Federated Deep Learning for Privacy-Preserving Cardiovascular Disease Risk Prediction

Cardiovascular disease risk prediction models often rely on data from a single institution or centrally pooled datasets. Extending these models across institutions could be limited by privacy regulations and constraints on sharing patient-level data. Federated learning enables collaborative model development without transferring sensitive patient data, but its application in healthcare remains challenging because datasets often differ in size, population characteristics, and outcome definitions. In this study, we present a federated deep learning approach for privacy-preserving cardiovascular disease risk prediction that integrates two population-based cohorts with different characteristics: Lifelines, including 148,230 participants meeting the study inclusion criteria with self-reported outcomes, and the Rotterdam Study, including a smaller cohort of 10,155 participants with digitally linked clinical outcomes. Model performance was primarily evaluated on the Rotterdam Study because of its complete follow-up. Deep survival models trained using federated learning achieved higher predictive performance than models trained locally without federation. For the Rotterdam Study, the C-statistic increased from 0.728 (95% CI: 0.717-0.739) to 0.739 (95% CI: 0.728-0.749). For Lifelines, the C-statistic increased from 0.783 (95% CI: 0.775-0.791) to 0.787 (95% CI: 0.780-0.792). These findings suggest that federated deep learning across heterogeneous cohorts can improve cardiovascular disease risk prediction while preserving the privacy of individual-level patient data.

MyDigiTwin: A Privacy-Preserving Framework for Personalized Cardiovascular Risk Prediction and Scenario Exploration

Cardiovascular disease (CVD) remains a leading cause of death, and primary prevention through personalized interventions is crucial. This paper introduces MyDigiTwin, a framework that integrates health digital twins with personal health environments to empower patients in exploring personalized health scenarios while ensuring data privacy. MyDigiTwin uses federated learning to train predictive models across distributed datasets without transferring raw data, and a novel data harmonization framework addresses semantic and format inconsistencies in health data. A proof-of-concept demonstrates the feasibility of harmonizing and using cohort data to train privacy-preserving CVD prediction models. This framework offers a scalable solution for proactive, personalized cardiovascular care and sets the stage for future applications in real-world healthcare settings.