Although the sharing of data is an important part of multicenter biomedical AI, direct data sharing is hindered by privacy laws, institutional data silos, and restrained trust and cooperation between institutions. While federated learning offers an opportunity for collaborative model training without centralizing patient data, many current methods rely on the same fixed levels of privacy protection on all clients, every layer of the model, each round, and each modality, resulting in suboptimal privacy–utility–latency trade-offs. In this study, we introduce Adaptive Trust-Aware Encrypted Federated Artificial Intelligence with Blockchain Auditability (ATEB-AI) for biomedical signal and medical image analysis. ATEB-AI is an adaptive CKKS encryption, trust-aware aggregation, and permissioned blockchain-based audit logging combination. The proposed framework was tested on four public benchmarks, namely, MIT-BIH, CHB-MIT, BraTS, and NIH ChestXray. ATEB-AI had the highest overall performance out of all compared federated methods and remained near the centralized training benchmark at up to 99.0% of the reference centralized training performance. It reduced membership-inference success from 0.71 to 0.24 (−66.2%), inversion leakage from 0.64 to 0.27 (−57.8%), and poisoning-related utility loss from 0.18 to 0.07 (−61.1%). Round latency was 1.90× FedAvg, compared with 2.85× for HE-FL (−33.3%) and 3.50× for BC-FL (−45.7%). The key contribution of this study is a single biomedical federated learning framework in which privacy, client trust, reliability, and auditability are unified, instead of being disjointed components. The results obtained with the proposed model prove the feasibility of co-optimizing confidentiality, robustness, efficiency, and governance in a single deployable multicenter medical AI pipeline.
Hussein et al. (Mon,) studied this question.
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