>
      <history>
        <date date-type="received"><day>27</day><month>February</month><year>2026</year></date>
           <date date-type="rev-request"><day>11</day><month>March</month><year>2026</year></date>
           <date date-type="rev-recd"><day>31</day><month>August</month><year>2026</year></date>
           <date date-type="accepted"><day>9</day><month>September</month><year>2026</year></date>
      </history>
      <permissions>
        <copyright-statement>Copyright: © 2026 Emma Holmberg</copyright-statement>
        <copyright-year>2026</copyright-year>
      <license license-type="open-access"><license-p>This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this licence, visit <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">https://creativecommons.org/licenses/by/4.0/</ext-link></license-p></license></permissions><self-uri xlink:href="https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026.html">This article is available from https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026.html</self-uri><self-uri xlink:href="https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026.pdf">The full text article is available as a PDF file from https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026.pdf</self-uri>
      <abstract><title>Abstract</title>

      <p id="d2e116">Heat has emerged as a major public health concern. Over 62 000 heat-related deaths were estimated to have occurred during the European summer of 2024, exemplifying the pressing need to develop effective early warning systems. Such systems depend critically on the quality of the underlying forecasts, and recent work has focused on developing impact-based forecasts for heat-related mortality, which provide impact-oriented information. To date, heat-related mortality forecasts have been based on the output of numerical weather prediction models, or physics-based forecasts. The field of weather forecasting is undergoing a rapid transformation with the advent of skillful data-driven forecasts. This case study compares European temperature-related mortality forecasts for summer 2024 based on physics-based weather forecasts with those based on data-driven weather forecasts. Our results highlight that both the physics-based and data-driven forecasts systematically underestimate temperature-related mortality, more pronouncedly so in the latter. Both types of forecasts appear sensitive to forecast errors at hot temperatures, due to the non-linear relationship between temperature and mortality. Nevertheless, temperature-related mortality forecasts based on data-driven weather forecasts appear to be a promising alternative to traditional physics-based weather forecasts, and targeted improvement of the representation of hot temperatures through bias correction or adjustment of the loss function to give greater weighting to hot temperatures could be beneficial for temperature-related mortality forecasting. We suggest the application of this approach to both data-driven and physics-based forecast ensembles as an important next step in the continued development of informative, impact-oriented forecasts.</p>
  </abstract>
    
<funding-group>
<award-group id="gs1">
<funding-source>Horizon 2020</funding-source>
<award-id>956396</award-id>
<award-id>948309</award-id>
</award-group>
<award-group id="gs2">
<funding-source>Vetenskapsrådet</funding-source>
<award-id>2022-06599</award-id>
<award-id>2022-03448</award-id>
</award-group>
</funding-group>
</article-meta>
  </front>
<body>
      

