Dataset Information

Federated and distributed learning applications for electronic health records and structured medical data: a scoping review.

ABSTRACT:

Objectives

Federated learning (FL) has gained popularity in clinical research in recent years to facilitate privacy-preserving collaboration. Structured data, one of the most prevalent forms of clinical data, has experienced significant growth in volume concurrently, notably with the widespread adoption of electronic health records in clinical practice. This review examines FL applications on structured medical data, identifies contemporary limitations, and discusses potential innovations.

Materials and methods

We searched 5 databases, SCOPUS, MEDLINE, Web of Science, Embase, and CINAHL, to identify articles that applied FL to structured medical data and reported results following the PRISMA guidelines. Each selected publication was evaluated from 3 primary perspectives, including data quality, modeling strategies, and FL frameworks.

Results

Out of the 1193 papers screened, 34 met the inclusion criteria, with each article consisting of one or more studies that used FL to handle structured clinical/medical data. Of these, 24 utilized data acquired from electronic health records, with clinical predictions and association studies being the most common clinical research tasks that FL was applied to. Only one article exclusively explored the vertical FL setting, while the remaining 33 explored the horizontal FL setting, with only 14 discussing comparisons between single-site (local) and FL (global) analysis.

Conclusions

The existing FL applications on structured medical data lack sufficient evaluations of clinically meaningful benefits, particularly when compared to single-site analyses. Therefore, it is crucial for future FL applications to prioritize clinical motivations and develop designs and methodologies that can effectively support and aid clinical practice and research.

SUBMITTER: Li S

PROVIDER: S-EPMC10654866 | biostudies-literature | 2023 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Federated and distributed learning applications for electronic health records and structured medical data: a scoping review.

Li Siqi S Liu Pinyan P Nascimento Gustavo G GG Wang Xinru X Leite Fabio Renato Manzolli FRM Chakraborty Bibhas B Hong Chuan C Ning Yilin Y Xie Feng F Teo Zhen Ling ZL Ting Daniel Shu Wei DSW Haddadi Hamed H Ong Marcus Eng Hock MEH Peres Marco Aurélio MA Liu Nan N

Journal of the American Medical Informatics Association : JAMIA 20231101 12

<h4>Objectives</h4>Federated learning (FL) has gained popularity in clinical research in recent years to facilitate privacy-preserving collaboration. Structured data, one of the most prevalent forms of clinical data, has experienced significant growth in volume concurrently, notably with the widespread adoption of electronic health records in clinical practice. This review examines FL applications on structured medical data, identifies contemporary limitations, and discusses potential innovation ...[more]

PMID: 37639629

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Project description:BackgroundThe proliferation of mobile health (mHealth) applications is partly driven by the advancements in sensing and communication technologies, as well as the integration of artificial intelligence techniques. Data collected from mHealth applications, for example, on sensor devices carried by patients, can be mined and analyzed using artificial intelligence-based solutions to facilitate remote and (near) real-time decision-making in health care settings. However, such data often sit in data silos, and patients are often concerned about the privacy implications of sharing their raw data. Federated learning (FL) is a potential solution, as it allows multiple data owners to collaboratively train a machine learning model without requiring access to each other's raw data.ObjectiveThe goal of this scoping review is to gain an understanding of FL and its potential in dealing with sensitive and heterogeneous data in mHealth applications. Through this review, various stakeholders, such as health care providers, practitioners, and policy makers, can gain insight into the limitations and challenges associated with using FL in mHealth and make informed decisions when considering implementing FL-based solutions.MethodsWe conducted a scoping review following the guidelines of PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). We searched 7 commonly used databases. The included studies were analyzed and summarized to identify the possible real-world applications and associated challenges of using FL in mHealth settings.ResultsA total of 1095 articles were retrieved during the database search, and 26 articles that met the inclusion criteria were included in the review. The analysis of these articles revealed 2 main application areas for FL in mHealth, that is, remote monitoring and diagnostic and treatment support. More specifically, FL was found to be commonly used for monitoring self-care ability, health status, and disease progression, as well as in diagnosis and treatment support of diseases. The review also identified several challenges (eg, expensive communication, statistical heterogeneity, and system heterogeneity) and potential solutions (eg, compression schemes, model personalization, and active sampling).ConclusionsThis scoping review has highlighted the potential of FL as a privacy-preserving approach in mHealth applications and identified the technical limitations associated with its use. The challenges and opportunities outlined in this review can inform the research agenda for future studies in this field, to overcome these limitations and further advance the use of FL in mHealth.

