4.8 Article

Federated learning for predicting clinical outcomes in patients with COVID-19

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NATURE MEDICINE
卷 27, 期 10, 页码 1735-+

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NATURE PORTFOLIO
DOI: 10.1038/s41591-021-01506-3

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  1. J. Brink, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
  2. M. Kalra, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
  3. N. Neumark, Center for Clinical Data Science, Massachusetts General Brigham, Boston
  4. T. Schultz, Department of Radiology, Massachusetts General Hospital, Boston
  5. N. Guo, Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
  6. J. K. Cramer, Director, QTIM lab at the Athinoula A. Martinos Center for Biomedical Imaging at MGH
  7. S. Pomerantz, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
  8. G. Boland, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston
  9. W. Mayo-Smith, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston
  10. Ratchadapisek Sompoch Endowment Fund RA [001/63]
  11. NIHR (Cambridge Biomedical Research Centre at the Cambridge University Hospitals NHS Foundation Trust)
  12. NIH
  13. Doris Duke Charitable Foundation
  14. American Association for Dental Research
  15. Colgate-Palmolive Company
  16. Genentech, alumni of student research programs

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Federated learning, a method for training artificial intelligence algorithms while protecting data privacy, was used to predict future oxygen requirements of symptomatic patients with COVID-19 using data from 20 different institutes globally. The study showed improved predictive accuracy and generalizability, setting the stage for wider applications in healthcare.
Federated learning (FL) is a method used for training artificial intelligence models with data from multiple sources while maintaining data anonymity, thus removing many barriers to data sharing. Here we used data from 20 institutes across the globe to train a FL model, called EXAM (electronic medical record (EMR) chest X-ray AI model), that predicts the future oxygen requirements of symptomatic patients with COVID-19 using inputs of vital signs, laboratory data and chest X-rays. EXAM achieved an average area under the curve (AUC) >0.92 for predicting outcomes at 24 and 72 h from the time of initial presentation to the emergency room, and it provided 16% improvement in average AUC measured across all participating sites and an average increase in generalizability of 38% when compared with models trained at a single site using that site's data. For prediction of mechanical ventilation treatment or death at 24 h at the largest independent test site, EXAM achieved a sensitivity of 0.950 and specificity of 0.882. In this study, FL facilitated rapid data science collaboration without data exchange and generated a model that generalized across heterogeneous, unharmonized datasets for prediction of clinical outcomes in patients with COVID-19, setting the stage for the broader use of FL in healthcare. Federated learning, a method for training artificial intelligence algorithms that protects data privacy, was used to predict future oxygen requirements of symptomatic patients with COVID-19 using data from 20 different institutes across the globe.

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