<sec id="Ch1.S1" sec-type="intro">
  <label>1</label><title>Introduction</title>
      <p id="d2e128">Heat has been highlighted as a major public health issue. Over 62 000 heat-related deaths were estimated to have occurred in Europe during the summer of 2024 <xref ref-type="bibr" rid="bib1.bibx17" id="paren.1"/>, which follows similarly high death tolls in the previous two summers <xref ref-type="bibr" rid="bib1.bibx1 bib1.bibx9" id="paren.2"/>. There is an urgent need to help society adapt to our warming climate, and to mitigate the burden of preventable heat-related fatalities <xref ref-type="bibr" rid="bib1.bibx18 bib1.bibx36" id="paren.3"/>. Effective early-warning systems are a key element in this process; these systems depend on reliable and informative underlying forecasts. Traditionally, heat warning systems were based on hazard-focused forecasts <xref ref-type="bibr" rid="bib1.bibx21" id="paren.4"/>. Recent work has argued for moving towards an impact-focused perspective, which is able to provide richer information to decision makers <xref ref-type="bibr" rid="bib1.bibx25" id="paren.5"/>.</p>
      <p id="d2e146">Impact-based forecasts typically depend on accurate and reliable hazard forecasts. Currently, two main frameworks exist for generating weather forecasts. Physics-based forecasts refer to weather forecasts issued from numerical weather prediction models. These models develop predictions by solving numerical equations representing the physics of the atmosphere, as well as other components of our earth system such as oceans, and have been the core framework for producing weather predictions for the past decades. Data-driven forecasts refer to weather forecasts where techniques from the field of statistics and artificial intelligence have been used to train weather models based on large amounts of historical weather data, typically in the form of reanalysis datasets such as ERA5. The rapid development of data-driven weather models contrasts the so called `quiet revolution' of traditional, physics-based numerical weather prediction (NWP) models <xref ref-type="bibr" rid="bib1.bibx2" id="paren.6"/>. In the last few years, data-driven approaches have achieved a level of improvement that took physics-based approaches decades to achieve <xref ref-type="bibr" rid="bib1.bibx32" id="paren.7"/>. Now, data driven approaches show competitiveness not only for general skill metrics, but also for extremes <xref ref-type="bibr" rid="bib1.bibx41 bib1.bibx27" id="paren.8"/>. Nevertheless, important challenges remain. Data-driven approaches still struggle to forecast extremes in some cases <xref ref-type="bibr" rid="bib1.bibx28 bib1.bibx40" id="paren.9"/>, and the loss functions typically used in deterministic training prioritise performance near the centre of the distribution rather than in its tails <xref ref-type="bibr" rid="bib1.bibx39 bib1.bibx26" id="paren.10"/>. As a result, these models are prone to underestimating extremes due to the double-penalty problem. Furthermore, it remains an open question as to whether data-driven models can reliably predict events outside the domain of their training data, particularly those approaching or exceeding historical records <xref ref-type="bibr" rid="bib1.bibx35" id="paren.11"/>.</p>
      <p id="d2e168">These limitations are likely to be especially relevant for impact forecasting, as impacts are often non-linearly related to hazards, with extreme conditions producing disproportionately large consequences <xref ref-type="bibr" rid="bib1.bibx6 bib1.bibx33" id="paren.12"/>. <xref ref-type="bibr" rid="bib1.bibx14" id="text.13"/> showed that this non-linear relationship is critically important for forecasts of heat-related mortality, which are particularly sensitive to errors in temperature forecasts at high temperatures. This means that weather forecasts with low average error may not necessarily translate to accurate and reliable impact forecasts. Instead, we posit that underlying weather forecasts that perform best for high temperatures would correspond to the lowest errors for heat-related mortality forecasts. Because of these reasons, it is currently not clear whether data driven approaches can outperform physics-based forecasts for impact forecasting.</p>
      <p id="d2e177">Here we compare European temperature-related mortality forecasts based on data-driven weather forecasts with those based on traditional physics-based NWP model forecasts for the summer of 2024. This summer was chosen as a case study both because it represented the most recent forecasts available at the time the analysis was conducted, thereby the most recent forecast model versions, and because 2024 provides an illustrative example of a hot summer <xref ref-type="bibr" rid="bib1.bibx4" id="paren.14"/> with a high heat-related death toll <xref ref-type="bibr" rid="bib1.bibx17" id="paren.15"/>. In our warming climate, this is representative of conditions where health impacts based forecasts could ideally be used operationally to inform early warning systems and heat action plans. In essence, our aim is to use an epidemiological transformation for temperature-related mortality as an explicitly impact-oriented error metric.</p>
      <p id="d2e187">The remainder of the study is structured as follows: Sect. <xref ref-type="sec" rid="Ch1.S2"/> details the data and methods used in this study. The results of this study are presented in Sect. <xref ref-type="sec" rid="Ch1.S3"/>, and then discussed in Sect. <xref ref-type="sec" rid="Ch1.S4"/>. Finally, we summarise the main conclusions of this work in Sect. <xref ref-type="sec" rid="Ch1.S5"/>.</p>
</sec>
<sec id="Ch1.S2">
  <label>2</label><title>Data and methods</title>
<sec id="Ch1.S2.SS1">
  <label>2.1</label><title>Meteorological data</title>
      <p id="d2e213">This study uses 2 m temperature values from two types of meteorological datasets: ERA5 reanalysis data <xref ref-type="bibr" rid="bib1.bibx12" id="paren.16"/> (spatial resolution: 0.25 <inline-formula><mml:math id="M1" display="inline"><mml:mo>×</mml:mo></mml:math></inline-formula> 0.25°) and operational forecast data from the European Centre for Medium-range Weather Forecasts (ECMWF; spatial resolution: 0.25 <inline-formula><mml:math id="M2" display="inline"><mml:mo>×</mml:mo></mml:math></inline-formula> 0.25°). The reanalysis data was temporally averaged to daily resolution to correspond to the temporal resolution of the health data as in <xref ref-type="bibr" rid="bib1.bibx23" id="text.17"/>. For the forecasts data we used 12-hourly forecast initialisations and performed a daily average so as to correspond to daily average values as in <xref ref-type="bibr" rid="bib1.bibx23" id="text.18"/>. Our temporal domain spans the boreal summer of 2024 (1 June 2024–31 August 2024), and the spatial domain encompasses Europe. Specifically, this study focuses on a selection of 854 cities across 30 European countries  further detailed in Sect. <xref ref-type="sec" rid="Ch1.S2.SS2"/>. The location of each of these cities was approximated by the closest grid point of the meteorological data. Here we consider reanalysis data to be our ground truth; in this case 2 m temperature from the ERA5 dataset <xref ref-type="bibr" rid="bib1.bibx12" id="paren.19"/>. We also use 2 m temperature from archived forecasts from two different types of weather prediction models, one physical model (IFS HRES cycle 48r1), and one data driven model (AIFS single v1), which were the model versions available at the time this analysis was performed. These models are the flagship, state-of-the-art models developed ECWMF, and are widely considered some of the best weather forecasting models in the world. We consider lead times of 1, 3, 5, 7 and 10 d, and take forecast initialisations so that the forecasts correspond to the reanalysis data and are valid for the time period 1 June 2024–31 August 2024. In both cases we only consider a deterministic perspective, which is a limitation of this study.</p>
</sec>
<sec id="Ch1.S2.SS2">
  <label>2.2</label><title>Epidemiological framework</title>
      <p id="d2e253">Temperature-related mortality is here calculated using an epidemiological framework to estimate the exposure-response relationship between temperature and all-cause mortality for a given location. This methodology relating lagged mortality effects to environmental variables was first developed by <xref ref-type="bibr" rid="bib1.bibx7 bib1.bibx34" id="text.20"/>, then subsequently expanded upon and popularised by <xref ref-type="bibr" rid="bib1.bibx10 bib1.bibx11" id="text.21"/>. We use the fits for 854 European cities presented by <xref ref-type="bibr" rid="bib1.bibx23" id="text.22"/>. Figure <xref ref-type="fig" rid="FA1"/> in the Appendix shows the location of these cities. This is based on a two-stage time series analysis which employs distributed lag non-linear models (DLNM) <xref ref-type="bibr" rid="bib1.bibx11" id="paren.23"/>. The exposure-response function is first estimated using a quasi-Poisson regression, which accounts for the over-dispersed nature of mortality data. The lagged effect due to temperature is taken into account by a cross-basis function, which allows for a high degree of flexibility to capture the complex dependence structure. These estimates are refined in a second stage by pooling the coefficients of the exposure-response functions in a repeated-measure multivariate meta-regression model <xref ref-type="bibr" rid="bib1.bibx23" id="paren.24"/>. This step accounts for the numerous, often correlated, factors affecting the differing vulnerability between cities. The risk of mortality is calculated based on the fitted regression model. The relative risk (RR) is then defined as the risk of mortality at a given temperature divided by the risk of mortality at the minimum mortality temperature (MMT):

            <disp-formula id="Ch1.E1" content-type="numbered"><label>1</label><mml:math id="M3" display="block"><mml:mrow><mml:mi mathvariant="normal">RR</mml:mi><mml:mo>(</mml:mo><mml:mi>t</mml:mi><mml:mn mathvariant="normal">2</mml:mn><mml:mspace width="0.125em" linebreak="nobreak"/><mml:mrow class="unit"><mml:mi mathvariant="normal">m</mml:mi></mml:mrow><mml:mo>(</mml:mo><mml:mi>t</mml:mi><mml:mo>)</mml:mo><mml:mo>)</mml:mo><mml:mo>=</mml:mo><mml:mstyle displaystyle="true"><mml:mfrac style="display"><mml:mrow><mml:mi>R</mml:mi><mml:mo>(</mml:mo><mml:mi>t</mml:mi><mml:mn mathvariant="normal">2</mml:mn><mml:mspace linebreak="nobreak" width="0.125em"/><mml:mrow class="unit"><mml:mi mathvariant="normal">m</mml:mi></mml:mrow><mml:mo>(</mml:mo><mml:mi>t</mml:mi><mml:mo>)</mml:mo><mml:mo>)</mml:mo></mml:mrow><mml:mrow><mml:mi>R</mml:mi><mml:mo>(</mml:mo><mml:mi mathvariant="normal">MMT</mml:mi><mml:mo>)</mml:mo></mml:mrow></mml:mfrac></mml:mstyle><mml:mo>,</mml:mo></mml:mrow></mml:math></disp-formula>

