KEEP: Integrating Medical Ontologies with Clinical Data for Robust Code Embeddings

Machine learning in healthcare requires effective representation of structured medical codes, but current methods face a trade off: knowledge graph based approaches capture formal relationships but miss real world patterns, while data driven methods learn empirical associations but often overlook structured knowledge in medical terminologies. We present KEEP (Knowledge preserving and Empirically refined Embedding Process), an efficient framework that bridges this gap by combining knowledge graph embeddings with adaptive learning from clinical data. KEEP first generates embeddings from knowledge graphs, then employs regularized training on patient records to adaptively integrate empirical patterns while preserving ontological relationships. Importantly, KEEP produces final embeddings without task specific auxiliary or end to end training enabling KEEP to support multiple downstream applications and model architectures. Evaluations on structured EHR from UK Biobank and MIMIC IV demonstrate that KEEP outperforms both traditional and Language Model based approaches in capturing semantic relationships and predicting clinical outcomes. Moreover, KEEP's minimal computational requirements make it particularly suitable for resource constrained environments.

PLayer-FL: A Principled Approach to Personalized Layer-wise Cross-Silo Federated Learning

Non-identically distributed data is a major challenge in Federated Learning (FL). Personalized FL tackles this by balancing local model adaptation with global model consistency. One variant, partial FL, leverages the observation that early layers learn more transferable features by federating only early layers. However, current partial FL approaches use predetermined, architecture-specific rules to select layers, limiting their applicability. We introduce Principled Layer-wise-FL (PLayer-FL), which uses a novel federation sensitivity metric to identify layers that benefit from federation. This metric, inspired by model pruning, quantifies each layer's contribution to cross-client generalization after the first training epoch, identifying a transition point in the network where the benefits of federation diminish. We first demonstrate that our federation sensitivity metric shows strong correlation with established generalization measures across diverse architectures. Next, we show that PLayer-FL outperforms existing FL algorithms on a range of tasks, also achieving more uniform performance improvements across clients.

A Universal Metric of Dataset Similarity for Cross-silo Federated Learning

Federated Learning is increasingly used in domains such as healthcare to facilitate collaborative model training without data-sharing. However, datasets located in different sites are often non-identically distributed, leading to degradation of model performance in FL. Most existing methods for assessing these distribution shifts are limited by being dataset or task-specific. Moreover, these metrics can only be calculated by exchanging data, a practice restricted in many FL scenarios. To address these challenges, we propose a novel metric for assessing dataset similarity. Our metric exhibits several desirable properties for FL: it is dataset-agnostic, is calculated in a privacy-preserving manner, and is computationally efficient, requiring no model training. In this paper, we first establish a theoretical connection between our metric and training dynamics in FL. Next, we extensively evaluate our metric on a range of datasets including synthetic, benchmark, and medical imaging datasets. We demonstrate that our metric shows a robust and interpretable relationship with model performance and can be calculated in privacy-preserving manner. As the first federated dataset similarity metric, we believe this metric can better facilitate successful collaborations between sites.

Privacy-preserving patient clustering for personalized federated learning

Federated Learning (FL) is a machine learning framework that enables multiple organizations to train a model without sharing their data with a central server. However, it experiences significant performance degradation if the data is non-identically independently distributed (non-IID). This is a problem in medical settings, where variations in the patient population contribute significantly to distribution differences across hospitals. Personalized FL addresses this issue by accounting for site-specific distribution differences. Clustered FL, a Personalized FL variant, was used to address this problem by clustering patients into groups across hospitals and training separate models on each group. However, privacy concerns remained as a challenge as the clustering process requires exchange of patient-level information. This was previously solved by forming clusters using aggregated data, which led to inaccurate groups and performance degradation. In this study, we propose Privacy-preserving Community-Based Federated machine Learning (PCBFL), a novel Clustered FL framework that can cluster patients using patient-level data while protecting privacy. PCBFL uses Secure Multiparty Computation, a cryptographic technique, to securely calculate patient-level similarity scores across hospitals. We then evaluate PCBFL by training a federated mortality prediction model using 20 sites from the eICU dataset. We compare the performance gain from PCBFL against traditional and existing Clustered FL frameworks. Our results show that PCBFL successfully forms clinically meaningful cohorts of low, medium, and high-risk patients. PCBFL outperforms traditional and existing Clustered FL frameworks with an average AUC improvement of 4.3% and AUPRC improvement of 7.8%.