Pushing the (Decision) Boundaries: Dynamically Calibrating Differentially Private Noise to Explainability in Federated Learning

Federated Learning (FL) with Differential Privacy (DP) is increasingly adopted to preserve data confidentiality in distributed machine learning. However, DP noise distorts learned representations and degrades explanation fidelity, limiting differentially private FL where trustworthy explanations are required, such as assistive clinical diagnosis. Prior work adapted DP noise with static feature-importance signals, restricting explainability to post hoc analysis and precluding noise calibration to explanation quality during training. We propose XCal-FL, a closed-loop, explainability-driven local training algorithm for image classification in cross-silo FL that dynamically calibrates DP noise from three complementary signals: (1) prediction logit variations, measuring causal influence on model confidence, (2) counterfactual margins, capturing decision-boundary sensitivity, and (3) saliency concentration, quantifying spatial coherence of model attention, while enforcing formal DP guarantees via adaptive privacy accounting. Experiments on three medical imaging datasets across varying FL configurations show that XCal-FL yields more accurate and interpretable global models, improving predictive performance by over 10\% and explanation fidelity by up to 5$\times$ over static-noise FL, and outperforming state-of-the-art adaptive DP methods in fidelity. XCal-FL also achieves higher privacy-budget efficiency, turning each unit of cumulative privacy loss into larger gains in both accuracy and explanation fidelity. Our analysis further reveals that, unlike predictive performance, which scales roughly linearly with privacy loss, explanation fidelity exhibits non-linear dynamics. These findings suggest explainability is a distinct dimension of the privacy trade-off that cannot be inferred from utility alone, with implications for training and privacy-budget allocation in decision-critical applications.

Similarity Weighted Aggregation with Global Differential Privacy for Federated Brain Lesion Segmentation

Federated Learning (FL) enables collaborative training of machine learning models across multiple institutions without sharing sensitive data, making it particularly suitable for medical imaging applications. However, heterogeneous data distributions across institutions and potential information leakage through model updates remain important challenges. In this work, we propose DP-SimAgg, a privacy-preserving federated learning framework that integrates similarity-weighted aggregation with a server-side differential privacy mechanism. The proposed method applies L2 clipping to bound collaborator updates, computes similarity-based aggregation weights to mitigate the effects of non-IID data distributions, and injects calibrated Gaussian noise at the central server, providing per-round privacy guarantees under the assumed sensitivity bound. The framework is implemented using Intel's OpenFL platform and evaluated on the FeTS 2022 dataset consisting of 1251 multi-modal MRI scans for brain tumor segmentation. Experimental results demonstrate that DP-SimAgg maintains competitive segmentation performance while providing privacy protection. Under a strict per-round privacy budget (epsilon = 1, cumulative epsilon_total = 20 over 20 rounds), the method achieves Dice scores of 0.6357, 0.5305, and 0.5274 for the enhancing tumor (ET), tumor core (TC), and whole tumor (WT) regions, respectively. With a more relaxed per-round budget (epsilon = 10, cumulative epsilon_total = 200), performance approaches that of the non-private baseline while incorporating a central Gaussian mechanism with per-round (epsilon, delta)-DP accounting under the assumed sensitivity bound. These results highlight the potential of DP-SimAgg for enabling privacy-preserving collaborative learning in medical imaging applications.

FedDP-PALD: A Privacy-Preserving Federated Latent Diffusion Framework with Prototype Aggregation for Medical Data Synthesis

Medical images and physiological signals provide valuable information for accurate diagnosis. Developing diagnostic models often requires patient data from multiple institutions, although strict privacy regulations limit the sharing of sensitive clinical records. Federated learning enables multiple hospitals to train a shared model without exchanging raw data. However, existing methods face two problems: the information exchanged during training can reveal whether a patient's data were used, and synthetic data meant to replace real records often fail to preserve their predictive structure, which limits clinical use. To address this issue, we propose FedDP-PALD, a privacy-preserving federated latent diffusion framework for multimodal medical data synthesis under formal privacy guarantees. It jointly processes chest X-ray images and electrocardiogram (ECG) signals through gated multi-head attention with modality-availability masks, remaining effective even when a modality is missing. We also introduce Differentially Private Prototype Mixture Aggregation (DP-PMA), which clips class-level latent prototypes and adds calibrated Gaussian noise before combining them on the server to maintain $(ε, δ)$ differential privacy. We evaluate FedDP-PALD on PneumoniaMNIST, ChestMNIST, and MIT-BIH datasets, where differential privacy reduced summary-level attack AUROC from 0.6229 $\pm$ 0.0026 to between 0.5016 and 0.5093 for privacy budgets from $ε= 1$ to $ε= 8$. On the test data, synthetic-latent training achieved an F1 score of 0.8993 $\pm$ 0.0006 and an AUROC of 0.9057 $\pm$ 0.0503, close to the 0.9747 $\pm$ 0.0132 real-latent training. These results show that FedDP-PALD generates private synthetic representations that preserve useful decision performance while strongly resisting membership inference.