          where <inline-formula><mml:math id="M4" display="inline"><mml:mrow><mml:mi mathvariant="normal">RR</mml:mi><mml:mo>(</mml:mo><mml:mi>t</mml:mi><mml:mn mathvariant="normal">2</mml:mn><mml:mspace linebreak="nobreak" width="0.125em"/><mml:mrow class="unit"><mml:mi mathvariant="normal">m</mml:mi></mml:mrow><mml:mo>)</mml:mo></mml:mrow></mml:math></inline-formula> is the RR, <inline-formula><mml:math id="M5" display="inline"><mml:mrow><mml:mi>R</mml:mi><mml:mo>(</mml:mo><mml:mi>t</mml:mi><mml:mn mathvariant="normal">2</mml:mn><mml:mspace width="0.125em" linebreak="nobreak"/><mml:mrow class="unit"><mml:mi mathvariant="normal">m</mml:mi></mml:mrow><mml:mo>(</mml:mo><mml:mi>t</mml:mi><mml:mo>)</mml:mo><mml:mo>)</mml:mo></mml:mrow></mml:math></inline-formula> is the risk of mortality, <inline-formula><mml:math id="M6" display="inline"><mml:mrow><mml:mi>t</mml:mi><mml:mn mathvariant="normal">2</mml:mn><mml:mspace linebreak="nobreak" width="0.125em"/><mml:mrow class="unit"><mml:mi mathvariant="normal">m</mml:mi></mml:mrow></mml:mrow></mml:math></inline-formula> is the temperature, <inline-formula><mml:math id="M7" display="inline"><mml:mi>t</mml:mi></mml:math></inline-formula> denotes time and MMT denotes the MMT. Equation (<xref ref-type="disp-formula" rid="Ch1.E1"/>) is equivalent to the following:

            <disp-formula id="Ch1.E2" content-type="numbered"><label>2</label><mml:math id="M8" display="block"><mml:mrow><mml:mi mathvariant="normal">RR</mml:mi><mml:mo>(</mml:mo><mml:mi>t</mml:mi><mml:mn mathvariant="normal">2</mml:mn><mml:mspace linebreak="nobreak" width="0.125em"/><mml:mrow class="unit"><mml:mi mathvariant="normal">m</mml:mi></mml:mrow><mml:mo>(</mml:mo><mml:mi>t</mml:mi><mml:mo>)</mml:mo><mml:mo>)</mml:mo><mml:mo>=</mml:mo><mml:mstyle displaystyle="true"><mml:mfrac style="display"><mml:mrow><mml:mi mathvariant="double-struck">E</mml:mi><mml:mfenced close=")" open="("><mml:mrow><mml:mi>M</mml:mi><mml:mfenced open="(" close=")"><mml:mrow><mml:mi>t</mml:mi><mml:mn mathvariant="normal">2</mml:mn><mml:mspace linebreak="nobreak" width="0.125em"/><mml:mrow class="unit"><mml:mi mathvariant="normal">m</mml:mi></mml:mrow><mml:mfenced close=")" open="("><mml:mi>t</mml:mi></mml:mfenced></mml:mrow></mml:mfenced></mml:mrow></mml:mfenced></mml:mrow><mml:mrow><mml:mi mathvariant="double-struck">E</mml:mi><mml:mfenced close=")" open="("><mml:mrow><mml:mi>M</mml:mi><mml:mfenced close=")" open="("><mml:mi mathvariant="normal">MMT</mml:mi></mml:mfenced></mml:mrow></mml:mfenced></mml:mrow></mml:mfrac></mml:mstyle><mml:mo>,</mml:mo></mml:mrow></mml:math></disp-formula>

          where <inline-formula><mml:math id="M9" display="inline"><mml:mrow><mml:mi mathvariant="double-struck">E</mml:mi><mml:mo>(</mml:mo><mml:mi>M</mml:mi><mml:mo>(</mml:mo><mml:mi>t</mml:mi><mml:mn mathvariant="normal">2</mml:mn><mml:mspace linebreak="nobreak" width="0.125em"/><mml:mrow class="unit"><mml:mi mathvariant="normal">m</mml:mi></mml:mrow><mml:mo>(</mml:mo><mml:mi>t</mml:mi><mml:mo>)</mml:mo><mml:mo>)</mml:mo><mml:mo>)</mml:mo></mml:mrow></mml:math></inline-formula> is the expected value of mortality at a given temperature, <inline-formula><mml:math id="M10" display="inline"><mml:mrow><mml:mi>t</mml:mi><mml:mn mathvariant="normal">2</mml:mn><mml:mspace width="0.125em" linebreak="nobreak"/><mml:mrow class="unit"><mml:mi mathvariant="normal">m</mml:mi></mml:mrow></mml:mrow></mml:math></inline-formula>. The RR is related to the attributable fraction of mortality due to non-optimal temperatures (AF) as follows:

            <disp-formula id="Ch1.E3" content-type="numbered"><label>3</label><mml:math id="M11" display="block"><mml:mrow><mml:mi mathvariant="normal">AF</mml:mi><mml:mo>=</mml:mo><mml:mn mathvariant="normal">1</mml:mn><mml:mo>-</mml:mo><mml:mstyle displaystyle="true"><mml:mfrac style="display"><mml:mn mathvariant="normal">1</mml:mn><mml:mi mathvariant="normal">RR</mml:mi></mml:mfrac></mml:mstyle><mml:mo>,</mml:mo></mml:mrow></mml:math></disp-formula>

          this quantity is a fraction and therefore unit-less. For further details on this methodology we refer the reader to <xref ref-type="bibr" rid="bib1.bibx23" id="text.25"/>.</p>
</sec>
<sec id="Ch1.S2.SS3">
  <label>2.3</label><title>Computation of temperature-related mortality forecasts</title>
      <p id="d2e550">We compute AF forecasts by applying the epidemiological framework outlined in Sect. <xref ref-type="sec" rid="Ch1.S2.SS2"/> to our weather forecasts and reanalysis data separately, following the methodology of <xref ref-type="bibr" rid="bib1.bibx31" id="text.26"/>. We compare the AF forecasts from the two forecasts models (IFS and AIFS), using the mean error and mean absolute error (MAE), calculated separately for each lead-time and location, as described in <xref ref-type="bibr" rid="bib1.bibx13 bib1.bibx29" id="text.27"/>, respectively. The mean error (bias) is a standard metric for assessing systematic biases in forecasts and is defined as the difference between the forecast and a reference dataset (here ERA5):

