Federated target trial emulation using distributed observational data for treatment effect estimation
Abstract Target trial emulation (TTE) aims to estimate treatment effects by simulating randomized controlled trials using real-world observational data. Applying TTE across distributed datasets shows great promise in improving generalizability and power but is always infeasible due to privacy and da...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-07-01
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| Series: | npj Digital Medicine |
| Online Access: | https://doi.org/10.1038/s41746-025-01803-y |
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| Summary: | Abstract Target trial emulation (TTE) aims to estimate treatment effects by simulating randomized controlled trials using real-world observational data. Applying TTE across distributed datasets shows great promise in improving generalizability and power but is always infeasible due to privacy and data-sharing constraints. Here we propose a Federated Learning-based TTE framework, FL-TTE, that enables TTE across multiple sites without sharing patient-level data. FL-TTE incorporates federated protocol design, federated inverse probability of treatment weighting, and a federated Cox proportional hazards model to estimate time-to-event outcomes across heterogeneous data. We validated FL-TTE by emulating Sepsis trials using eICU and MIMIC-IV data from 192 hospitals, and Alzheimer’s trials using INSIGHT Network across five New York City health systems. FL-TTE produced less biased estimates than traditional meta-analysis methods when compared to pooled results and is theoretically supported. Our FL-TTE enables federated treatment effect estimation across distributed and heterogeneous data in a privacy-preserved way. |
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| ISSN: | 2398-6352 |