利用真实的跨省初级保健数据对加拿大成年人进行联合糖尿病预测

Guojun Tang, Jason E. Black, Tyler S. Williamson, Steve H. Drew
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摘要

整合电子健康记录(EHR)和机器学习的应用为提高数据驱动的糖尿病预测的准确性和可及性带来了机遇。特别是,开发数据驱动的机器学习模型可以及早识别糖尿病高风险患者,从而有可能制定更有效的治疗策略并降低医疗成本。然而,监管限制给开发集中式预测模型造成了障碍。本文通过引入联合学习方法来应对这些挑战,该方法无需集中式数据存储和处理即可合并预测模型,从而避免了隐私问题。这是联合学习在加拿大的首次应用,它使用从加拿大初级保健哨点监测网络(CPCSSN)中提取的真实临床数据集预测糖尿病,无需跨省共享患者数据。我们通过下采样技术解决了类不平衡问题,并将联合学习的性能与基于省的模型和集中模型进行了比较。实验结果表明,联合 MLP 模型与集中式方法训练的模型相比,具有相似或更高的性能。然而,联合逻辑回归模型的性能却低于集中式模型。
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Federated Diabetes Prediction in Canadian Adults Using Real-world Cross-Province Primary Care Data
Integrating Electronic Health Records (EHR) and the application of machine learning present opportunities for enhancing the accuracy and accessibility of data-driven diabetes prediction. In particular, developing data-driven machine learning models can provide early identification of patients with high risk for diabetes, potentially leading to more effective therapeutic strategies and reduced healthcare costs. However, regulation restrictions create barriers to developing centralized predictive models. This paper addresses the challenges by introducing a federated learning approach, which amalgamates predictive models without centralized data storage and processing, thus avoiding privacy issues. This marks the first application of federated learning to predict diabetes using real clinical datasets in Canada extracted from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) without crossprovince patient data sharing. We address class-imbalance issues through downsampling techniques and compare federated learning performance against province-based and centralized models. Experimental results show that the federated MLP model presents a similar or higher performance compared to the model trained with the centralized approach. However, the federated logistic regression model showed inferior performance compared to its centralized peer.
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