            <disp-formula id="Ch1.E4" content-type="numbered"><label>4</label><mml:math id="M12" display="block"><mml:mrow><mml:mtext>bias</mml:mtext><mml:mo>=</mml:mo><mml:mstyle displaystyle="true"><mml:mfrac style="display"><mml:mn mathvariant="normal">1</mml:mn><mml:mi>N</mml:mi></mml:mfrac></mml:mstyle><mml:munderover><mml:mo movablelimits="false">∑</mml:mo><mml:mrow><mml:mi>i</mml:mi><mml:mo>=</mml:mo><mml:mn mathvariant="normal">1</mml:mn></mml:mrow><mml:mi>N</mml:mi></mml:munderover><mml:mo>(</mml:mo><mml:msub><mml:mi>x</mml:mi><mml:mi>i</mml:mi></mml:msub><mml:mo>-</mml:mo><mml:msub><mml:mi>y</mml:mi><mml:mi>i</mml:mi></mml:msub><mml:mo>)</mml:mo><mml:mo>,</mml:mo></mml:mrow></mml:math></disp-formula>

          where <inline-formula><mml:math id="M13" display="inline"><mml:mi>N</mml:mi></mml:math></inline-formula> is the total number of forecast initialisations (here <inline-formula><mml:math id="M14" display="inline"><mml:mrow><mml:mi>N</mml:mi><mml:mo>=</mml:mo><mml:mn mathvariant="normal">92</mml:mn></mml:mrow></mml:math></inline-formula>, and corresponds to once per day over boreal summer), <inline-formula><mml:math id="M15" display="inline"><mml:mrow><mml:msub><mml:mi>x</mml:mi><mml:mi>i</mml:mi></mml:msub></mml:mrow></mml:math></inline-formula> is the <inline-formula><mml:math id="M16" display="inline"><mml:mi>i</mml:mi></mml:math></inline-formula>th realisation of the forecast, and <inline-formula><mml:math id="M17" display="inline"><mml:mrow><mml:msub><mml:mi>y</mml:mi><mml:mi>i</mml:mi></mml:msub></mml:mrow></mml:math></inline-formula> is the corresponding ground truth value, in our case ERA5. This metric is applied as a means of assessing for the presence of systematic under- or over-estimation of temperature related mortality. In this study we consider only one year, and so consider the average over all days in the study. Additionally, we consider the bias of forecast quantiles with the help of quantile-quantile plots, as for instance in <xref ref-type="bibr" rid="bib1.bibx3" id="text.28"/>. The MAE is a standard metric for evaluating the performance of deterministic forecasts, and is defined as:

            <disp-formula id="Ch1.E5" content-type="numbered"><label>5</label><mml:math id="M18" display="block"><mml:mrow><mml:mi mathvariant="normal">MAE</mml:mi><mml:mo>=</mml:mo><mml:mstyle displaystyle="true"><mml:mfrac style="display"><mml:mn mathvariant="normal">1</mml:mn><mml:mi>N</mml:mi></mml:mfrac></mml:mstyle><mml:munderover><mml:mo movablelimits="false">∑</mml:mo><mml:mrow><mml:mi>i</mml:mi><mml:mo>=</mml:mo><mml:mn mathvariant="normal">1</mml:mn></mml:mrow><mml:mi>N</mml:mi></mml:munderover><mml:mo>|</mml:mo><mml:msub><mml:mi>x</mml:mi><mml:mi>i</mml:mi></mml:msub><mml:mo>-</mml:mo><mml:msub><mml:mi>y</mml:mi><mml:mi>i</mml:mi></mml:msub><mml:mo>|</mml:mo><mml:mo>,</mml:mo></mml:mrow></mml:math></disp-formula>

          where again <inline-formula><mml:math id="M19" display="inline"><mml:mi>N</mml:mi></mml:math></inline-formula> is the total number of forecast initialisations, <inline-formula><mml:math id="M20" display="inline"><mml:mrow><mml:msub><mml:mi>x</mml:mi><mml:mi>i</mml:mi></mml:msub></mml:mrow></mml:math></inline-formula> is the <inline-formula><mml:math id="M21" display="inline"><mml:mi>i</mml:mi></mml:math></inline-formula>th realisation of the forecast, and <inline-formula><mml:math id="M22" display="inline"><mml:mrow><mml:msub><mml:mi>y</mml:mi><mml:mi>i</mml:mi></mml:msub></mml:mrow></mml:math></inline-formula> is the corresponding ground truth value. This metric complements the forecast bias as it is not vulnerable to the cancellation of errors. We quantify uncertainty using a bootstrapping approach from the bootstrap function from the stats module of the Python package SciPy <xref ref-type="bibr" rid="bib1.bibx38" id="paren.29"/> to estimate the 95 % confidence interval for the mean. We do not evaluate the uncertainty owing to the epidemiological fit as we are here focusing on the performance of the two different types of forecasts. The linear fits were performed using the “linregress” routine from the Python package Scipy <xref ref-type="bibr" rid="bib1.bibx38" id="paren.30"/>.</p>
</sec>
</sec>
<sec id="Ch1.S3">
  <label>3</label><title>Results</title>
      <p id="d2e757">We present our results in two parts: first we examine Rome as an illustrative case study, and then proceed to perform a skill assessment for Europe at continental scale. Italy reported the highest heat-related death toll for Europe in 2024 <xref ref-type="bibr" rid="bib1.bibx17" id="paren.31"/>, thus we have selected its capital as the location of our case study. The continental scale assessment was performed using population weighted averages for the variables concerned, where the population data was that provided together with the temperature-mortality associations by <xref ref-type="bibr" rid="bib1.bibx23" id="text.32"/>.</p>

      <fig id="F1" specific-use="star"><label>Figure 1</label><caption><p id="d2e768">Time series of temperature <bold>(a)</bold> and AF <bold>(b)</bold> for the summer of 2024 in Rome. The minimum mortality temperature for Rome is shown by the black dashed line in <bold>(a)</bold>. Time series of the AF forecast bias for Rome during the summer of 2024, where green denotes the physics-based forecast (HRES) and purple denotes the data-driven forecast (AIFS), smoothed with a 7 d rolling mean <bold>(c–f)</bold>. Lead times 1 d <bold>(c)</bold>, 3 d <bold>(d)</bold>, 5 d <bold>(e)</bold> and 7 d <bold>(f)</bold> are shown. The dashed black line represents the ground truth obtained when using ERA5 as meteorological input data.</p></caption>
        <graphic xlink:href="https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026-f01.png"/>

