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Suthesh Sivapalaratnam

Publications and source records attributed to Suthesh Sivapalaratnam.

4 recordsLinked to original sources

Embedding-Based Federated Learning with Runtime Governance for Iron Deficiency Prediction

Recent reviews find that the vast majority of published healthcare federated learning (FL) studies never reach real-world deployment. We developed an embedding-based FL pipeline for iron deficiency prediction from routine full blood count (FBC) data and deployed it across real institutional environments at Amsterdam University Medical Centre (AUMC) and NHS Blood and Transplant (NHSBT), two clinical environments that differ markedly in iron deficiency prevalence, ferritin distribution, and subject populations. A frozen domain-specific haematology foundation model, DeepCBC, performs site-local representation extraction, restricting federated training to a compact downstream classifier and substantially reducing recurrent communication relative to full-encoder federation. The two clinical datasets are structurally not independent and identically distributed (non-IID), with heterogeneity arising from distinct population differences rather than sampling artefacts. Runtime governance is enforced by FLA$^3$, a healthcare-oriented FL platform providing study-scoped execution, policy-based authorisation, and signed audit logging. Standard sample-size-weighted aggregation (FedAvg) reduced the area under the receiver operating characteristic curve (ROC-AUC) at both sites relative to local-only training, as the global update was biased towards the larger AUMC distribution. FedMAP, a personalised aggregation method, raised ROC-AUC from 0.9470 to 0.9594 at AUMC and from 0.8558 to 0.8671 at NHSBT relative to local-only training, achieving the highest macro ROC-AUC of 0.9133 and the best macro balanced accuracy overall. These results support personalised aggregation in clinical federations where client sample size and task relevance diverge substantially.

cs.LG↗

Building Privacy-and-Security-Focused Federated Learning Infrastructure for Global Multi-Centre Healthcare Research

Collaborative healthcare research across multiple institutions increasingly requires diverse clinical datasets, but cross-border data sharing is strictly constrained by privacy regulations. Federated learning (FL) enables model training while keeping data local; however, many existing frameworks remain proof-of-concept and do not adequately address governance risks such as unauthorised participation, misuse, and lack of accountability. In particular, enforceable mechanisms for authentication, authorisation, and accounting (AAA) are often missing, limiting real-world clinical deployment. This paper presents FLA$^3$ (Federated Learning with Authentication, Authorisation, and Accounting), a governance-aware federated learning platform that operationalises regulatory obligations through runtime policy enforcement. FLA$^3$ integrates eXtensible Access Control Markup Language (XACML) compliant attribute-based access control (ABAC), cryptographic accounting, and study-scoped federation directly into the federated learning orchestration layer to enforce institutional sovereignty and protocol adherence. We evaluate FLA$^3$ through two complementary studies. First, we demonstrate operational feasibility by deploying the platform infrastructure across five BloodCounts! Consortium institutions in four countries: United Kingdom, Netherlands, India, and The Gambia. Second, we assess clinical utility using simulated federation of full blood count (FBC) data from 54,446 samples from 35,315 subjects across 25 centres in the INTERVAL study. Results show that FLA$^3$ achieves predictive performance comparable to centralised training while strictly enforcing governance constraints. These results show that enforceable governance can function as a first-class privacy-preserving control, improving trustworthiness for scalable artificial intelligence (AI) in cross-jurisdictional healthcare deployments.

cs.CR↗

Deep Generative Classification of Blood Cell Morphology

Accurate classification of haematological cells is critical for diagnosing blood disorders, but presents significant challenges for machine automation owing to the complexity of cell morphology, heterogeneities of biological, pathological, and imaging characteristics, and the imbalance of cell type frequencies. We introduce CytoDiffusion, a diffusion-based classifier that effectively models blood cell morphology, combining accurate classification with robust anomaly detection, resistance to distributional shifts, interpretability, data efficiency, and superhuman uncertainty quantification. Our approach outperforms state-of-the-art discriminative models in anomaly detection (AUC 0.990 vs. 0.918), resistance to domain shifts (85.85% vs. 74.38% balanced accuracy), and performance in low-data regimes (95.88% vs. 94.95% balanced accuracy). Notably, our model generates synthetic blood cell images that are nearly indistinguishable from real images, as demonstrated by an authenticity test in which expert haematologists achieved only 52.3% accuracy (95% CI: [50.5%, 54.2%]) in distinguishing real from generated images. Furthermore, we enhance model explainability through the generation of directly interpretable counterfactual heatmaps. Our comprehensive evaluation framework, encompassing these multiple performance dimensions, establishes a new benchmark for medical image analysis in haematology, ultimately enabling improved diagnostic accuracy in clinical settings. Our code is available at https://github.com/CambridgeCIA/CytoDiffusion.

cs.CV↗

Dis-AE: Multi-domain & Multi-task Generalisation on Real-World Clinical Data

Clinical data is often affected by clinically irrelevant factors such as discrepancies between measurement devices or differing processing methods between sites. In the field of machine learning (ML), these factors are known as domains and the distribution differences they cause in the data are known as domain shifts. ML models trained using data from one domain often perform poorly when applied to data from another domain, potentially leading to wrong predictions. As such, developing machine learning models that can generalise well across multiple domains is a challenging yet essential task in the successful application of ML in clinical practice. In this paper, we propose a novel disentangled autoencoder (Dis-AE) neural network architecture that can learn domain-invariant data representations for multi-label classification of medical measurements even when the data is influenced by multiple interacting domain shifts at once. The model utilises adversarial training to produce data representations from which the domain can no longer be determined. We evaluate the model's domain generalisation capabilities on synthetic datasets and full blood count (FBC) data from blood donors as well as primary and secondary care patients, showing that Dis-AE improves model generalisation on multiple domains simultaneously while preserving clinically relevant information.

cs.LG↗