Abstract
MOTIVATION: There is growing interest in estimating population reference ranges across age and sex to better identify atypical clinically-relevant measurements throughout the lifespan. For this task, the World Health Organization recommends using Generalized Additive Models for Location, Scale, and Shape (GAMLSS), which can model non-linear growth trajectories under complex distributions that address the heterogeneity in human populations.Fitting GAMLSS models requires large, generalizable sample sizes, especially for accurate estimation of extreme quantiles, but obtaining such multi-site data can be challenging due to privacy concerns and practical considerations. In settings where patient data cannot be shared, privacy-preserving distributed algorithms for federated learning can be used, but no such algorithm exists for GAMLSS. RESULTS: We propose distributed GAMLSS (dGAMLSS), a distributed algorithm that can fit GAMLSS models across multiple sites without sharing patient-level data. This includes specific considerations for the fitting of smooth functions at varying levels of communication efficiency. We demonstrate the effectiveness of dGAMLSS in constructing population reference charts across clinical, genomics, and neuroimaging settings and show that dGAMLSS is able to reproduce pooled reference charts and inference down to numerical differences. AVAILABILITY AND IMPLEMENTATION: An R package providing examples of the dGAMLSS algorithm, as well as functions for sharing and aggregating site-specific parameters, is available at https://github.com/hufengling/dGAMLSS.