ArticleJournal of medical Internet research2023
Architectural Design of a Blockchain-Enabled, Federated Learning Platform for Algorithmic Fairness in Predictive Health Care: Design Science Study.
Article in Journal of medical Internet research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- A Systematic Review of Federated and Cloud Computing Approaches for Predicting Mental Health Risks.Sensors (Basel, Switzerland) · 2025Pooled it
- Integration of Federated Learning and Blockchain in Health Care: Tutorial on Medical Data, Architectures, Privacy, Security, and Regulatory Compliance.Journal of medical Internet research · 2026Article
- Blockchain-Based Mobile App for Digital Identification of Older Adults in Rural Peru: Design and Usability Evaluation Study.JMIR rehabilitation and assistive technologies · 2026Article
- A robust and verifiable federated learning framework for preventing data poisonous threats in e-health.Frontiers in public health · 2026Article
- Federated Learning in Public Health: A Systematic Review of Decentralized, Equitable, and Secure Disease Prevention Approaches.Healthcare (Basel, Switzerland) · 2025Review
- From Serendipity to Precision: Integrating AI, Multi-Omics, and Human-Specific Models for Personalized Neuropsychiatric Care.Biomedicines · 2025Review
- Optimizing Proof-of-Work for Secure Health Data Blockchain Using Compute Unified Device Architecture.Blockchain in healthcare today · 2025Article
- Swarm learning network for privacy-preserving and collaborative deep learning assisted diagnosis of fracture: a multi-center diagnostic study.Frontiers in medicine · 2025Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDeveloping effective and generalizable predictive models is critical for disease prediction and clinical decision-making, often requiring diverse samples to mitigate population bias and address algorithmic fairness. However, a major challenge is to retrieve learning models across multiple institutions without bringing in local biases and inequity, while preserving individual patients' privacy at each site.
objectiveThis study aims to understand the issues of bias and fairness in the machine learning process used in the predictive health care domain. We proposed a software architecture that integrates federated learning and blockchain to improve fairness, while maintaining acceptable prediction accuracy and minimizing overhead costs.
methodsWe improved existing federated learning platforms by integrating blockchain through an iterative design approach. We used the design science research method, which involves 2 design cycles (federated learning for bias mitigation and decentralized architecture). The design involves a bias-mitigation process within the blockchain-empowered federated learning framework based on a novel architecture. Under this architecture, multiple medical institutions can jointly train predictive models using their privacy-protected data effectively and efficiently and ultimately achieve fairness in decision-making in the health care domain.
resultsWe designed and implemented our solution using the Aplos smart contract, microservices, Rahasak blockchain, and Apache Cassandra-based distributed storage. By conducting 20,000 local model training iterations and 1000 federated model training iterations across 5 simulated medical centers as peers in the Rahasak blockchain network, we demonstrated how our solution with an improved fairness mechanism can enhance the accuracy of predictive diagnosis.
conclusionsOur study identified the technical challenges of prediction biases faced by existing predictive models in the health care domain. To overcome these challenges, we presented an innovative design solution using federated learning and blockchain, along with the adoption of a unique distributed architecture for a fairness-aware system. We have illustrated how this design can address privacy, security, prediction accuracy, and scalability challenges, ultimately improving fairness and equity in the predictive health care domain.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.