Evidence map›Paper›PMID 41992288›Full record

ArticleBMC medical informatics and decision making2026

PASTA-4-PHT: a pipeline for automated security and technical audits for the personal health train.

Sascha Welten, Karl Kindermann, Ahmet Polat, Martin Görz, Maximilian Jugl, Laurenz Neumann, Alexander Neumann, Johannes Lohmöller, Jan Pennekamp, Stefan Decker

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Article in BMC medical informatics and decision making, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sascha WeltenChair of Computer Science 5, RWTH Aachen University, Ahornstrasse 55, 52074, Aachen, NRW, Germany. welten@dbis.rwth-aachen.de.
Karl KindermannChair of Computer Science 5, RWTH Aachen University, Ahornstrasse 55, 52074, Aachen, NRW, Germany.
Ahmet PolatChair of Computer Science 5, RWTH Aachen University, Ahornstrasse 55, 52074, Aachen, NRW, Germany.
Martin GörzChair of Computer Science 5, RWTH Aachen University, Ahornstrasse 55, 52074, Aachen, NRW, Germany.
Maximilian JuglDepartment Medical Data Science, Leipzig University Medical Center, Stephanstraße 9c, 04103, Leipzig, SN, Germany.
Laurenz NeumannChair of Computer Science 5, RWTH Aachen University, Ahornstrasse 55, 52074, Aachen, NRW, Germany.
Alexander NeumannChair of Computer Science 5, RWTH Aachen University, Ahornstrasse 55, 52074, Aachen, NRW, Germany.
Johannes LohmöllerCommunication and Distributed Systems, RWTH Aachen University, Ahornstraße 55, 52074, Aachen, NRW, Germany.
Jan PennekampCommunication and Distributed Systems, RWTH Aachen University, Ahornstraße 55, 52074, Aachen, NRW, Germany.
Stefan DeckerChair of Computer Science 5, RWTH Aachen University, Ahornstrasse 55, 52074, Aachen, NRW, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWith the introduction of data protection regulations, the need for innovative privacy-preserving approaches to process and analyse sensitive data has become apparent. One approach is the Personal Health Train (PHT) that brings analysis code to the data and conducts the data processing at the data premises. However, despite its demonstrated success in various studies, the execution of external code in sensitive environments, such as hospitals, introduces new research challenges because the interactions of the code with sensitive data are often incomprehensible and lack transparency. Such interactions introduce potential threats to data integrity and expand the attack surface, exposing the system to risks including code injection, supply chain software vulnerabilities, and unauthorised runtime network communication.

resultsTo address this issue, this work discusses a Personal Health Train (PHT)-aligned security and audit pipeline inspired by DevSecOps principles, called Pipeline for Automated Security and Technical Audits for the Personal Health Train (PASTA-4-PHT). The automated pipeline incorporates multiple phases that detect vulnerabilities, such as unintentionally or intentionally introduced weaknesses in the code of the PHT, before its deployment. To thoroughly study its versatility, we evaluate PASTA-4-PHT in two ways. First, we deliberately introduce vulnerabilities into a PHT. Second, we apply our pipeline to five real-world PHTs, which have been utilised in real-world studies, to audit them for potential vulnerabilities. The controlled evaluation confirmed detection of all injected vulnerability types showing that the audit pipeline is effective. In the real-world audit of five Trains, the image analysis phase identified up to 35 critical vulnerabilities per Train, indicating that container images pose the most significant threat vector according to our evaluation.

conclusionOur evaluation demonstrates that our designed pipeline successfully identifies potential vulnerabilities and can be applied to real-world studies. In compliance with the requirements of the General Data Protection Regulation (GDPR) for data management, documentation, and protection, our automated approach supports researchers using the PHT in their data-intensive work and reduces manual overhead. PASTA-4-PHT can be used as a decision-making tool to assess and document potential vulnerabilities in code for data processing. The associated artefacts of this article, along with the pipeline configuration, are available online for adaptation and reuse. Ultimately, our work contributes to an increased security and overall transparency of data processing activities within the PHT framework.

Indexed as

Computer SecurityConfidentialityDigital HealthHumansAuditsCode evaluationDevOpsDevSecOpsPersonal health trainSecurity

Identifiers

PMID41992288
PMCPMC13097913

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.