Federated Learning with Multi-Partner OneFlorida+ Consortium Data for Predicting Major Postoperative Complications

TL;DR

This study develops federated learning models using multicenter data to accurately predict major postoperative complications and mortality, demonstrating strong performance and generalizability while preserving patient data privacy.

Contribution

It introduces a robust federated learning approach for multicenter surgical risk prediction, outperforming local and pooled models in accuracy and privacy preservation.

Findings

Federated models achieved high AUROC and AUPRC scores.

Models demonstrated strong generalizability across centers.

Federated learning preserved data privacy effectively.

Abstract

Background: This study aims to develop and validate federated learning models for predicting major postoperative complications and mortality using a large multicenter dataset from the OneFlorida Data Trust. We hypothesize that federated learning models will offer robust generalizability while preserving data privacy and security. Methods: This retrospective, longitudinal, multicenter cohort study included 358,644 adult patients admitted to five healthcare institutions, who underwent 494,163 inpatient major surgical procedures from 2012-2023. We developed and internally and externally validated federated learning models to predict the postoperative risk of intensive care unit (ICU) admission, mechanical ventilation (MV) therapy, acute kidney injury (AKI), and in-hospital mortality. These models were compared with local models trained on data from a single center and central models trained on a pooled dataset from all centers. Performance was primarily evaluated using area under the receiver operating characteristics curve (AUROC) and the area under the precision-recall curve (AUPRC) values. Results: Our federated learning models demonstrated strong predictive performance, with AUROC scores consistently comparable or superior performance in terms of AUROC and AUPRC across all outcomes and sites. Our federated learning models also demonstrated strong generalizability, with comparable or superior performance in terms of both AUROC and AUPRC compared to the best local learning model at each site. Conclusions: By leveraging multicenter data, we developed robust, generalizable, and privacy-preserving predictive models for major postoperative complications and mortality. These findings support the feasibility of federated learning in clinical decision support systems.