Recovering Clinical Utility Under Differential Privacy: Empirical Validation of Adaptive Federated Aggregation on Heterogeneous Cardiovascular Datasets

Validating federated learning frameworks on real clinical data is an essential step between proof-of-concept demonstrations in controlled synthetic environments and deployment in real multicenter healthcare settings. A prior architectural study by the same authors (Tertulino and Alencar, 2026) demonstrated, on a synthetic six-feature benchmark, that server-side adaptive optimization acts as a temporal denoiser for Differential Privacy noise, answering an open challenge identified in the original pipeline work (Tertulino, 2025). That study used synthetically generated data and explicitly identified real-world validation as a priority future direction. The present work addresses this gap by validating the FedCVR framework on five publicly available real cardiovascular datasets (Framingham, Cleveland, Hungarian, Switzerland, and Long Beach VA), harmonized to the 13-attribute UCI Heart Disease schema and configured as a heterogeneous federated scenario with leave-one-institution-out cross-validation. Results demonstrate that FedCVR preserves its adaptive advantage on real data, achieving an F1-Score of 79.2% and AUC of 0.96 under the operational privacy budget (noise multiplier = 0.8, privacy budget epsilon approximately 4.2), while statistically outperforming standard FedAvg on all evaluated metrics (paired t-tests, all p <= 0.003, significant under the Bonferroni-corrected threshold). The measured privacy cost on real data confirms the graceful degradation pattern observed in the synthetic experiments, providing empirical evidence of the framework's clinical viability in genuine multicenter contexts.

From Gradient Clipping to Structural Refinement: Improving DPSGD for Medical Image Segmentation

Medical image segmentation is widely used for disease detection but relies on sensitive data, raising privacy concerns as trained models can leak information. Differential privacy, typically implemented via Differential Private Stochastic Gradient Descent (DPSGD), provides a solution, though at the cost of reduced utility. Recent DPSGD variants, including Automatic clipping (Auto-S), Normalised SGD with perturbation (NSGD), and Per-sample adaptive clipping (PSAC), have shown promise in image classification, but their behavior in medical segmentation remains underexplored. We evaluate these methods across binary and multi-class tasks and analyze gradient alignment, showing that prior assumptions, particularly for PSAC, do not consistently hold. We further demonstrate that combining clipping strategies with morphological refinement improves segmentation quality under privacy constraints. Finally, we propose an adaptive DP-Morph variant that captures class-specific structures and enhances performance in multi-class settings.

Privacy-Preserving Federated Autoencoder for ECG Anomaly Detection on Edge Devices

Continuous electrocardiography (ECG) monitoring could surface rhythm abnormalities before they escalate into cardiovascular events. However, a deployable system must satisfy three requirements simultaneously: legal-grade privacy (GDPR, HIPAA), real-time inference on constrained edge hardware, and detection quality under non-IID cross-hospital data. We design and evaluate an end-to-end federated system addressing all three for unsupervised 12-lead ECG anomaly detection on PTB-XL dataset, combining three autoencoder families (VanillaAE, ConvAE, VAE), Flower-based federated averaging (FedAvg) across ten simulated hospitals, client-side differentially private SGD (DP-SGD) with a Rényi-DP accountant, and 8-bit integer (INT8) post-training quantization with Raspberry Pi 4 benchmarking. Our main contributions are: an empirical characterization of how these mechanisms compose, practical DP-specific recommendations, and technical and security insights for a clinically sensitive setting. Federated learning matches or exceeds the centralized baseline across all architectures (ConvAE federated area under the ROC curve, AUROC, $0.782$), and an $\varepsilon$ sweep identifies $\varepsilon=4$ as the recommended clinical operating point. INT8 quantization roughly halves model size and cuts Pi 4 latency by up to $44%$ with $<0.12%$ AUROC loss. Crucially, DP and quantization penalties are empirically independent, so practitioners need not trade a strong privacy guarantee for a compact edge footprint. To our knowledge, this is the first system combining federated learning, formal $(\varepsilon,δ)$-DP, unsupervised reconstruction-based detection, and quantized AArch64 deployment.

Privacy-Preserving Federated Learning via Differential Privacy and Homomorphic Encryption for Cardiovascular Disease Risk Modeling

Protecting sensitive health data while enabling collaborative analysis is a central challenge in healthcare. Traditional machine learning (ML) requires institutions to pool anonymized patient records, centralizing analytical development and privacy risks at a single site. Privacy-enhancing technologies (PETs), including Differential Privacy (DP) and Homomorphic Encryption (HE), can mitigate these risks. However, they are mainly studied in conventional data-sharing settings and often introduce trade-offs, including reduced model utility, higher computational cost, and increased implementation complexity. Federated Learning (FL) reduces data centralization by enabling institutions to train models locally and share only model updates. Nevertheless, FL does not eliminate privacy risks, as shared parameters or gradients may still reveal sensitive information. Integrating DP or HE into FL can strengthen privacy guarantees, yet their comparative performance and deployment implications in real-world healthcare settings remain unclear. We systematically evaluated DP and HE integration in FL under real-world conditions, comparing them with standard FL and centralized ML (cML) to quantify privacy-utility trade-offs in multi-institutional settings. Using nationwide Swedish healthcare data, we evaluated cardiovascular disease risk prediction using logistic regression (LR) and neural network (NN) learners. FL with HE achieved performance comparable to cML but introduced measurable cryptographic overhead, particularly in the NN implementation. FL with DP incurred lower computational cost; however, LR was more sensitive to calibrated noise than the NN, resulting in greater performance degradation. Our findings provide practical guidance for deploying privacy-preserving FL in fragmented healthcare systems.