      </fig>

<sec id="Ch1.S3.SS1">
  <label>3.1</label><title>Case study: Rome</title>
      <p id="d2e809">We begin by looking at time series of temperature and AF for our case study. Figure <xref ref-type="fig" rid="F1"/>a shows a time series of temperature corresponding to the city of Rome. June is generally cooler and more variable than later in the summer, albeit with several hot periods clearly exceeding the MMT. The corresponding AF is highly variable; no clear trend is evident, which may be due to the small sample size (Fig. <xref ref-type="fig" rid="F1"/>b). In Fig. <xref ref-type="fig" rid="F1"/>c–f we see that the AF forecast bias is smaller in magnitude for the physics-based forecasts than the data-driven forecasts for all lead times. On average the MAE is lower for the data-driven forecasts than the physics-based forecasts (Appendix Figs. <xref ref-type="fig" rid="FA3"/>, <xref ref-type="fig" rid="FA4"/>). We also show the distribution of forecast bias with a histogram in Fig. <xref ref-type="fig" rid="FA2"/>. No pattern with respect to lead-time is clearly visible.</p>
      <p id="d2e825">We now consider the relationship between temperature and AF, and lead time. Figure <xref ref-type="fig" rid="F2"/>a shows a systematic overestimation of temperature for Rome from the physics-based forecast, which increases with lead time. The data-driven forecast overestimates temperature for lead times 1 and 3 d, and decreases with lead time. After transforming to AF, the physics-based forecast shows no significant systematic error. The data-driven forecast shows an underestimation, albeit with the upper bound of the 95 % confidence interval very close to zero for the first week of forecasts (Fig. <xref ref-type="fig" rid="F2"/>b). The data-driven temperature forecasts show lower MAE than for the physics based temperature forecasts (Fig. <xref ref-type="fig" rid="F2"/>c), the signal remains present but weaker for the AF MAE (Fig. <xref ref-type="fig" rid="F2"/>d).</p>

      <fig id="F2" specific-use="star"><label>Figure 2</label><caption><p id="d2e838"><bold>(a)</bold> Mean temperature forecast bias vs. lead time for the summer of 2024 in Rome. <bold>(b)</bold> Mean AF forecast bias vs. lead time. <bold>(c)</bold> MAE for temperature forecasts vs. lead time. <bold>(d)</bold> MAE for AF forecasts vs. lead time. Physics-based forecasts are shown in green and data-driven forecasts are shown in purple <bold>(a–d)</bold>. The shading denotes the 95 % confidence intervals, which were computed by bootstrapping as described in the methods section.</p></caption>
          <graphic xlink:href="https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026-f02.png"/>

        </fig>

      <p id="d2e862">In summary, this case study showcases the high variability within AF estimations and predictions for summer 2024. Nonetheless, these results highlight the non-linear relationship between temperature and AF; this forecast evaluation showed qualitatively different results for temperature and AF, as well as for the different types of AF forecasts, for the summer of 2024 in Rome.</p>
</sec>
<sec id="Ch1.S3.SS2">
  <label>3.2</label><title>Forecast assessment at continental scale</title>
      <p id="d2e874">We now turn our attention to a continental scale, considering a population-weighted average for all cities in the study. First we show time series of temperature and AF. Figure <xref ref-type="fig" rid="F3"/>a shows the hottest temperatures from mid-July through to mid August, although another hot period of slightly lower intensity is also visible in late June. The corresponding AF shows larger variability than for temperature, although again the highest values are present during the middle of summer (Fig. <xref ref-type="fig" rid="F3"/>b). The remainder of Fig. <xref ref-type="fig" rid="F3"/> considers AF forecast bias time series for the different lead times. Figure <xref ref-type="fig" rid="F3"/>c–f shows largest positive forecast bias at the beginning of summer in June, and negative forecast bias in the late summer in August, for all lead times. The signal for positive bias in June is most evident for the physics-based forecasts, with this becoming more prominent with increasing lead time (Fig. <xref ref-type="fig" rid="F3"/>d–f). The data-driven forecasts show larger (negative) bias than the physics-based forecasts, with the bias increasing in size for longer lead times (Fig. <xref ref-type="fig" rid="F3"/>d–f).</p>

      <fig id="F3" specific-use="star"><label>Figure 3</label><caption><p id="d2e892">Time series for the summer of 2024 for temperature <bold>(a)</bold>, AF <bold>(b)</bold>, AF forecast bias smoothed with a 7 d rolling mean for lead times 1 d <bold>(c)</bold>, 3 d <bold>(d)</bold>, 5 d <bold>(e)</bold> and 7 d <bold>(f)</bold>, where values are population-weighted means. Green denotes the physics-based forecast and purple denotes the data-driven forecast <bold>(a–f)</bold>.</p></caption>
          <graphic xlink:href="https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026-f03.png"/>

        </fig>

      <p id="d2e923">Next we look into systematic errors in more detail by considering a series of QQ plots to compare the distributions of several quantities. First, we examine the population-weighted mean temperature forecasts compared to the ground truth, here represented by the population-weighted mean temperature from the ERA5 data (Fig. <xref ref-type="fig" rid="F4"/>). Both forecasts fall close to the 45 ° line, although the data-driven forecasts are consistently lower than the physics-based forecasts across all lead times (Fig. <xref ref-type="fig" rid="F4"/>a–d).</p>

      <fig id="F4" specific-use="star"><label>Figure 4</label><caption><p id="d2e933">QQ plot of population-weighted mean temperature forecast vs. ground truth for lead time 1 d <bold>(a)</bold>, 3 d <bold>(b)</bold>, 5 d <bold>(c)</bold> and 7 d <bold>(d)</bold>. Green denotes the physics-based forecasts, purple denotes the data-driven forecasts <bold>(a–d)</bold>. The solid lines denote the 45 ° line.</p></caption>
          <graphic xlink:href="https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026-f04.png"/>

        </fig>

      <p id="d2e957">We then repeat the analysis but for population-weighted mean AF forecasts compared to the ground truth here represented by the population-weighted mean AF estimated using ERA5 data. The results suggest some systematic under-estimation with more values falling below the 45 ° line than above for both types of forecast, although this is more pronounced for the data-driven forecasts (Fig. <xref ref-type="fig" rid="F5"/>a–d). Both types of forecast show heavy tails (Fig. <xref ref-type="fig" rid="F5"/>a–d).</p>

