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To address the issues of privacy-utility imbalance, insufficient incentives, and lack of verifiable computation in current medical data sharing, this paper proposes a blockchain-based fair verification and adaptive differential privacy mechanism. The mechanism adopts an integrated design that systematically tackles three core challenges: privacy protection, fair incentives, and verifiability. Instead of using a traditional fixed privacy budget allocation, it introduces a reputation-aware adaptive strategy that dynamically adjusts the privacy budget based on the contributors’ historical behavior and data quality, thereby improving aggregation performance under the same privacy constraints. Meanwhile, a fair incentive verification layer is established via smart contracts to quantify and confirm data contributions on-chain, automatically executing reciprocal rewards and mitigating the trust and motivation deficiencies in collaboration. To ensure enforceable privacy guarantees, the mechanism integrates lightweight zero-knowledge proof (zk-SNARK) technology to publicly verify off-chain differential privacy computations, proving correctness without revealing private data and achieving auditable privacy protection. Experimental results on multiple real-world medical datasets demonstrate that the proposed mechanism significantly improves analytical accuracy and fairness in budget allocation compared with baseline approaches, while maintaining controllable system overhead. The innovation lies in the organic integration of adaptive differential privacy, blockchain, fair incentives, and zero-knowledge proofs, establishing a trustworthy, efficient, and fair framework for medical data sharing.
Feier et al. (Tue,) studied this question.