Dual-Layer PSO-Enhanced Federated Heterogeneous Data Fusion for Hemodialysis Complication Prediction.

Taiwan has one of the highest dialysis prevalences worldwide, making safe and reliable hemodialysis monitoring a critical sensor-based healthcare challenge. Modern hemodialysis machines integrate heterogeneous multimodal sensors (pressure, flow, conductivity, temperature, and cardiovascular signals), but differences in machine brands, data formats, and privacy constraints hinder centralized learning and robust complication prediction. This work proposes a Medical IoT-oriented federated learning framework, PSOFed-HD, that performs dual-layer Particle Swarm Optimization (PSO) to enhance heterogeneous sensor fusion for predicting dialysis-related hypotension and discomfort events. The events are defined as abnormal blood-pressure states, defined as systolic blood pressure <90 mmHg. Each hemodialysis machine is paired with an edge gateway acting as an FL client, where local PSO optimizes CNN feature weights over non-IID sensor subsets, while the central server applies PSO-driven aggregation to adaptively weight client models according to validation performance. Experiments on real-world hemodialysis datasets with 17 most commonly seen HD physiological features demonstrate that standard FedAvg yields an accuracy of 65.24% and F1-score of 0.5318, server-side PSO improves accuracy to 75.11%, and client-side PSO further raises accuracy to 81.97%. The proposed dual-layer PSO framework achieves the best performance, with 90.56% accuracy and an F1-score of 0.8533, along with superior ROC characteristics (AUC = 0.908) and stable cross-validation across 11 folds. State-of-the-art federated learning techniques for non-IID data such as SCAFFOLD and FedProx are also examined using the same heterogeneous HD dataset. The performance is close to our client-only PSO techniques, proving the merits of our dual-layer PSO architecture. These results confirm that jointly optimizing local feature representations and global aggregation weights enables effective fusion of heterogeneous hemodialysis sensor data under privacy-preserving Medical IoT constraints, providing a practical decision-support approach for real-time complication prediction in dialysis units. Future work will incorporate temporal models such as LSTM or Transformer architectures to achieve early event prediction.