      <fig id="F5" specific-use="star"><label>Figure 5</label><caption><p id="d2e966">QQ plot of population-weighted mean AF forecast vs. AF ground truth (estimated from ERA5) for lead time 1 d <bold>(a)</bold>, 3 d <bold>(b)</bold>, 5 d <bold>(c)</bold> and 7 d <bold>(d)</bold>. Green denotes the physics-based forecasts, purple denotes the data-driven forecasts <bold>(a–d</bold>). The solid line denotes the zero error line.</p></caption>
          <graphic xlink:href="https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026-f05.png"/>

        </fig>

      <p id="d2e990">To investigate the relationship between AF forecast bias and temperature further, we compare the distributions of AF forecast bias of the two models by performing Kolmogorov-Smirnov tests. The results indicated that for lead times 3, 5 and 7 d, the physics-based and data-driven AF forecasts correspond to different distributions (<inline-formula><mml:math id="M23" display="inline"><mml:mi>p</mml:mi></mml:math></inline-formula>-values<inline-formula><mml:math id="M24" display="inline"><mml:mrow><mml:mspace width="0.125em" linebreak="nobreak"/><mml:mo>=</mml:mo></mml:mrow></mml:math></inline-formula> 0.026, 0.026 and <inline-formula><mml:math id="M25" display="inline"><mml:mo>&lt;</mml:mo></mml:math></inline-formula> 0.001 respectively). This underscores the complex relation between errors in AF forecasts and temperature, particularly for hot temperatures where AF forecasts would be most relevant for application in heat warning systems.</p>
      <p id="d2e1016">We further consider the relationship between AF forecast bias and temperature in Fig. <xref ref-type="fig" rid="F6"/>a–d, which shows negative correlations between the two quantities. On average both forecasts underestimate temperature-related mortality at hot temperatures for all lead times, although this is more clearly visible for the data-driven forecasts than the physics-based forecasts. The physics-based forecasts show a markedly stronger correlation for lead times 1, 5 and 7 d than the data-driven forecasts (Fig. <xref ref-type="fig" rid="F6"/>a, c, d). For lead time 3 d the two forecasts show a correlation (slope) of similar magnitude (Fig. <xref ref-type="fig" rid="F6"/>b).</p>

      <fig id="F6" specific-use="star"><label>Figure 6</label><caption><p id="d2e1028">Scatter plot of the population-weighted mean AF forecast bias vs. temperature for the summer of 2024; green denotes the physics-based forecast (HRES) and purple denotes the data-driven forecast (AIFS) <bold>(a–d)</bold>. Lead times 1 d <bold>(a)</bold>, 3 d <bold>(b)</bold>, 5 d <bold>(c)</bold> and 7 d <bold>(d)</bold> are shown. The lines show a linear fit and the shading denotes the 95 % confidence interval.</p></caption>
          <graphic xlink:href="https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026-f06.png"/>

        </fig>

      <p id="d2e1052">We repeat the analysis for the MAE. Figure <xref ref-type="fig" rid="F7"/>a shows an extremely weak correlation between the MAE and temperature for the physics-based forecast, and a weak positive correlation for the data driven forecast for lead time 1 d. Considering lead time 3 d, no correlation between MAE and temperature is evident for the physics based forecasts, whilst there is again a weak positive correlation for the data driven forecast (Fig. <xref ref-type="fig" rid="F7"/>b). At longer lead times of 5 and 7 d, we see a weak negative correlation for the physics based forecasts, and a weak positive correlation for the data driven forecasts (Fig. <xref ref-type="fig" rid="F7"/>c, d).</p>

      <fig id="F7" specific-use="star"><label>Figure 7</label><caption><p id="d2e1063">Scatter plot of the population-weighted mean AF forecast MAE vs. temperature for the summer of 2024; green denotes the physics-based forecast (HRES) and purple denotes the data-driven forecast (AIFS) <bold>(a–d)</bold>. Lead times 1 d <bold>(a)</bold>, 3 d <bold>(b)</bold>, 5 d <bold>(c)</bold> and 7 d <bold>(d)</bold> are shown. The lines show a linear fit and the shading denotes the 95 % confidence interval.</p></caption>
          <graphic xlink:href="https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026-f07.png"/>

        </fig>

      <p id="d2e1087">Lastly, we consider the perspective of forecast performance with respect to lead time. Figure <xref ref-type="fig" rid="F8"/>a shows the physics-based forecast systematically overestimating temperature, with the error growing for longer lead times. Initially the data-driven forecast overestimates temperature at lead time 1 d, and then underestimates for forecasts at lead times 7 and 10 d. After transforming to AF, the physics-based forecasts underestimate AF for short lead times, and overestimate for long lead times (Fig. <xref ref-type="fig" rid="F8"/>b). The data-driven forecast systematically underestimates at all lead times; this is most visible at lead times corresponding to the end of the first week of the forecast. This corresponds to the predictability limit for AF <xref ref-type="bibr" rid="bib1.bibx31 bib1.bibx14" id="paren.33"/>, beyond which the forecast typically loses deterministic skill. As expected, Fig. <xref ref-type="fig" rid="F8"/>c shows the MAE of the temperature forecasts increasing with respect to lead time. Furthermore, the data-driven forecast has slightly lower values for all lead times. Finally, we consider the MAE for AF forecasts in Fig. <xref ref-type="fig" rid="F8"/>d. The MAE for both AF forecasts is very similar up to and including lead time 5 d. Beyond this there is a sharp increase in the MAE for the physics-based forecasts, before both forecasts show a decrease in MAE at lead time 10 d. MAE does not typically decrease for increasing lead time, and this is potentially a sampling issue, as evidenced especially by the large confidence interval for the physics-based AF forecast at lead time 7 d.</p>

      <fig id="F8" specific-use="star"><label>Figure 8</label><caption><p id="d2e1103"><bold>(a)</bold> Mean temperature forecast bias vs. lead time. <bold>(b)</bold> Mean AF forecast bias vs. lead time. <bold>(c)</bold> MAE for temperature forecasts vs. lead time. <bold>(d)</bold> MAE for AF forecasts vs. lead time. Physics based forecasts are denoted by green and data-driven forecasts by purple <bold>(a–d)</bold>. The shading denotes the 95 % confidence intervals, which were computed by bootstrapping as described in the methods section.</p></caption>
          <graphic xlink:href="https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026-f08.png"/>

