The adoption of EHRs has expanded opportunities to leverage data-driven algorithms in clinical care and research. A major bottleneck in effectively conducting multi-institutional EHR studies is the data heterogeneity across systems with numerous codes that either do not exist or represent different clinical concepts across institutions. The need for data privacy further limits the feasibility of including multi-institutional patient-level data required to study similarities and differences across patient subgroups. To address these challenges, we developed the GAME algorithm. Tested and validated across 7 institutions and 2 languages, GAME integrates data in several levels: (1) at the institutional level with knowledge graphs to establish relationships between codes and existing knowledge sources, providing the medical context for standard codes and their relationship to each other; (2) between institutions, leveraging language models to determine the relationships between institution-specific codes with established standard codes; and (3) quantifying the strength of the relationships between codes using a graph attention network. Jointly trained embeddings are created using transfer and federated learning to preserve data privacy. In this study, we demonstrate the applicability of GAME in selecting relevant features as inputs for AI-driven algorithms in a range of conditions, e.g., heart failure, rheumatoid arthritis. We then highlight the application of GAME harmonized multi-institutional EHR data in a study of Alzheimer's disease outcomes and suicide risk among patients with mental health disorders, without sharing patient-level data outside individual institutions.

Many existing transfer learning methods rely on leveraging information from source data that closely resembles the target data. However, this approach often overlooks valuable knowledge that may be present in different yet potentially related auxiliary samples. When dealing with a limited amount of target data and a diverse range of source models, our paper introduces a novel approach, Distributionally Robust Optimization for Transfer Learning (TransDRO), that breaks free from strict similarity constraints. TransDRO is designed to optimize the most adversarial loss within an uncertainty set, defined as a collection of target populations generated as a convex combination of source distributions that guarantee excellent prediction performances for the target data. TransDRO effectively bridges the realms of transfer learning and distributional robustness prediction models. We establish the identifiability of TransDRO and its interpretation as a weighted average of source models closest to the baseline model. We also show that TransDRO achieves a faster convergence rate than the model fitted with the target data. Our comprehensive numerical studies and analysis of multi-institutional electronic health records data using TransDRO further substantiate the robustness and accuracy of TransDRO, highlighting its potential as a powerful tool in transfer learning applications.

Graph contrastive learning (GCL) shows great potential in unsupervised graph representation learning. Data augmentation plays a vital role in GCL, and its optimal choice heavily depends on the downstream task. Many GCL methods with automated data augmentation face the risk of insufficient information as they fail to preserve the essential information necessary for the downstream task. To solve this problem, we propose InfoMin-Max for automated Graph contrastive learning (GIMM), which prevents GCL from encoding redundant information and losing essential information. GIMM consists of two major modules: (1) automated graph view generator, which acquires the approximation of InfoMin's optimal views through adversarial training without requiring task-relevant information; (2) view comparison, which learns an excellent encoder by applying InfoMax to view representations. To the best of our knowledge, GIMM is the first method that combines the InfoMin and InfoMax principles in GCL. Besides, GIMM introduces randomness to augmentation, thus stabilizing the model against perturbations. Extensive experiments on unsupervised and semi-supervised learning for node and graph classification demonstrate the superiority of our GIMM over state-of-the-art GCL methods with automated and manual data augmentation.