Client Recruitment for Federated Learning in ICU Length of Stay Prediction

Machine and deep learning methods for medical and healthcare applications have shown significant progress and performance improvement in recent years. These methods require vast amounts of training data which are available in the medical sector, albeit decentralized. Medical institutions generate vast amounts of data for which sharing and centralizing remains a challenge as the result of data and privacy regulations. The federated learning technique is well-suited to tackle these challenges. However, federated learning comes with a new set of open problems related to communication overhead, efficient parameter aggregation, client selection strategies and more. In this work, we address the step prior to the initiation of a federated network for model training, client recruitment. By intelligently recruiting clients, communication overhead and overall cost of training can be reduced without sacrificing predictive performance. Client recruitment aims at pre-excluding potential clients from partaking in the federation based on a set of criteria indicative of their eventual contributions to the federation. In this work, we propose a client recruitment approach using only the output distribution and sample size at the client site. We show how a subset of clients can be recruited without sacrificing model performance whilst, at the same time, significantly improving computation time. By applying the recruitment approach to the training of federated models for accurate patient Length of Stay prediction using data from 189 Intensive Care Units, we show how the models trained in federations made up from recruited clients significantly outperform federated models trained with the standard procedure in terms of predictive power and training time.