The emerging landscape of health research based on biobanks linked to electronic health records: Existing resources, statistical challenges, and potential opportunities

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154448/1/sim8445_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154448/2/sim8445.pd

Explaining Multi-label Black-Box Classifiers for Health Applications

Today the state-of-the-art performance in classification is achieved by the so-called “black boxesâ€\u9d, i.e. decision-making systems whose internal logic is obscure. Such models could revolutionize the health-care system, however their deployment in real-world diagnosis decision support systems is subject to several risks and limitations due to the lack of transparency. The typical classification problem in health-care requires a multi-label approach since the possible labels are not mutually exclusive, e.g. diagnoses. We propose MARLENA, a model-agnostic method which explains multi-label black box decisions. MARLENA explains an individual decision in three steps. First, it generates a synthetic neighborhood around the instance to be explained using a strategy suitable for multi-label decisions. It then learns a decision tree on such neighborhood and finally derives from it a decision rule that explains the black box decision. Our experiments show that MARLENA performs well in terms of mimicking the black box behavior while gaining at the same time a notable amount of interpretability through compact decision rules, i.e. rules with limited length

Evaluation of federated learning variations for COVID-19 diagnosis using chest radiographs from 42 US and European hospitals

Objective: Federated learning (FL) allows multiple distributed data holders to collaboratively learn a shared model without data sharing. However, individual health system data are heterogeneous. "Personalized" FL variations have been developed to counter data heterogeneity, but few have been evaluated using real-world healthcare data. The purpose of this study is to investigate the performance of a single-site versus a 3-client federated model using a previously described Coronavirus Disease 19 (COVID-19) diagnostic model. Additionally, to investigate the effect of system heterogeneity, we evaluate the performance of 4 FL variations. Materials and methods: We leverage a FL healthcare collaborative including data from 5 international healthcare systems (US and Europe) encompassing 42 hospitals. We implemented a COVID-19 computer vision diagnosis system using the Federated Averaging (FedAvg) algorithm implemented on Clara Train SDK 4.0. To study the effect of data heterogeneity, training data was pooled from 3 systems locally and federation was simulated. We compared a centralized/pooled model, versus FedAvg, and 3 personalized FL variations (FedProx, FedBN, and FedAMP). Results: We observed comparable model performance with respect to internal validation (local model: AUROC 0.94 vs FedAvg: 0.95, P = .5) and improved model generalizability with the FedAvg model (P < .05). When investigating the effects of model heterogeneity, we observed poor performance with FedAvg on internal validation as compared to personalized FL algorithms. FedAvg did have improved generalizability compared to personalized FL algorithms. On average, FedBN had the best rank performance on internal and external validation. Conclusion: FedAvg can significantly improve the generalization of the model compared to other personalization FL algorithms; however, at the cost of poor internal validity. Personalized FL may offer an opportunity to develop both internal and externally validated algorithms