ArticleNature medicine2021
Federated learning for predicting clinical outcomes in patients with COVID-19.
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Article in Nature medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 241 papers, 7 of them syntheses that pooled it.
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241citing papers in PubMed, 7 pooled it
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
241 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Machine learning-assisted mRNA vaccine pharmacovigilance: a systematic review of multi-source real-world data.BMC medical informatics and decision making · 2026Pooled it
- Artificial Intelligence Platform Architecture for Hospital Systems: Systematic Review.Journal of medical Internet research · 2025Pooled it
- Federated Learning-Based Model for Predicting Mortality: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2025Pooled it
- AI-driven techniques for detection and mitigation of SARS-CoV-2 spread: a review, taxonomy, and trends.Clinical and experimental medicine · 2025Pooled it
- A meta-analysis of the diagnostic test accuracy of artificial intelligence predicting emergency department dispositions.BMC medical informatics and decision making · 2025Pooled it
- Federated machine learning in healthcare: A systematic review on clinical applications and technical architecture.Cell reports. Medicine · 2024Pooled it
- Efficient differential privacy enabled federated learning model for detecting COVID-19 disease using chest X-ray images.Frontiers in medicine · 2024Pooled it
- Federated Learning-Based Multi-Task Framework for Privacy-Preserving Diagnosis of Muscle Invasion in Bladder Cancer.Journal of imaging informatics in medicine · 2026Article
- Artificial Intelligence and Large Language Models in Surgical Shared Decision-Making and Informed Consent: A Narrative Review.Healthcare (Basel, Switzerland) · 2026Review
- Machine Learning-Based Prediction of 48-Hour Extubation Success in Mechanically Ventilated Children: A Single-Center Retrospective Cohort Study.Children (Basel, Switzerland) · 2026Article
- Advancing Tumor Treatment Through Artificial Intelligence and Mathematical Modeling: A Comprehensive Review.Health science reports · 2026Article
- Eleven quick tips for Biomedical Federated Learning.PLoS computational biology · 2026Article
- Machine Learning Methods to Predict the Length of Stay for Acute Stroke: A Scoping Review and Meta-Analysis.Health care science · 2026Review
- Artificial intelligence in healthcare: Clinical decision making algorithms, evidence-based applications, future insights, and beyond.The Journal of international medical research · 2026Article
- Artificial Intelligence for Neonatal and Perinatal Mortality Prevention: A Systematic Review of Machine Learning and Deep Learning Applications.Healthcare (Basel, Switzerland) · 2026Review
- A meta-learning method with reduced data requirements for training and updating deep learning models on wearable devices.Communications medicine · 2026Article
- CLEAR: an auditable foundation model for radiology grounded in clinical concepts.Nature biomedical engineering · 2026Article
- Real-World Imaging Data: Opportunities and Challenges.JMIR medical informatics · 2026Article
- Differentially private federated learning for localized control of infectious disease dynamics.Scientific reports · 2026Article
- Integration of Federated Learning and Blockchain in Health Care: Tutorial on Medical Data, Architectures, Privacy, Security, and Regulatory Compliance.Journal of medical Internet research · 2026Article
181 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
99 authors.
Ittai Dayan *MGH Radiology and Harvard Medical School, Boston, MA, USA.
Holger R Roth *NVIDIA, Santa Clara, CA, USA.ORCID http://orcid.org/0000-0002-3662-8743
Aoxiao Zhong *Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0002-7584-5476
Ahmed HarouniNVIDIA, Santa Clara, CA, USA.
Amilcare GentiliSan Diego VA Health Care System, San Diego, CA, USA.
Anas Z AbidinNVIDIA, Santa Clara, CA, USA.
Andrew LiuNVIDIA, Santa Clara, CA, USA.
Anthony Beardsworth CostaDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.ORCID http://orcid.org/0000-0002-2202-6450
Bradford J WoodRadiology & Imaging Sciences/Clinical Center, National Institutes of Health, Bethesda, MD, USA.ORCID http://orcid.org/0000-0002-4297-0051
Chien-Sung TsaiDivision of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Chih-Hung WangDepartment of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.ORCID http://orcid.org/0000-0001-5058-4356
Chun-Nan HsuCenter for Research in Biological Systems, University of California, San Diego, CA, USA.ORCID http://orcid.org/0000-0002-5240-4707
C K LeeNVIDIA, Santa Clara, CA, USA.
Peiying RuanNVIDIA, Santa Clara, CA, USA.
Daguang XuNVIDIA, Santa Clara, CA, USA.
Dufan WuCenter for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Eddie HuangNVIDIA, Santa Clara, CA, USA.
Felipe Campos KitamuraDasaInova, Diagnósticos da América SA, Barueri, Brazil.ORCID http://orcid.org/0000-0002-9992-5630
Griffin LaceyNVIDIA, Santa Clara, CA, USA.
Gustavo César de Antônio CorradiDasaInova, Diagnósticos da América SA, Barueri, Brazil.
Gustavo NinoDivision of Pediatric Pulmonary and Sleep Medicine, Children's National Hospital, Washington, DC, USA.
