Arife Erdogan

Prof. Dr. Arife Erdogan


Research Focus & Metrics

Academic Career Length

1Year (2026-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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20 July 2026 in Applied Sciences
Verified
Journal Article
Open access
PDF file
CBCenab Batu Bora
Cenab Batu Bora
AKAylin Kantarci
Aylin Kantarci
AEArife Erdogan
Arife Erdogan
VEVedat Evren
Vedat Evren
SBSebnem Bora
Sebnem Bora
Emergency triage artificial intelligence (AI) is usually evaluated as a centralized prediction problem, yet many hospitals cannot pool patient-level records across governance boundaries. We studied a narrower and safety-relevant task: within-dataset federated simulation for detecting Emergency Severity Index (ESI)-2/ESI-1 encounters using information available before or during triage. Zendal is a reproducible within-dataset federated evaluation framework for critical emergency triage escalation. It defines a triage-time feature boundary, site-aligned cross-silo splits, training-split-only imputation and scaling, validation-selected operating thresholds, bootstrap uncertainty, decision-curve analysis, calibration analysis, local-only baselines, per-site and subgroup diagnostics, and leave-one-site-out transfer stress testing. In 558,029 public emergency department encounters, the endpoint was binary critical-band ESI assignment (ESI-2/ESI-1 vs. ESI-3/ESI-4/ESI-5), not an independently adjudicated clinical outcome. The feature set contained 240 pre-triage variables: demographics, arrival metadata, previous utilization counts, triage vital signs, and chief-complaint indicators; disposition, diagnoses, medications, procedures, imaging, laboratories, and target-derived imputations were excluded. A centralized logistic reference reached AUROC 0.879 (95% CI: 0.876–0.882), average precision 0.767, sensitivity 0.900 (95% CI: 0.895–0.905), specificity 0.654 (95% CI: 0.649–0.658), and positive predictive value (PPV) 0.530 at a validation-selected threshold targeting at least 90% sensitivity. Federated logistic training across three site-aligned clients nearly matched the centralized reference: AUROC 0.878 (95% CI: 0.875–0.880), average precision 0.767, sensitivity 0.900 (95% CI: 0.896–0.904), specificity 0.650 (95% CI: 0.645–0.655), and PPV 0.527. Post hoc Platt scaling reduced the federated expected calibration error from 0.160 to 0.011, supporting recalibration before direct risk interpretation. Model-guided escalation produced a positive mean decision-curve net benefit across thresholds 0.05–0.50 (0.164 for federated logistic vs. −0.003 for flag-all and 0 for flag-none). In leave-one-site-out transfer tests, federated source-site models retained AUROC 0.846–0.876 and sensitivity 0.871–0.909 on held-out sites, but the low-prevalence site had PPV 0.107 and negative net benefit. An open MIMIC-IV-ED Demo smoke test supported schema feasibility but was too small for external validation. Zendal is therefore a transparent framework for no-raw-row-exchange triage model evaluation, not a deployment-ready clinical system or a demonstration of formal privacy protection.