Personalized federated learning (PFL) has emerged as a promising technique for addressing the challenge of data heterogeneity. While recent studies have made notable progress in mitigating heterogeneity associated with label distributions, the issue of effectively handling feature heterogeneity remains an open question. In this paper, we propose a personalization approach by Local-global updates Mixing (LG-Mix) via Neural Tangent Kernel (NTK)-based convergence. The core idea is to leverage the convergence rate induced by NTK to quantify the importance of local and global updates, and subsequently mix these updates based on their importance. Specifically, we find the trace of the NTK matrix can manifest the convergence rate, and propose an efficient and effective approximation to calculate the trace of a feature matrix instead of the NTK matrix. Such approximation significantly reduces the cost of computing NTK, and the feature matrix explicitly considers the heterogeneous features among samples. We have theoretically analyzed the convergence of our method in the over-parameterize regime, and experimentally evaluated our method on five datasets. These datasets present heterogeneous data features in natural and medical images. With comprehensive comparison to existing state-of-the-art approaches, our LG-Mix has consistently outperformed them across all datasets (largest accuracy improvement of 5.01\%), demonstrating the outstanding efficacy of our method for model personalization. Code is available at \url{https://github.com/med-air/HeteroPFL}.

Federated learning (FL) is a learning paradigm that enables collaborative training of models using decentralized data. Recently, the utilization of pre-trained weight initialization in FL has been demonstrated to effectively improve model performance. However, the evolving complexity of current pre-trained models, characterized by a substantial increase in parameters, markedly intensifies the challenges associated with communication rounds required for their adaptation to FL. To address these communication cost issues and increase the performance of pre-trained model adaptation in FL, we propose an innovative model interpolation-based local training technique called ``Local Superior Soups.'' Our method enhances local training across different clients, encouraging the exploration of a connected low-loss basin within a few communication rounds through regularized model interpolation. This approach acts as a catalyst for the seamless adaptation of pre-trained models in in FL. We demonstrated its effectiveness and efficiency across diverse widely-used FL datasets.

Aneurysmal subarachnoid hemorrhage is a medical emergency of brain that has high mortality and poor prognosis. Causal effect estimation of treatment strategies on patient outcomes is crucial for aneurysmal subarachnoid hemorrhage treatment decision-making. However, most existing studies on treatment decision-making support of this disease are unable to simultaneously compare the potential outcomes of different treatments for a patient. Furthermore, these studies fail to harmoniously integrate the imaging data with non-imaging clinical data, both of which are useful in clinical scenarios. In this paper, we estimate the causal effect of various treatments on patients with aneurysmal subarachnoid hemorrhage by integrating plain CT with non-imaging clinical data, which is represented using structured tabular data. Specifically, we first propose a novel scheme that uses multi-modality confounders distillation architecture to predict the treatment outcome and treatment assignment simultaneously. With these distilled confounder features, we design an imaging and non-imaging interaction representation learning strategy to use the complementary information extracted from different modalities to balance the feature distribution of different treatment groups. We have conducted extensive experiments using a clinical dataset of 656 subarachnoid hemorrhage cases, which was collected from the Hospital Authority Data Collaboration Laboratory in Hong Kong. Our method shows consistent improvements on the evaluation metrics of treatment effect estimation, achieving state-of-the-art results over strong competitors. Code is released at https://github.com/med-air/TOP-aSAH.

How to ensure fairness is an important topic in federated learning (FL). Recent studies have investigated how to reward clients based on their contribution (collaboration fairness), and how to achieve uniformity of performance across clients (performance fairness). Despite achieving progress on either one, we argue that it is critical to consider them together, in order to engage and motivate more diverse clients joining FL to derive a high-quality global model. In this work, we propose a novel method to optimize both types of fairness simultaneously. Specifically, we propose to estimate client contribution in gradient and data space. In gradient space, we monitor the gradient direction differences of each client with respect to others. And in data space, we measure the prediction error on client data using an auxiliary model. Based on this contribution estimation, we propose a FL method, federated training via contribution estimation (FedCE), i.e., using estimation as global model aggregation weights. We have theoretically analyzed our method and empirically evaluated it on two real-world medical datasets. The effectiveness of our approach has been validated with significant performance improvements, better collaboration fairness, better performance fairness, and comprehensive analytical studies. Code is available at https://nvidia.github.io/NVFlare/research/fed-ce

Domain generalization (DG) has been a hot topic in image recognition, with a goal to train a general model that can perform well on unseen domains. Recently, federated learning (FL), an emerging machine learning paradigm to train a global model from multiple decentralized clients without compromising data privacy, has brought new challenges and possibilities to DG. In the FL scenario, many existing state-of-the-art (SOTA) DG methods become ineffective because they require the centralization of data from different domains during training. In this paper, we propose a novel domain generalization method for image recognition under federated learning through cross-client style transfer (CCST) without exchanging data samples. Our CCST method can lead to more uniform distributions of source clients, and make each local model learn to fit the image styles of all the clients to avoid the different model biases. Two types of style (single image style and overall domain style) with corresponding mechanisms are proposed to be chosen according to different scenarios. Our style representation is exceptionally lightweight and can hardly be used to reconstruct the dataset. The level of diversity is also flexible to be controlled with a hyper-parameter. Our method outperforms recent SOTA DG methods on two DG benchmarks (PACS, OfficeHome) and a large-scale medical image dataset (Camelyon17) in the FL setting. Last but not least, our method is orthogonal to many classic DG methods, achieving additive performance by combined utilization. Our code is available at: https://chenjunming.ml/proj/CCST.

