Enabling End-to-End Secure Federated Learning in Biomedical Research on Heterogeneous Computing Environments with APPFLx (preprint)

Facilitating large-scale, cross-institutional collaboration in biomedical machine learning projects requires a trustworthy and resilient federated learning (FL) environment to ensure that sensitive information such as protected health information is kept confidential. In this work, we introduce APPFLx, a low-code FL framework that enables the easy setup, configuration, and running of FL experiments across organizational and administrative boundaries while providing secure end-to-end communication, privacy-preserving functionality, and identity management. APPFLx is completely agnostic to the underlying computational infrastructure of participating clients. We demonstrate the capability of APPFLx as an easy-to-use framework for accelerating biomedical studies across institutions and healthcare systems while maintaining the protection of private medical data in two case studies: (1) predicting participant age from electrocardiogram (ECG) waveforms, and (2) detecting COVID-19 disease from chest radiographs. These experiments were performed securely across heterogeneous compute resources, including a mixture of on-premise high-performance computing and cloud computing, and highlight the role of federated learning in improving model generalizability and performance when aggregating data from multiple healthcare systems. Finally, we demonstrate that APPFLx serves as a convenient and easy-to-use framework for accelerating biomedical studies across institutions and healthcare system while maintaining the protection of private medical data.

A Phenome-Wide Association Study of genes associated with COVID-19 severity reveals shared genetics with complex diseases in the Million Veteran Program (preprint)

The study aims to determine the shared genetic architecture between COVID-19 severity with existing medical conditions using electronic health record (EHR) data. We conducted a Phenome-Wide Association Study (PheWAS) of genetic variants associated with critical illness (n=35) or hospitalization (n=42) due to severe COVID-19 using genome-wide association summary from the Host Genetics Initiative. PheWAS analysis was performed using genotype-phenotype data from the Veterans Affairs Million Veteran Program (MVP). Phenotypes were defined by International Classification of Diseases (ICD) codes mapped to clinically relevant groups using published PheWAS methods. Among 658,582 Veterans, variants associated with severe COVID-19 were tested for association across 1,559 phenotypes. Variants at the ABO locus (rs495828, rs505922) associated with the largest number of phenotypes (nrs495828= 53 and nrs505922=59); strongest association with venous embolism, odds ratio (ORrs495828 1.33 (p=1.32 x 10-199), and thrombosis ORrs505922 1.33, p=2.2 x10-265. Among 67 respiratory conditions tested, 11 had significant associations including MUC5B locus (rs35705950) with increased risk of idiopathic fibrosing alveolitis OR 2.83, p=4.12 x 10-191; CRHR1 (rs61667602) associated with reduced risk of pulmonary fibrosis, OR 0.84, p=2.26x 10-12. The TYK2 locus (rs11085727) associated with reduced risk for autoimmune conditions, e.g., psoriasis OR 0.88, p=6.48 x10-23, lupus OR 0.84, p=3.97 x 10-06. PheWAS stratified by genetic ancestry demonstrated differences in genotype-phenotype associations across ancestry. LMNA (rs581342) associated with neutropenia OR 1.29 p=4.1 x 10-13 among Veterans of African ancestry but not European. Overall, we observed a shared genetic architecture between COVID-19 severity and conditions related to underlying risk factors for severe and poor COVID-19 outcomes. Differing associations between genotype-phenotype across ancestries may inform heterogenous outcomes observed with COVID-19. Divergent associations between risk for severe COVID-19 with autoimmune inflammatory conditions both respiratory and non-respiratory highlights the shared pathways and fine balance of immune host response and autoimmunity and caution required when considering treatment targets.