Fed-Equilibrium Framework for Topological Pareto Control in Robust and Fair Clinical Federated Learning

Federated learning is an emerging distributed paradigm that addresses the challenges posed by heterogeneous, privacy-sensitive data. It enables multiple clients to train a model collaboratively by aggregating their local updates at a server. However, conventional aggregation schemes typically use fixed weights that fail to reflect unequal and time-varying client contributions, leading to biased and unstable learning. To improve fairness and stability, we propose the Trajectory Shapley Value (TSV), a contribution metric that evaluates how each client influences the optimization trajectory of the global model using a validation-based, temporally consistent utility. Building on TSV, we design FedTSV, an adaptive aggregation method that converts per-round evaluations into dynamic client weights, allowing the server to respond to heterogeneous and adversarial participation in real time. Experiments on benchmark datasets show that FedTSV accelerates convergence, improves robustness, and yields more equitable contribution assessments, thereby providing a principled foundation for fairness-aware federated optimization.

Federated learning (FL) in healthcare faces pronounced heterogeneity and temporal concept drift across clinical centers, where evolving patient populations and care practices shift data distributions. Existing approaches rely on persistent global communication, incurring substantial bandwidth overhead while risking negative transfer from poorly aligned peers. We propose Adaptive Bayesian Partner Selection (ABPS), a peer-to-peer framework that governs who collaborates, when, and at what cost. Each center maintains a Beta-Bernoulli posterior over prospective peers' Shapley marginal utility, ranks candidates with an Upper Confidence Bound (UCB) criterion, and forms collaborations through a lightweight propose-reject mechanism, with the option to abstain from communication when no mutually beneficial partner exists. The framework admits a stochastic decision interpretation, yielding finite-sample concentration guarantees and O(kappa log T) regret in partner selection, along with conditions under which intentional isolation is optimal under negative transfer. Lightweight extensions (head personalization, bfloat16 quantized communication, and a tunable active-set size) further improve efficiency, and a goal-aware metadata filter enables institution-specific collaboration strategies. On binary in-hospital mortality prediction over the first 24 hours of an ICU stay, with 230 non-IID clinical centers drawn from MIMIC-IV, the full ABPS-X variant matches the strongest federated baseline (FedDyn, AUROC 0.758) at 0.09x the communication cost of FedAvg, with reduced variability. A diversity-driven configuration activates intentional isolation for a substantial fraction of centers. These results show that adaptive, utility-aware collaboration reduces communication without sacrificing accuracy when centers are numerous and small, offering a scalable paradigm for healthcare FL.

Federated learning enables collaborative training without sharing patient-level data, but most studies remain simulations. Based on five requirements derived from the literature, we analyzed 14 FL frameworks and found that none fully satisfied these requirements. We present FL-Net, a novel federated clinical research framework to fulfill all requirements. It integrates modular data harmonization, data discovery, disclosure control, securely built versioned FL-Net-Tools and containerized federated workflow execution into a persistent network. It enables the re-use of harmonized data and workflows across studies. FL-Net's end-to-end capabilities were evaluated through harmonization, cross-study patient discovery across MIMIC and US-130, and reproducible, audited federated workflows with up to 50 concurrent clients. FL-Net is being developed within the dAIbetes and Microb-AI-ome EU projects and will cover over 800,000 patients across 10 hospitals in 9 countries covering longitudinal and single point in time data, FL-Net provides a practical foundation for interoperable, reproducible, and privacy-preserving multicenter clinical research.