Incongruent Multimodal Federated Learning for Medical Vision and Language-based Multi-label Disease Detection

Federated Learning (FL) in healthcare ensures patient privacy by allowing hospitals to collaboratively train machine learning models while keeping sensitive medical data secure and localized. Most existing research in FL has concentrated on unimodal scenarios, where all healthcare institutes share the same type of data. However, in real-world healthcare situations, some clients may have access to multiple types of data pertaining to the same disease. Multimodal Federated Learning (MMFL) utilizes multiple modalities to build a more powerful FL model than its unimodal counterpart. However, the impact of missing modality in different clients, called modality incongruity, has been greatly overlooked. This paper, for the first time, analyses the impact of modality incongruity and reveals its connection with data heterogeneity across participating clients. We particularly inspect whether incongruent MMFL with unimodal and multimodal clients is more beneficial than unimodal FL. Furthermore, we examine three potential routes of addressing this issue. Firstly, we study the effectiveness of various self-attention mechanisms towards incongruity-agnostic information fusion in MMFL. Secondly, we introduce a modality imputation network (MIN) pre-trained in a multimodal client for modality translation in unimodal clients and investigate its potential towards mitigating the missing modality problem. Thirdly, we introduce several client-level and server-level regularization techniques including Modality-aware knowledge Distillation (MAD) and Leave-one-out teacher (LOOT) towards mitigating modality incongruity effects. Experiments are conducted with Chest X-Ray and radiology reports under several MMFL settings on two publicly available real-world datasets, MIMIC-CXR and Open-I.