Consensus Modeling: A Transfer Learning Approach for Small Health Systems

Roshan Tourani, Dennis H. Murphree, Ying Zhu, Adam Sheka, Genevieve B. Melton, Daryl J. Kor, Gyorgy J. Simon

Research output: Chapter in Book/Report/Conference proceedingConference contribution


The adoption of predictive modeling for clinical decision support is accelerating in healthcare, however, the need for large sample sizes puts smaller health systems at a disadvantage. Small health systems have insufficient positive cases to build models are left with three choices. First, they can obtain already trained models, which are often too generic. Second, they can participate in research networks, building a model through a network-wide data set. Since small hospitals can only contribute small amounts of data influencing the resulting shared model minimally, this approach yields only minimal specialization. The third option is transfer learning, where a model previously trained on a large population is refined to the specific population, which carries the danger of over-specializing to the idiosyncrasies of the small data set. In this paper, we present a novel paradigm, consensus modeling, that allows a small health system to collaborate with a larger system to build a model specific to the smaller system without sharing any data instances. The method is similar to transfer learning in that it refines models from the larger system to be specific to the small system, but through iterative refinement, the larger system alleviates the risk of over-specializing to the small system. We evaluated the approach on predicting postoperative complications at two health systems with 9,044 and 38,545 patients. The model obtained from the proposed consensus modeling paradigm achieved a predictive performance on the small system that is as good as the transfer learning approach (AUC 0.71 vs 0.71) but significantly outperformed the transfer learning approach on the large dataset (AUC 0.80 vs 0.65) suggesting significantly reduced over-specializing.

Original languageEnglish (US)
Title of host publicationArtificial Intelligence in Medicine - 18th International Conference on Artificial Intelligence in Medicine, AIME 2020, Proceedings
EditorsMartin Michalowski, Robert Moskovitch
PublisherSpringer Science and Business Media Deutschland GmbH
Number of pages11
ISBN (Print)9783030591366
StatePublished - 2020
Event18th International Conference on Artificial Intelligence in Medicine, AIME 2020 - Minneapolis, United States
Duration: Aug 25 2020Aug 28 2020

Publication series

NameLecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)
Volume12299 LNAI
ISSN (Print)0302-9743
ISSN (Electronic)1611-3349


Conference18th International Conference on Artificial Intelligence in Medicine, AIME 2020
Country/TerritoryUnited States


  • Hospital acquired infection
  • Machine learning
  • Predictive modeling
  • Transfer learning

ASJC Scopus subject areas

  • Theoretical Computer Science
  • General Computer Science


Dive into the research topics of 'Consensus Modeling: A Transfer Learning Approach for Small Health Systems'. Together they form a unique fingerprint.

Cite this