Yiziting Zhu

Xixi Tian, Di Wu, Xiang Liu et al.

Privacy-sensitive and distributed characteristics of multi-center medical data bring severe obstacles to centralized modeling for accurate early prediction of sepsis. Federated learning (FL) has attracted growing attention as a promising framework for collaborative model development, as it allows multiple institutions to jointly train predictive models without directly sharing or centralizing raw data. Nevertheless, its practical performance, robustness, and privacy-preserving benefits remain insufficiently evaluated using real-world clinical datasets. To bridge this gap, this study systematically examines the application of federated learning to multi-center sepsis prediction. The experimental dataset consists of 648 clinically screened samples collected from three tertiary hospitals in China, with rigorous inclusion and exclusion criteria. We establish a centralized training paradigm as the performance baseline, and then implement a horizontal federated learning framework for distributed collaborative modeling. Extensive experimental results demonstrate that the federated learning-based model achieves highly comparable prediction accuracy to the centralized counterpart, while fundamentally avoiding privacy leakage. Further privacy security analysis verifies that malicious attackers cannot reconstruct the original patient data from the transmitted model parameters, indicating strong resistance against data reconstruction attacks. This work not only validates the practicality and security of federated learning in clinical sepsis prediction, but also provides a reliable and feasible solution for privacy-preserving multi-center medical collaboration.

Bozhi Dan, Di Wu, Ji Xu et al.

In the intensive care setting, sepsis continues to be a major contributor to patient illness and death; however, its timely detection is hindered by the complex, sparse, and heterogeneous nature of electronic health record (EHR) data. We propose Triplet-GCN, a single-branch graph convolutional model that represents each encounter as patient-feature-value triplets, constructs a bipartite EHR graph, and learns patient embeddings via a Graph Convolutional Network (GCN) followed by a lightweight multilayer perceptron (MLP). The pipeline applies type-specific preprocessing -- median imputation and standardization for numeric variables, effect coding for binary features, and mode imputation with low-dimensional embeddings for rare categorical attributes -- and initializes patient nodes with summary statistics, while retaining measurement values on edges to preserve "who measured what and by how much". In a retrospective, multi-center Chinese cohort (N = 648; 70/30 train-test split) drawn from three tertiary hospitals, Triplet-GCN consistently outperforms strong tabular baselines (KNN, SVM, XGBoost, Random Forest) across discrimination and balanced error metrics, yielding a more favorable sensitivity-specificity trade-off and improved overall utility for early warning. These findings indicate that encoding EHR as triplets and propagating information over a patient-feature graph produce more informative patient representations than feature-independent models, offering a simple, end-to-end blueprint for deployable sepsis risk stratification.