Hybrid Federated and Split Learning for Privacy Preserving Clinical Prediction and Treatment Optimization

Federated Learning (FL) with Differential Privacy (DP) can ensure the protection of healthcare data privacy against malicious user attacks. However, FL with the DP method faces an inherent trade-off: stronger privacy protection degrades predictive accuracy due to injected noise. On the other hand, Homomorphic Encryption (HE) enables computations on encrypted data and the aggregation of encrypted gradients without introducing DP-induced noise, thereby potentially increasing the predictive accuracy. However, it may increase the computation cost. To improve the predictive accuracy while considering the computational ability of heterogeneous clients, we propose a Privacy-Preserving Machine Learning (PPML)-Hybrid method. In the proposed PPML-Hybrid method, clients distributedly select either HE or DP based on their computational resources, so that HE clients contribute noise-free updates while DP clients reduce computational overhead. Meanwhile, clients with high computational resources can flexibly adopt HE or DP according to their privacy needs. Performance evaluation on omics datasets shows that our proposed method achieves comparable predictive accuracy while significantly reducing computation time relative to HE-only. Additionally, it outperforms DP-only methods under equivalent or stricter privacy budgets.

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.

Federated learning (FL) is a privacy-preserving machine learning paradigm that enables multiple parties to collaboratively train models on privately owned data without sharing raw information. While standard FL typically addresses either horizontal or vertical data partitions, many real-world scenarios exhibit a complex hybrid distribution. This paper proposes Hybrid Federated Learning (HybridFL) to address data split both horizontally across disjoint users and vertically across complementary feature sets. We evaluate HybridFL in a financial crime detection context, where a transaction party holds transaction-level attributes and multiple banks maintain private account-level features. By integrating horizontal aggregation and vertical feature fusion, the proposed architecture enables joint learning while strictly preserving data locality. Experiments on AMLSim and SWIFT datasets demonstrate that HybridFL significantly outperforms the transaction-only local model and achieves performance comparable to a centralized benchmark.