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Yiziting Zhu

Publications and source records attributed to Yiziting Zhu.

4 recordsLinked to original sources

Federated Learning for Multi-Center Sepsis Early Prediction with Privacy-Preserving

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.

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Sepsis Prediction Using Graph Convolutional Networks over Patient-Feature-Value Triplets

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.

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TECM*: A Data-Driven Assessment to Reinforcement Learning Methods and Application to Heparin Treatment Strategy for Surgical Sepsis

Objective: Sepsis is a life-threatening condition caused by severe infection leading to acute organ dysfunction. This study proposes a data-driven metric and a continuous reward function to optimize personalized heparin therapy in surgical sepsis patients. Methods: Data from the MIMIC-IV v1.0 and eICU v2.0 databases were used for model development and evaluation. The training cohort consisted of abdominal surgery patients receiving unfractionated heparin (UFH) after postoperative sepsis onset. We introduce a new RL-based framework: converting the discrete SOFA score to a continuous cxSOFA for more nuanced state and reward functions; Second, defining "good" or "bad" strategies based on cxSOFA by a stepwise manner; Third, proposing a Treatment Effect Comparison Matrix (TECM), analogous to a confusion matrix for classification tasks, to evaluate the treatment strategies. We applied different RL algorithms, Q-Learning, DQN, DDQN, BCQ and CQL to optimize the treatment and comprehensively evaluated the framework. Results: Among the AI-derived strategies, the cxSOFA-CQL model achieved the best performance, reducing mortality from 1.83% to 0.74% with the average hospital stay from 11.11 to 9.42 days. TECM demonstrated consistent outcomes across models, highlighting robustness. Conclusion: The proposed RL framework enables interpretable and robust optimization of heparin therapy in surgical sepsis. Continuous cxSOFA scoring and TECM-based evaluation provide nuanced treatment assessment, showing promise for improving clinical outcomes and decision-support reliability.

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End to End Autoencoder MLP Framework for Sepsis Prediction

Sepsis is a life threatening condition that requires timely detection in intensive care settings. Traditional machine learning approaches, including Naive Bayes, Support Vector Machine (SVM), Random Forest, and XGBoost, often rely on manual feature engineering and struggle with irregular, incomplete time-series data commonly present in electronic health records. We introduce an end-to-end deep learning framework integrating an unsupervised autoencoder for automatic feature extraction with a multilayer perceptron classifier for binary sepsis risk prediction. To enhance clinical applicability, we implement a customized down sampling strategy that extracts high information density segments during training and a non-overlapping dynamic sliding window mechanism for real-time inference. Preprocessed time series data are represented as fixed dimension vectors with explicit missingness indicators, mitigating bias and noise. We validate our approach on three ICU cohorts. Our end-to-end model achieves accuracies of 74.6 percent, 80.6 percent, and 93.5 percent, respectively, consistently outperforming traditional machine learning baselines. These results demonstrate the framework's superior robustness, generalizability, and clinical utility for early sepsis detection across heterogeneous ICU environments.

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