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Background  Securing the representativeness of study populations is crucial in biomedical research to ensure high generalizability. In this regard, using multi-institutional data have advantages in medicine. However, combining data physically is difficult as the confidential nature of biomedical data causes privacy issues. Therefore, a methodological approach is necessary when using multi-institution medical data for research to develop a model without sharing data between institutions.    Objective  This study aims to develop a weight-based integrated predictive model of multi-institutional data, which does not require iterative communication between institutions, to improve average predictive performance by increasing the generalizability of the model under privacy-preserving conditions without sharing patient-level data.    Methods  The weight-based integrated model generates a weight for each institutional model and builds an integrated model for multi-institutional data based on these weights. We performed 3 simulations to show the weight characteristics and to determine the number of repetitions of the weight required to obtain stable values. We also conducted an experiment using real multi-institutional data to verify the developed weight-based integrated model. We selected 10 hospitals (2845 intensive care unit [ICU] stays in total) from the electronic intensive care unit Collaborative Research Database to predict ICU mortality with 11 features. To evaluate the validity of our model, compared with a centralized model, which was developed by combining all the data of 10 hospitals, we used proportional overlap (ie, 0.5 or less indicates a significant difference at a level of .05; and 2 indicates 2 CIs overlapping completely). Standard and firth logistic regression models were applied for the 2 simulations and the experiment.    Results  The results of these simulations indicate that the weight of each institution is determined by 2 factors (ie, the data size of each institution and how well each institutional model fits into the overall institutional data) and that repeatedly generating 200 weights is necessary per institution. In the experiment, the estimated area under the receiver operating characteristic curve (AUC) and 95% CIs were 81.36% (79.37%-83.36%) and 81.95% (80.03%-83.87%) in the centralized model and weight-based integrated model, respectively. The proportional overlap of the CIs for AUC in both the weight-based integrated model and the centralized model was approximately 1.70, and that of overlap of the 11 estimated odds ratios was over 1, except for 1 case.    Conclusions  In the experiment where real multi-institutional data were used, our model showed similar results to the centralized model without iterative communication between institutions. In addition, our weight-based integrated model provided a weighted average model by integrating 10 models overfitted or underfitted, compared with the centralized model. The proposed weight-based integrated model is expected to provide an efficient distributed research approach as it increases the generalizability of the model and does not require iterative communication.

jmir medical informatics

Weight-Based Framework for Predictive Modeling of Multiple Databases With Noniterative Communication Without Data Sharing: Privacy-Protecting Analytic Method for Multi-Institutional Studies