Cited by 168Privacy-Preserving Technologies in DataArtificial Intelligence in Healthcare and EducationBlockchain Technology Applications and Security

The DOI matches its Crossref record; 116 of the 116 references it cites were found in a registry or an index; 2 of the 99 sources its claims cite were checked for support.

Handling Privacy-Sensitive Medical Data With Federated Learning: Challenges and Future Directions

Open access
Aouedi, Ons, Sacco, Alessio, Piamrat, Kandaraj, Marchetto, Guido·2023·IEEE Journal of Biomedical and Health Informatics

Abstract

Recent medical applications are largely dominated by the application of Machine Learning (ML) models to assist expert decisions, leading to disruptive innovations in radiology, pathology, genomics, and hence modern healthcare systems in general. Despite the profitable usage of AI-based algorithms, these data-driven methods are facing issues such as the scarcity and privacy of user data, as well as the difficulty of institutions exchanging medical information. With insufficient data, ML is prevented from reaching its full potential, which is only possible if the database consists of the full spectrum of possible anatomies, pathologies, and input data types. To solve these issues, Federated Learning (FL) appeared as a valuable approach in the medical field, allowing patient data to stay where it is generated. Since an FL setting allows many clients to collaboratively train a model while keeping training data decentralized, it can protect privacy-sensitive medical data. However, FL is still unable to deliver all its promises and meets the more stringent requirements (e.g., latency, security) of a healthcare system based on multiple Internet of Medical Things (IoMT). For example, although no data are shared among the participants by definition in FL systems, some security risks are still present and can be considered as vulnerabilities from multiple aspects. This paper sheds light upon the emerging deployment of FL, provides a broad overview of current approaches and existing challenges, and outlines several directions of future work that are relevant to solving existing problems in federated healthcare, with a particular focus on security and privacy issues.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review surveys federated learning (FL) for privacy-sensitive medical data and the Internet of Medical Things (IoMT), covering applications, security/privacy countermeasures, and open challenges. It argues FL can protect patient data while enabling collaboration, but practical issues such as non-IID data, communication overhead, stragglers, and constrained devices remain unresolved.

Key findings

  • FL enables collaborative model training while keeping patient data local; a general FL-trained model can achieve performance comparable to centrally hosted datasets and superior to models trained on isolated single-institutional data.
  • Reviewed IoMT/healthcare applications include electronic health record patient similarity, hospitalization prediction, activity recognition, teledermatology, COVID-19 detection, and drug discovery (the Melloddy project applies multi-task FL to datasets from 10 pharmaceutical companies).
  • Reported quantitative results include: IID data difference between FL and non-FL within 3%; PerFit accuracy 11.12% higher than classical FL; non-IID data caused up to 50% accuracy reduction; Federated Dropout reduced local computations by 1.7× without affecting accuracy; compression reduced communication costs by two orders of magnitude.
  • Security and privacy risks remain despite FL, including gradient-based reconstruction, model inversion, and adversarial attacks; countermeasures include secure aggregation, differential privacy, blockchain, and homomorphic encryption, with trade-offs between security and model accuracy or system efficiency.

Methods

  • Narrative review/survey design; no primary experiments or new dataset are collected.
  • Synthesizes existing literature on FL concepts, IoMT applications, security/privacy concerns, and practical challenges.
  • Uses summary tables (Table I on related reviews; Table II on FL-IoMT approaches) and discusses representative works across healthcare and IoMT scenarios.

Limitations

  • The paper does not explicitly state limitations of its own review.
  • Evident from the text: as a survey, it provides no new experimental validation; performance numbers are drawn from cited studies.
  • Evident from the text: no systematic search protocol, inclusion criteria, or meta-analysis are described.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1109/jbhi.2022.3185673

Cites

116 of 116 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

83 Not checked yet · 42 Own interpretation · 19 No basis given · 1 Supported · 1 Partly supported · 1 Own result · accuracy not yet measured

Verify all 97 references — free account
  • It may state two separate claims as one. 74
  • Probably not a substantial claim. 87
120 of 120
  • The paper relies on this without support.