Hao-Hsin ShinMemorial Sloan Kettering Cancer Center, New York, NY, USA.ORCID http://orcid.org/0000-0003-2127-8645
Hirofumi ObinataSelf-Defense Forces Central Hospital, Tokyo, Japan.
Hui RenCenter for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Jason C CraneCenter for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
Jesse TetreaultNVIDIA, Santa Clara, CA, USA.
Jiahui GuanNVIDIA, Santa Clara, CA, USA.
John W GarrettDepartments of Radiology and Medical Physics, The University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.ORCID http://orcid.org/0000-0002-8152-736X
Joshua D KaggieDepartment of Radiology, NIHR Cambridge Biomedical Resource Centre, University of Cambridge, Cambridge, UK.
Jung Gil ParkDepartment of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea.ORCID http://orcid.org/0000-0001-5472-4731
Keith DreyerMGH Radiology and Harvard Medical School, Boston, MA, USA.
Krishna JuluruMemorial Sloan Kettering Cancer Center, New York, NY, USA.
Kristopher KerstenNVIDIA, Santa Clara, CA, USA.
Marcio Aloisio Bezerra Cavalcanti RockenbachCenter for Clinical Data Science, Massachusetts General Brigham, Boston, MA, USA.ORCID http://orcid.org/0000-0003-1783-0441
Marius George LinguraruSheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA.
Masoom A HaiderJoint Dept. of Medical Imaging, Sinai Health System, University of Toronto, Toronto, Ontario, Canada.
Meena AbdelMaseehLunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada.
Nicola RiekeNVIDIA, Santa Clara, CA, USA.ORCID http://orcid.org/0000-0003-0241-9334
Pablo F DamascenoCenter for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.ORCID http://orcid.org/0000-0001-5615-121X
Pedro Mario Cruz E SilvaNVIDIA, Santa Clara, CA, USA.
Pochuan WangMeDA Lab Institute of Applied Mathematical Sciences, National Taiwan University, Taipei, Taiwan.ORCID http://orcid.org/0000-0002-3856-048X
Sheng XuRadiology & Imaging Sciences/Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Shuichi KawanoSelf-Defense Forces Central Hospital, Tokyo, Japan.
Sira SriswasdiResearch Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.ORCID http://orcid.org/0000-0002-4117-3632
Soo Young ParkDepartment of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea.
Thomas M GristDepartments of Radiology, Medical Physics, and Biomedical Engineering, The University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.
Varun BuchCenter for Clinical Data Science, Massachusetts General Brigham, Boston, MA, USA.
Watsamon JantarabenjakulDepartment of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Weichung WangMeDA Lab Institute of Applied Mathematical Sciences, National Taiwan University, Taipei, Taiwan.
Won Young TakDepartment of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea.
Xiang LiCenter for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0002-9851-6376
Xihong LinHarvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.ORCID http://orcid.org/0000-0001-7067-7752
Young Joon KwonDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Abood QurainiNVIDIA, Santa Clara, CA, USA.
Andrew FengNVIDIA, Santa Clara, CA, USA.
Andrew N PriestDepartment of Radiology, NIHR Cambridge Biomedical Resource Centre, Cambridge University Hospital, Cambridge, UK.ORCID http://orcid.org/0000-0002-9771-4290
Baris TurkbeyNational Cancer Institute, National Institutes of Health, Bethesda, MD, USA.ORCID http://orcid.org/0000-0003-0853-6494
Benjamin GlicksbergHasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.ORCID http://orcid.org/0000-0003-4515-8090
Bernardo BizzoCenter for Clinical Data Science, Massachusetts General Brigham, Boston, MA, USA.ORCID http://orcid.org/0000-0002-9686-6751
Byung Seok KimDepartment of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea.
Carlos Tor-DíezSheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA.
Chia-Cheng LeePlanning and Management Office, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Chia-Jung HsuPlanning and Management Office, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Chin LinSchool of Medicine, National Defense Medical Center, Taipei, Taiwan.
Chiu-Ling LaiMedical Review and Pharmaceutical Benefits Division, National Health Insurance Administration, Taipei, Taiwan.
Christopher P HessCenter for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
Colin CompasNVIDIA, Santa Clara, CA, USA.
Deepeksha BhatiaNVIDIA, Santa Clara, CA, USA.
Eric K OermannDepartment of Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA.
Evan LeibovitzCenter for Clinical Data Science, Massachusetts General Brigham, Boston, MA, USA.
Hisashi SasakiSelf-Defense Forces Central Hospital, Tokyo, Japan.
Hitoshi MoriSelf-Defense Forces Central Hospital, Tokyo, Japan.
Isaac YangNVIDIA, Santa Clara, CA, USA.
Jae Ho SohnCenter for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
Krishna Nand Keshava MurthyMemorial Sloan Kettering Cancer Center, New York, NY, USA.ORCID http://orcid.org/0000-0003-2408-7414
Li-Chen FuMOST/NTU All Vista Healthcare Center, Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taipei, Taiwan.