        </fig>

</sec>
</sec>
<sec id="Ch1.S4">
  <label>4</label><title>Discussion</title>
      <p id="d2e1135">Our results show that data-driven forecasts performed approximately as well as physics-based forecasts when considering the average forecast bias over the summer of 2024, however, these data-driven forecasts systematically underestimated AF, especially for hot temperatures. This is consistent with past work showing data-driven approaches generally outperforming physics-based forecasts on key variables like 2 m temperature, but struggling to capture extremes <xref ref-type="bibr" rid="bib1.bibx26" id="paren.34"/>. For the physics-based forecasts, this underestimation was to a lesser extent also evident, but only for exceptionally hot temperatures. Surface temperature is affected by complex interactions with the land-surface – <xref ref-type="bibr" rid="bib1.bibx8" id="text.35"/> highlight the important role of land-atmosphere coupling for a number of European heatwaves. Representing the effects of quantities such as soil moisture, vegetation and urban landscapes is an ongoing area of development for NWP modelling <xref ref-type="bibr" rid="bib1.bibx16" id="paren.36"/>, and is in part challenging due to the fine spatial resolution of these local effects. To produce accurate and reliable AF forecasts it is nevertheless crucial that the underlying weather forecasts are able to represent hot temperatures well. Continued development in this field is imperative, not just for improving physics-based forecasts for hot temperatures, but also for the continued improvement of reanalysis datasets, which are used to train data-driven weather models.</p>
      <p id="d2e1147">Shifting focus to lead-time dependency, our results showed a different relationship for AF than temperature. The MAE for temperature forecasts increased with respect to lead time, as expected, whilst this trend was not as clearly evident for AF forecasts. Previous work showed AF forecast errors depending critically on absolute temperature, owing to the non-linear transformation <xref ref-type="bibr" rid="bib1.bibx14" id="paren.37"/>. We suggest that the weak lead-time dependent signal for AF MAE is an artefact of our small sample size combined with the interaction between the lead-time dependent error growth in temperature forecasts, and the amplification of forecast errors for hot temperatures. The non-linear propagation of errors from temperature to AF forecasts likely obscures the lead-time dependent error growth for temperature forecasts, leading to a far less clear signal for AF error growth with respect to lead time than is seen for temperature forecasts. Further verification of these results through a systematic study considering multiple years is necessary.</p>
      <p id="d2e1153">For explicitly impact-focused applications such as the AF forecasts presented here, alternate weightings giving more importance to the extremes could be considered in the training of data-driven forecast models. Furthermore, even a simplistic approach of post processing data-driven forecasts using a tailored bias correction could prove useful for AF forecasts. In particular, we suggest that future work could explore a bias correction which is dependent on forecast temperature, to account for the apparent underestimation of AF for hot temperatures. These findings have important ramifications for the up-take of such forecasts by agencies who issue health warnings. A major advantage of data-driven forecasts is that they are cheap to run. This means that bespoke AF forecasts could be run comparatively cheaply, which is attractive for settings with limited computational resources.</p>
      <p id="d2e1156">This study has a number of limitations. Firstly, we consider one summer as a case study, which limits the generalisability of our results. We apply this epidemiological framework to temperatures outside the range of temperatures used for fitting, similar to approaches taken in e.g. <xref ref-type="bibr" rid="bib1.bibx19 bib1.bibx20" id="text.38"/>. This means that we have large uncertainties associated with the hottest temperatures of 2024. Nonetheless, our focus here is to compare forecast model performance relative to reanalysis data from an impact-focused perspective, rather than to evaluate the performance of the underlying epidemiological model. Furthermore, we only consider weather forecasts output from two global models, one data-driven and one physics-based, as opposed to regional weather forecasts produced by national weather services. This study is associated with uncertainty from both the weather forecasting and epidemiological perspective. These are two fundamentally different approaches to uncertainty quantification since the epidemiological framework is at its core an advanced statistical model, whilst the uncertainty due to weather is due to the chaotic nature of the atmosphere. The extension of this approach to ensemble weather forecasts could prove illustrative for the quantification of the uncertainty stemming from the weather forecasts. We further note that multiple long term trends affect temperature-related mortality; anthropogenic warming from the climate perspective <xref ref-type="bibr" rid="bib1.bibx37" id="paren.39"/>, and a combination of population ageing, improving health care systems, and adaptation to our changing climate from the epidemiological perspective <xref ref-type="bibr" rid="bib1.bibx9 bib1.bibx15 bib1.bibx24" id="paren.40"/>. This is an active area of research and we welcome future studies which provide the broader scientific community with updated epidemiological fits accounting for long term trends from both perspectives.</p>
      <p id="d2e1169">Recent developments in the AI forecast model domain have moved towards ensemble forecasts trained to represent a distribution rather than an ensemble average, leading to remarkable improvements in terms of representation of extremes <xref ref-type="bibr" rid="bib1.bibx30" id="paren.41"><named-content content-type="pre">e.g.</named-content></xref>. We thus suggest that this study could be expanded to an ensemble perspective, where sufficient computational resources were available, or extended to focus specifically on heatwaves. A further extension of the work presented here would be to focus on specific subregions within Europe, as well as regions beyond Europe, particularly those that have been highlighted as being especially vulnerable to climate change. Furthermore, this framework could be readily applied to other health outcomes where an analogous exposure-response function is available. The association between heat and health outcomes beyond all cause mortality is an active area of research within the health community, and we warmly welcome efforts to increase accessibility to this data. Further progress in this domain would be very beneficial for enabling targeted preventative measures to help improve health outcomes.</p>
</sec>
<sec id="Ch1.S5" sec-type="conclusions">
  <label>5</label><title>Conclusions</title>
      <p id="d2e1186">This study evaluated the performance of temperature-related mortality forecasts based on data-driven weather forecasts relative to those based on physics-based weather forecasts for the European summer of 2024. We found that the temperature-related mortality forecasts based on data-driven weather forecasts performed approximately as well as those based on physics-based forecasts. The temperature-related mortality forecasts based on data-driven weather forecasts showed a more pronounced systematic underestimation than their physics-based counterparts. Both types of forecasts showed sensitivity to errors at hot temperatures. We suggest that for temperature-related mortality forecasts based on data-driven weather forecasts, a temperature-dependent bias correction or adjustment of the loss function to give greater weighting to hot temperatures could present a fruitful line of further inquiry. This is particularly relevant for resource limited settings, since running data-driven weather forecasts is far less computationally expensive. Irrespective of the underlying type of weather forecast, our finding underscore the importance of continued development in weather forecasts for hot temperatures. Further investigation of these findings from a systematic perspective would be crucial for providing robust recommendations to stakeholders and local authorities about the potential for integrating these forecasts into heat action plans or early warning systems.</p>
</sec>

