Michael S. Roberts

Fan Zhang, Daniel Kreuter, Yichen Chen et al.

For healthcare datasets, it is often not possible to combine data samples from multiple sites due to ethical, privacy or logistical concerns. Federated learning allows for the utilisation of powerful machine learning algorithms without requiring the pooling of data. Healthcare data has many simultaneous challenges which require new methodologies to address, such as highly-siloed data, class imbalance, missing data, distribution shifts and non-standardised variables. Federated learning adds significant methodological complexity to conventional centralised machine learning, requiring distributed optimisation, communication between nodes, aggregation of models and redistribution of models. In this systematic review, we consider all papers on Scopus that were published between January 2015 and February 2023 and which describe new federated learning methodologies for addressing challenges with healthcare data. We performed a detailed review of the 89 papers which fulfilled these criteria. Significant systemic issues were identified throughout the literature which compromise the methodologies in many of the papers reviewed. We give detailed recommendations to help improve the quality of the methodology development for federated learning in healthcare.

Sören Dittmer, Michael Roberts, Jacobus Preller et al.

Survival analysis is an integral part of the statistical toolbox. However, while most domains of classical statistics have embraced deep learning, survival analysis only recently gained some minor attention from the deep learning community. This recent development is likely in part motivated by the COVID-19 pandemic. We aim to provide the tools needed to fully harness the potential of survival analysis in deep learning. On the one hand, we discuss how survival analysis connects to classification and regression. On the other hand, we provide technical tools. We provide a new loss function, evaluation metrics, and the first universal approximating network that provably produces survival curves without numeric integration. We show that the loss function and model outperform other approaches using a large numerical study.

Michael Roberts, J. Ignacio Deza, Hisham Ihshaish et al.

We present the first empirical study on customer churn prediction in the scholarly publishing industry. The study examines our proposed method for prediction on a customer subscription data over a period of 6.5 years, which was provided by a major academic publisher. We explore the subscription-type market within the context of customer defection and modelling, and provide analysis of the business model of such markets, and how these characterise the academic publishing business. The proposed method for prediction attempts to provide inference of customer's likelihood of defection on the basis of their re-sampled use of provider resources -in this context, the volume and frequency of content downloads. We show that this approach can be both accurate as well as uniquely useful in the business-to-business context, with which the scholarly publishing business model shares similarities. The main findings of this work suggest that whilst all predictive models examined, especially ensemble methods of machine learning, achieve substantially accurate prediction of churn, nearly a year ahead, this can be furthermore achieved even when the specific behavioural attributes that can be associated to each customer probability to churn are overlooked. Allowing as such highly accurate inference of churn from minimal possible data. We show that modelling churn on the basis of re-sampling customers' use of resources over subscription time is a better (simplified) approach than when considering the high granularity that can often characterise consumption behaviour.

Michael Roberts, Alon Hazan, Sören Dittmer et al.

Whilst the size and complexity of ML models have rapidly and significantly increased over the past decade, the methods for assessing their performance have not kept pace. In particular, among the many potential performance metrics, the ML community stubbornly continues to use (a) the area under the receiver operating characteristic curve (AUROC) for a validation and test cohort (distinct from training data) or (b) the sensitivity and specificity for the test data at an optimal threshold determined from the validation ROC. However, we argue that considering scores derived from the test ROC curve alone gives only a narrow insight into how a model performs and its ability to generalise.

Yichen Kelly Chen, Sören Dittmer, Kinga Bernatowicz et al.

We propose a neural-network based survival model (SurvSurf) specifically designed for direct and simultaneous probabilistic prediction of the first hitting time of sequential events from baseline. Unlike existing models, SurvSurf is theoretically guaranteed to never violate the monotonic relationship between the cumulative incidence functions of sequential events, while allowing nonlinear influence from predictors. It also incorporates implicit truths for unobserved intermediate events in model fitting, and supports both discrete and continuous time and events. We also identified a variant of the Integrated Brier Score (IBS) that showed robust correlation with the mean squared error (MSE) between the true and predicted probabilities by accounting for implied truths about the missing intermediate events. We demonstrated the superiority of SurvSurf compared to modern and traditional predictive survival models in two simulated datasets and two real-world datasets, using MSE, the more robust IBS and by measuring the extent of monotonicity violation.

Yang Nan, Javier Del Ser, Simon Walsh et al.

Removing the bias and variance of multicentre data has always been a challenge in large scale digital healthcare studies, which requires the ability to integrate clinical features extracted from data acquired by different scanners and protocols to improve stability and robustness. Previous studies have described various computational approaches to fuse single modality multicentre datasets. However, these surveys rarely focused on evaluation metrics and lacked a checklist for computational data harmonisation studies. In this systematic review, we summarise the computational data harmonisation approaches for multi-modality data in the digital healthcare field, including harmonisation strategies and evaluation metrics based on different theories. In addition, a comprehensive checklist that summarises common practices for data harmonisation studies is proposed to guide researchers to report their research findings more effectively. Last but not least, flowcharts presenting possible ways for methodology and metric selection are proposed and the limitations of different methods have been surveyed for future research.

Xiang Bai, Hanchen Wang, Liya Ma et al.

Artificial intelligence (AI) provides a promising substitution for streamlining COVID-19 diagnoses. However, concerns surrounding security and trustworthiness impede the collection of large-scale representative medical data, posing a considerable challenge for training a well-generalised model in clinical practices. To address this, we launch the Unified CT-COVID AI Diagnostic Initiative (UCADI), where the AI model can be distributedly trained and independently executed at each host institution under a federated learning framework (FL) without data sharing. Here we show that our FL model outperformed all the local models by a large yield (test sensitivity /specificity in China: 0.973/0.951, in the UK: 0.730/0.942), achieving comparable performance with a panel of professional radiologists. We further evaluated the model on the hold-out (collected from another two hospitals leaving out the FL) and heterogeneous (acquired with contrast materials) data, provided visual explanations for decisions made by the model, and analysed the trade-offs between the model performance and the communication costs in the federated training process. Our study is based on 9,573 chest computed tomography scans (CTs) from 3,336 patients collected from 23 hospitals located in China and the UK. Collectively, our work advanced the prospects of utilising federated learning for privacy-preserving AI in digital health.