PURPOSE: Surgical workflow and skill analysis are key technologies for the next generation of cognitive surgical assistance systems. These systems could increase the safety of the operation through context-sensitive warnings and semi-autonomous robotic assistance or improve training of surgeons via data-driven feedback. In surgical workflow analysis up to 91% average precision has been reported for phase recognition on an open data single-center video dataset. In this work we investigated the generalizability of phase recognition algorithms in a multicenter setting including more difficult recognition tasks such as surgical action and surgical skill. METHODS: To achieve this goal, a dataset with 33 laparoscopic cholecystectomy videos from three surgical centers with a total operation time of 22 h was created. Labels included framewise annotation of seven surgical phases with 250 phase transitions, 5514 occurences of four surgical actions, 6980 occurences of 21 surgical instruments from seven instrument categories and 495 skill classifications in five skill dimensions. The dataset was used in the 2019 international Endoscopic Vision challenge, sub-challenge for surgical workflow and skill analysis. Here, 12 research teams trained and submitted their machine learning algorithms for recognition of phase, action, instrument and/or skill assessment. RESULTS: F1-scores were achieved for phase recognition between 23.9% and 67.7% (n = 9 teams), for instrument presence detection between 38.5% and 63.8% (n = 8 teams), but for action recognition only between 21.8% and 23.3% (n = 5 teams). The average absolute error for skill assessment was 0.78 (n = 1 team). CONCLUSION: Surgical workflow and skill analysis are promising technologies to support the surgical team, but there is still room for improvement, as shown by our comparison of machine learning algorithms. This novel HeiChole benchmark can be used for comparable evaluation and validation of future work. In future studies, it is of utmost importance to create more open, high-quality datasets in order to allow the development of artificial intelligence and cognitive robotics in surgery.

Federated learning (FL) allows multiple medical institutions to collaboratively learn a global model without centralizing client data. It is difficult, if possible at all, for such a global model to commonly achieve optimal performance for each individual client, due to the heterogeneity of medical images from various scanners and patient demographics. This problem becomes even more significant when deploying the global model to unseen clients outside the FL with unseen distributions not presented during federated training. To optimize the prediction accuracy of each individual client for medical imaging tasks, we propose a novel unified framework for both Inside and Outside model Personalization in FL (IOP-FL). Our inside personalization uses a lightweight gradient-based approach that exploits the local adapted model for each client, by accumulating both the global gradients for common knowledge and the local gradients for client-specific optimization. Moreover, and importantly, the obtained local personalized models and the global model can form a diverse and informative routing space to personalize an adapted model for outside FL clients. Hence, we design a new test-time routing scheme using the consistency loss with a shape constraint to dynamically incorporate the models, given the distribution information conveyed by the test data. Our extensive experimental results on two medical image segmentation tasks present significant improvements over SOTA methods on both inside and outside personalization, demonstrating the potential of our IOP-FL scheme for clinical practice. Code is available at https://github.com/med-air/IOP-FL.

Multiple medical institutions collaboratively training a model using federated learning (FL) has become a promising solution for maximizing the potential of data-driven models, yet the non-independent and identically distributed (non-iid) data in medical images is still an outstanding challenge in real-world practice. The feature heterogeneity caused by diverse scanners or protocols introduces a drift in the learning process, in both local (client) and global (server) optimizations, which harms the convergence as well as model performance. Many previous works have attempted to address the non-iid issue by tackling the drift locally or globally, but how to jointly solve the two essentially coupled drifts is still unclear. In this work, we concentrate on handling both local and global drifts and introduce a new harmonizing framework called HarmoFL. First, we propose to mitigate the local update drift by normalizing amplitudes of images transformed into the frequency domain to mimic a unified imaging setting, in order to generate a harmonized feature space across local clients. Second, based on harmonized features, we design a client weight perturbation guiding each local model to reach a flat optimum, where a neighborhood area of the local optimal solution has a uniformly low loss. Without any extra communication cost, the perturbation assists the global model to optimize towards a converged optimal solution by aggregating several local flat optima. We have theoretically analyzed the proposed method and empirically conducted extensive experiments on three medical image classification and segmentation tasks, showing that HarmoFL outperforms a set of recent state-of-the-art methods with promising convergence behavior. Code is available at: https://github.com/med-air/HarmoFL

Test-time adaptation (TTA) has increasingly been an important topic to efficiently tackle the cross-domain distribution shift at test time for medical images from different institutions. Previous TTA methods have a common limitation of using a fixed learning rate for all the test samples. Such a practice would be sub-optimal for TTA, because test data may arrive sequentially therefore the scale of distribution shift would change frequently. To address this problem, we propose a novel dynamic learning rate adjustment method for test-time adaptation, called DLTTA, which dynamically modulates the amount of weights update for each test image to account for the differences in their distribution shift. Specifically, our DLTTA is equipped with a memory bank based estimation scheme to effectively measure the discrepancy of a given test sample. Based on this estimated discrepancy, a dynamic learning rate adjustment strategy is then developed to achieve a suitable degree of adaptation for each test sample. The effectiveness and general applicability of our DLTTA is extensively demonstrated on three tasks including retinal optical coherence tomography (OCT) segmentation, histopathological image classification, and prostate 3D MRI segmentation. Our method achieves effective and fast test-time adaptation with consistent performance improvement over current state-of-the-art test-time adaptation methods. Code is available at https://github.com/med-air/DLTTA.