Matheus Ribeiro Furtado de MendonçaDasaInova, Diagnósticos da América SA, Barueri, Brazil.ORCID http://orcid.org/0000-0001-5541-7207
Mike FralickDivision of General Internal Medicine and Geriatrics (Fralick), Sinai Health System, Toronto, Ontario, Canada.
Min Kyu KangDepartment of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea.ORCID http://orcid.org/0000-0002-1435-3312
Mohammad AdilNVIDIA, Santa Clara, CA, USA.
Natalie GangaiMemorial Sloan Kettering Cancer Center, New York, NY, USA.
Peerapon VateekulDepartment of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand.ORCID http://orcid.org/0000-0001-9718-3592
Pierre ElnajjarMemorial Sloan Kettering Cancer Center, New York, NY, USA.
Sarah HickmanDepartment of Radiology, NIHR Cambridge Biomedical Resource Centre, University of Cambridge, Cambridge, UK.
Sharmila MajumdarCenter for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
Shelley L McLeodSchwartz/Reisman Emergency Medicine Institute, Sinai Health, Toronto, Ontario, Canada.
Sheridan ReedRadiology & Imaging Sciences/Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Stefan GräfDepartment of Medicine and NIHR BioResource for Translational Research, NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-1315-8873
Stephanie HarmonNational Cancer Institute, National Institutes of Health, Bethesda, MD, USA.ORCID http://orcid.org/0000-0002-2507-2399
Tatsuya KodamaSelf-Defense Forces Central Hospital, Tokyo, Japan.
Thanyawee PuthanakitDepartment of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Tony MazzulliDepartment of Microbiology, Sinai Health/University Health Network, Toronto, Ontario, Canada.
Vitor Lima de LavorDasaInova, Diagnósticos da América SA, Barueri, Brazil.
Yothin RakvongthaiChulalongkorn University Biomedical Imaging Group and Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Yu Rim LeeDepartment of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea.
Yuhong WenNVIDIA, Santa Clara, CA, USA.
Fiona J Gilbert *Department of Radiology, NIHR Cambridge Biomedical Resource Centre, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-0124-9962
Mona G Flores *NVIDIA, Santa Clara, CA, USA. mflores@nvidia.com.ORCID http://orcid.org/0000-0002-7362-3044
Quanzheng Li *Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Funding
X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4MCenter for Interventional OncologyZIDBC011242 · NCI · DIVISION OF BASIC SCIENCES - NCI · PI WOOD, BRADFORD J · 2009 to 2025
$18.7MTHE HUMAN INFANT AIRWAY EPITHELIUM AND RECURRENT WHEEZING AFTER RV AND RSV INFECTIONR01HL141237 · NHLBI · CHILDREN'S RESEARCH INSTITUTE · PI NINO, GUSTAVO · 2019 to 2022
$2.8MImaging biomarkers of severe respiratory infections in premature infants Phase IIR42HL145669 · NHLBI · KITWARE, INC. · PI ENQUOBAHRIE, ANDINET ASMAMAW, LINGURARU, MARIUS GEORGE · 2021 to 2022
$1.7MCan machines be trusted? Robustification of deep learning for medical imagingR01LM013151 · NLM · UNIVERSITY OF WISCONSIN-MADISON · PI GARRETT, JOHN WILLIAM, MCMILLAN, ALAN BLAIR · 2020 to 2023
$1.3MInterventional OncologyZIACL040015 · CLC · CLINICAL CENTER · PI WOOD, BRADFORD · 2009 to 2025
$0kCancer Research UK 26884Intramural NIH HHS ZIA CL040015Intramural NIH HHS ZID BC011242NCI NIH HHS P30 CA008748NHLBI NIH HHS R01 HL141237NHLBI NIH HHS R42 HL145669NLM NIH HHS R01 LM013151
Abstract
Federated learning (FL) is a method used for training artificial intelligence models with data from multiple sources while maintaining data anonymity, thus removing many barriers to data sharing. Here we used data from 20 institutes across the globe to train a FL model, called EXAM (electronic medical record (EMR) chest X-ray AI model), that predicts the future oxygen requirements of symptomatic patients with COVID-19 using inputs of vital signs, laboratory data and chest X-rays. EXAM achieved an average area under the curve (AUC) >0.92 for predicting outcomes at 24 and 72 h from the time of initial presentation to the emergency room, and it provided 16% improvement in average AUC measured across all participating sites and an average increase in generalizability of 38% when compared with models trained at a single site using that site's data. For prediction of mechanical ventilation treatment or death at 24 h at the largest independent test site, EXAM achieved a sensitivity of 0.950 and specificity of 0.882. In this study, FL facilitated rapid data science collaboration without data exchange and generated a model that generalized across heterogeneous, unharmonized datasets for prediction of clinical outcomes in patients with COVID-19, setting the stage for the broader use of FL in healthcare.
Indexed as
Machine LearningOutcome Assessment, Health CareCOVID-19Electronic Health RecordsHumansPrognosisSARS-CoV-2
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