      
      </body>
    <back><app-group>

<app id="App1.Ch1.S1">
  <label>Appendix A</label><title/>
      <p id="d2e1199">Figure <xref ref-type="fig" rid="FA1"/> shows a map indicating the cities included in this study from <xref ref-type="bibr" rid="bib1.bibx23" id="text.42"/>.</p>

      <fig id="FA1"><label>Figure A1</label><caption><p id="d2e1209">Map of the cities included in this study, with marker size indicating the population.</p></caption>
        
        <graphic xlink:href="https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026-f09.png"/>

      </fig>

      <p id="d2e1220">Figure <xref ref-type="fig" rid="FA2"/> shows a histogram of AF forecast bias for Rome. Initially for lead time 1 d the distributions are similar (Fig. <xref ref-type="fig" rid="FA2"/>a), however, for the remaining lead times, the physics-based forecast shows a heavier right hand tail, demonstrating larger positive bias (Fig. <xref ref-type="fig" rid="FA2"/>b–d).</p>

      <fig id="FA2"><label>Figure A2</label><caption><p id="d2e1233">Histogram of the distribution of AF forecast biases for lead times 1 d <bold>(a)</bold>, 3 d <bold>(b)</bold>, 5 d <bold>(c)</bold> and 7 d <bold>(d)</bold> for Rome. Green denotes the physics-based forecast whilst purple denotes the data-driven forecast.</p></caption>
        
        <graphic xlink:href="https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026-f10.png"/>

      </fig>

      <p id="d2e1256">Now we investigate for the presence of a systematic bias by looking at the relationship between AF forecast bias and temperature. We first consider our case study of Rome, before investigating population-weighted averages. As for Fig. <xref ref-type="fig" rid="F1"/>c–f in the main text, Fig. <xref ref-type="fig" rid="FA3"/>a–d shows lower mean forecast bias for data-driven forecasts at all lead-times for Rome. No trend is evident with respect to temperature or lead time.</p>

      <fig id="FA3"><label>Figure A3</label><caption><p id="d2e1266">Scatter plot of the AF forecast bias for Rome during the summer of 2024, where green denotes the physics-based forecast (HRES) and purple denotes the data-driven forecast (AIFS) <bold>(a–d)</bold>. Lead times 1 d <bold>(a)</bold>, 3 d <bold>(b)</bold>, 5 d <bold>(c)</bold> and 7 d <bold>(d)</bold> are shown.</p></caption>
        
        <graphic xlink:href="https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026-f11.png"/>

      </fig>

      <p id="d2e1292">Repeating the analysis for the MAE we see a noisy signal across all lead times with no clearly visible trend (Fig. <xref ref-type="fig" rid="FA4"/>a–d).</p>

      <fig id="FA4"><label>Figure A4</label><caption><p id="d2e1300">Scatter plot of the AF forecast MAE vs. temperature for Rome durng the summer of 2024; green denotes the physics-based forecast (HRES) and purple denotes the data-driven forecast (AIFS) <bold>(a–d)</bold>. Lead times 1 d <bold>(a)</bold>, 3 d <bold>(b)</bold>, 5 d <bold>(c)</bold> and 7 d <bold>(d)</bold> are shown.</p></caption>
        
        <graphic xlink:href="https://nhess.copernicus.org/articles/26/4825/2026/nhess-26-4825-2026-f12.png"/>

      </fig>


</app>
  </app-group><notes notes-type="codedataavailability"><title>Code and data availability</title>

      <p id="d2e1332">The reanalysis and forecast data used in this study are freely available online (CC-BY 4.0) and were retrieved from ECMWF Copernicus at <ext-link xlink:href="https://doi.org/10.24381/cds.adbb2d47" ext-link-type="DOI">10.24381/cds.adbb2d47</ext-link> <xref ref-type="bibr" rid="bib1.bibx5" id="paren.43"/> and MARS archives (<uri>https://www.ecmwf.int/en/forecasts/access-forecasts/access-archive-datasets</uri>, last access: 2 October 2026). The coefficients for the epidemiological analysis and population data were retrieved from <ext-link xlink:href="https://doi.org/10.5281/zenodo.10288665" ext-link-type="DOI">10.5281/zenodo.10288665</ext-link> <xref ref-type="bibr" rid="bib1.bibx22" id="paren.44"/>.</p>
  </notes><notes notes-type="authorcontribution"><title>Author contributions</title>

      <p id="d2e1353">EH: formal analysis, software, investigation, visualisation, primary responsibility for writing of the original manuscript. EH and OL shared responsibility for conceptualisation, data curation methodology, review and editing, validation.</p>
  </notes><notes notes-type="competinginterests"><title>Competing interests</title>

      <p id="d2e1359">The contact author has declared that neither of the authors has any competing interests.</p>
  </notes><notes notes-type="disclaimer"><title>Disclaimer</title>

      <p id="d2e1365">ECMWF does not accept any liability whatsoever for any error or omission in the data, their availability, or for any loss or damage arising from their use. Publisher's note: Copernicus Publications remains neutral with regard to jurisdictional claims made in the text, published maps, institutional affiliations, or any other geographical representation in this paper. The authors bear the ultimate responsibility for providing appropriate place names. Views expressed in the text are those of the authors and do not necessarily reflect the views of the publisher.</p>
  </notes><ack><title>Acknowledgements</title><p id="d2e1374">EH  gratefully acknowledges funding from the European Union's Horizon 2020 research and innovation programme , the Swedish Research Council Vetenskapsrådet, and the COST Action CA22162 FutureMed. LO thankfully acknowledges the support of the European Research Council (ERC) and the Swedish Research Council Vetenskapsrådet. The authors would like to thank Gabriele Messori for valuable discussions.</p></ack><notes notes-type="financialsupport"><title>Financial support</title>

      <p id="d2e1379">EH has been supported by the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement no. 956396 (EDIPI – European weather extremes: drivers, predictability and impacts), the Swedish Research Council Vetenskapsrådet Grant Agreement No. 2022-06599 and 2022-03448 and the COST Action CA22162 FutureMed. LO has been supported by the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (project CENÆ (“compound Climate Extremes in North America and Europe: from dynamics to predictability”); grant no. 948309) and of the Swedish Research Council Vetenskapsrådet (grant. no. 2022-06599).The publication of this article was funded by the  Swedish Research Council, Forte, Formas, and Vinnova.</p>
  </notes><notes notes-type="reviewstatement"><title>Review statement</title>

      <p id="d2e1390">This paper was edited by Henning Rust and reviewed by two anonymous referees.</p>
  </notes><ref-list>
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