Project description:BackgroundPersonal electronic health records (PEHRs) allow patients to view, generate, and manage their personal and medical data that are relevant across illness episodes, such as their medications, allergies, immunizations, and their medical, social, and family health history. Thus, patients can actively participate in the management of their health care by ensuring that their health care providers have an updated and accurate overview of the patients' medical records. However, the uptake of PEHRs remains low, especially in terms of patients entering and managing their personal and medical data in their PEHR.ObjectiveThis scoping review aimed to explore the barriers and facilitators that patients face when deciding to review, enter, update, or modify their personal and medical data in their PEHR. This review also explores the extent to which patient-generated and -managed data affect the quality and safety of care, patient engagement, patient satisfaction, and patients' health and health care services.MethodsWe searched the MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, Web of Science, and Google Scholar web-based databases, as well as reference lists of all primary and review articles using a predefined search query.ResultsOf the 182 eligible papers, 37 (20%) provided sufficient information about patients' data management activities. The results showed that patients tend to use their PEHRs passively rather than actively. Patients refrain from generating and managing their medical data in a PEHR, especially when these data are complex and sensitive. The reasons for patients' passive data management behavior were related to their concerns about the validity, applicability, and confidentiality of patient-generated data. Our synthesis also showed that patient-generated and -managed health data ensures that the medical record is complete and up to date and is positively associated with patient engagement and patient satisfaction.ConclusionsThe findings of this study suggest recommendations for implementing design features within the PEHR and the construal of a dedicated policy to inform both clinical staff and patients about the added value of patient-generated data. Moreover, clinicians should be involved as important ambassadors in informing, reminding, and encouraging patients to manage the data in their PEHR.

Project description:BackgroundThe collection, storage, and analysis of large data sets are relevant in many sectors. Especially in the medical field, the processing of patient data promises great progress in personalized health care. However, it is strictly regulated, such as by the General Data Protection Regulation (GDPR). These regulations mandate strict data security and data protection and, thus, create major challenges for collecting and using large data sets. Technologies such as federated learning (FL), especially paired with differential privacy (DP) and secure multiparty computation (SMPC), aim to solve these challenges.ObjectiveThis scoping review aimed to summarize the current discussion on the legal questions and concerns related to FL systems in medical research. We were particularly interested in whether and to what extent FL applications and training processes are compliant with the GDPR data protection law and whether the use of the aforementioned privacy-enhancing technologies (DP and SMPC) affects this legal compliance. We placed special emphasis on the consequences for medical research and development.MethodsWe performed a scoping review according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). We reviewed articles on Beck-Online, SSRN, ScienceDirect, arXiv, and Google Scholar published in German or English between 2016 and 2022. We examined 4 questions: whether local and global models are "personal data" as per the GDPR; what the "roles" as defined by the GDPR of various parties in FL are; who controls the data at various stages of the training process; and how, if at all, the use of privacy-enhancing technologies affects these findings.ResultsWe identified and summarized the findings of 56 relevant publications on FL. Local and likely also global models constitute personal data according to the GDPR. FL strengthens data protection but is still vulnerable to a number of attacks and the possibility of data leakage. These concerns can be successfully addressed through the privacy-enhancing technologies SMPC and DP.ConclusionsCombining FL with SMPC and DP is necessary to fulfill the legal data protection requirements (GDPR) in medical research dealing with personal data. Even though some technical and legal challenges remain, for example, the possibility of successful attacks on the system, combining FL with SMPC and DP creates enough security to satisfy the legal requirements of the GDPR. This combination thereby provides an attractive technical solution for health institutions willing to collaborate without exposing their data to risk. From a legal perspective, the combination provides enough built-in security measures to satisfy data protection requirements, and from a technical perspective, the combination provides secure systems with comparable performance with centralized machine learning applications.

Project description:IntroductionFederated Learning (FL) is a decentralised approach to training statistical models, where training is performed across multiple clients, producing one global model. Since the training data remains with each local client and is not shared or exchanged with other clients the use of FL may reduce privacy and security risks (compared to methods where multiple data sources are pooled) and can also address data access and heterogeneity problems. Synthetic data is artificially generated data that has the same structure and statistical properties as the original but that does not contain any of the original data records, therefore minimising disclosure risk. Using FL to produce synthetic data (which we refer to as "federated synthesis") has the potential to combine data from multiple clients without compromising privacy, allowing access to data that may otherwise be inaccessible in its raw format.ObjectivesThe objective was to review current research and practices for using FL to generate synthetic data and determine the extent to which research has been undertaken, the methods and evaluation practices used, and any research gaps.MethodsA scoping review was conducted to systematically map and describe the published literature on the use of FL to generate synthetic data. Relevant studies were identified through online databases and the findings are described, grouped, and summarised. Information extracted included article characteristics, documenting the type of data that is synthesised, the model architecture and the methods (if any) used to evaluate utility and privacy risk.ResultsA total of 69 articles were included in the scoping review; all were published between 2018 and 2023 with two thirds (46) in 2022. 30% (21) were focussed on synthetic data generation as the main model output (with 6 of these generating tabular data), whereas 59% (41) focussed on data augmentation. Of the 21 performing federated synthesis, all used deep learning methods (predominantly Generative Adversarial Networks) to generate the synthetic data.ConclusionsFederated synthesis is in its early days but shows promise as a method that can construct a global synthetic dataset without sharing any of the local client data. As a field in its infancy there are areas to explore in terms of the privacy risk associated with the various methods proposed, and more generally in how we measure those risks.

Dataset Information

Federated and distributed learning applications for electronic health records and structured medical data: a scoping review.

Objectives

Materials and methods

Results

Conclusions

Publications

Federated and distributed learning applications for electronic health records and structured medical data: a scoping review.

Similar Datasets

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