Inpatient violence is a common and severe problem within psychiatry. Knowing who might become violent can influence staffing levels and mitigate severity. Predictive machine learning models can assess each patient's likelihood of becoming violent based on clinical notes. Yet, while machine learning models benefit from having more data, data availability is limited as hospitals typically do not share their data for privacy preservation. Federated Learning (FL) can overcome the problem of data limitation by training models in a decentralised manner, without disclosing data between collaborators. However, although several FL approaches exist, none of these train Natural Language Processing models on clinical notes. In this work, we investigate the application of Federated Learning to clinical Natural Language Processing, applied to the task of Violence Risk Assessment by simulating a cross-institutional psychiatric setting. We train and compare four models: two local models, a federated model and a data-centralised model. Our results indicate that the federated model outperforms the local models and has similar performance as the data-centralised model. These findings suggest that Federated Learning can be used successfully in a cross-institutional setting and is a step towards new applications of Federated Learning based on clinical notes
翻译:在精神病学中,住院暴力是一个常见和严重的问题。知道谁可能成为暴力,可以影响人员配备水平并减轻严重程度。预测机器学习模式可以根据临床记录评估每个病人的暴力可能性。然而,虽然机器学习模式受益于更多的数据,但数据提供有限,因为医院通常不分享隐私保护数据。联邦学习(FL)可以通过分散培训模式,在不披露合作者之间数据的情况下,通过分散化的方式克服数据限制问题。尽管存在若干FL方法,但这些培训的自然语言处理模式都无法在临床记录上进行。在这项工作中,我们通过模拟跨机构精神病学环境,调查将联邦学习应用于临床自然语言处理的可能性,用于暴力风险评估任务。我们培训和比较了四个模式:两个地方模型、一个联邦模式和一个数据集中模式。我们的结果表明,联邦学习模式超越了当地模式,其性能与数据集中模式相似。这些调查结果表明,联邦学习可以在跨机构环境中成功使用,并朝着基于临床记录的新应用联邦学习方向迈出了一步。