    Medical data is highly sensitive and must be protected by appropriate confidentiality procedures.

    “Medical data is highly sensitive and must be protected by means of appropriate confidentiality procedures.”
  • The paper relies on this without support.

    Security problems in FL are primarily caused by curious or malicious attackers targeting vulnerabilities of the FL system, which can lead to significant performance drop and sometimes model invalidation.

    “This type of problem is primarily caused by curious or malicious attackers targeting vulnerabilities of the FL system, which can lead to significant performance drop and sometimes model invalidation.”
  • The paper relies on this without support.

    In healthcare and IoMT scenarios, an attacker can directly manipulate the model and data of a local affiliation, resulting in a malicious update of the global model or mislabeled data.

    “In the context of healthcare and IoMT scenarios, an attacker can directly manipulate the model and data of a local affiliation, resulting in a malicious update of the global model or mislabeled data.”
  • The paper relies on this without support.

    Increased heterogeneity of data sources can decrease model performance, bottleneck the network, and increase storage and processing costs.

    “Moreover, the increase in heterogeneity of data sources could decrease the performance of the model, bottleneck the whole network, and cause an extra computational cost for both storage and processing.”
  • The authors state this as an assumption.

    In global privacy-enhancing mechanisms, the global server is trusted.

    “In other words, in a global privacy-enhancing mechanism, the global server is assumed trusted, while in local privacy, the central server may be malicious.”
  • The paper relies on this without support.

    Data breaches can result in reduced public trust.

    “because data breaches can result in reduced public trust.”
  • The paper relies on this without support.

    Some IoMT devices, even though not limited in size, have limitations in the available on-board resources.

    “Some IoMT devices, even though not limited in size, come with limitations in the available on-board resources.”
  • The paper relies on this without support.

    Data-driven medical methods face scarcity and privacy of user data, as well as difficulty of institutions exchanging medical information.

    “Despite the profitable usage of AI-based algorithms, these data-driven methods are facing issues such as the scarcity and privacy of user data, as well as the difficulty of institutions exchanging medical information.”
  • The paper relies on this without support.

    With insufficient data, ML is prevented from reaching its full potential, which is only possible if the database consists of the full spectrum of possible anatomies, pathologies, and input data types.

    “With insufficient data, ML is prevented from reaching its full potential, which is only possible if the database consists of the full spectrum of possible anatomies, pathologies, and input data types.”
9 of 9

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Self-check

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Each contradiction between two passages listed here was confirmed by an independent check.

1 of 1

Citations

Cites

Show all 111 references

Research works printed but not linked: 1

  1. Bonawitz, 2019, Toward federated learning at scale: System design, 1, 374

Cited by

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Metadata

Authors
Aouedi, O., Sacco, A., Piamrat, K., & Marchetto, G.
Affiliations
  • Laboratoire des Sciences du Numérique de Nantes (FR)
  • Politecnico di Torino (IT)
Venue
IEEE Journal of Biomedical and Health Informatics
Published
2023-02
Volume
27
Issue
2
Pages
790-803
ISSN
  • 2168-2194 (ISSN-L)
  • 2168-2208
OpenAlex
W4283373300
Cited by
165
References
111
Citations by year
2026: 44 · 2025: 60 · 2024: 44 · 2023: 15
FWCI
9.95
Type
journal article
Language
en
Open access
Locations
  • IEEE Journal of Biomedical and Health Informatics (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PORTO@Iris (submittedVersion, cc-by)
  • HAL (submittedVersion, cc-by)
Topics
  • Physical Sciences › Computer Science › Artificial Intelligence › Privacy-Preserving Technologies in Data
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
  • Physical Sciences › Computer Science › Information Systems › Blockchain Technology Applications and Security
Keywords
federated learning, privacy-preserving machine learning, medical data privacy, Internet of Medical Things, security vulnerabilities, data scarcity, health data sharing
MeSH terms
Internet of Things, Algorithms, Humans, Databases, Factual, Privacy, Genomics

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