Multicenter Analysis of Emergency Patient Severity through Local Model Evaluation Client Selection: Optimizing Client Selection Based on Local Model Evaluation

Abstract

In multi-institutional emergency room settings, the early identification of high-risk patients is crucial for effective severity management. This necessitates the development of advanced models capable of accurately predicting patient severity based on initial conditions. However, collecting and analyzing large-scale data for high-performance predictive models is challenging due to privacy and data security concerns in integrating data from multiple emergency rooms. To address this, our work applies federated learning (FL) techniques, maintaining privacy without centralizing data. Medical data, which are often non-independent and identically distributed (non-IID), pose challenges for existing FL, where random client selection can impact overall FL performance. Therefore, we introduce a new client selection mechanism based on local model evaluation (LMECS), enhancing performance and practicality. This approach shows that the proposed FL model can achieve comparable performance to centralized models and maintain data privacy. The execution time was reduced by up to 27% compared to the existing FL algorithm. In addition, compared to the average performance of local models without FL, our LMECS improved the AUC by 2% and achieved up to 23% performance improvement compared to the existing FL algorithm. This work presents the potential for effective patient severity management in multi-institutional emergency rooms using FL without data movement, offering an innovative approach that satisfies both medical data privacy and efficient utilization.

Keywords

• federated learning
• centralized learning
• patient severity analysis
• local model evaluation
• client selection