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Main Authors: Zhang, Fan, Deltadahl, Simon, Delouee, Majid Lotfian, Kreuter, Daniel, Taylor, Joseph, Visser, Allerdien, Consortium, BloodCounts, Rudd, James H. F., Gleadall, Nicholas S., Sivapalaratnam, Suthesh, Asselbergs, Folkert, Schut, Martijn C., Roberts, Michael
Format: Preprint
Published: 2026
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Online Access:https://arxiv.org/abs/2605.21563
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author Zhang, Fan
Deltadahl, Simon
Delouee, Majid Lotfian
Kreuter, Daniel
Taylor, Joseph
Visser, Allerdien
Consortium, BloodCounts
Rudd, James H. F.
Gleadall, Nicholas S.
Sivapalaratnam, Suthesh
Asselbergs, Folkert
Schut, Martijn C.
Roberts, Michael
author_facet Zhang, Fan
Deltadahl, Simon
Delouee, Majid Lotfian
Kreuter, Daniel
Taylor, Joseph
Visser, Allerdien
Consortium, BloodCounts
Rudd, James H. F.
Gleadall, Nicholas S.
Sivapalaratnam, Suthesh
Asselbergs, Folkert
Schut, Martijn C.
Roberts, Michael
contents Recent reviews find that the vast majority of published healthcare federated learning (FL) studies never reach real-world deployment. We developed an embedding-based FL pipeline for iron deficiency prediction from routine full blood count (FBC) data and deployed it across real institutional environments at Amsterdam University Medical Centre (AUMC) and NHS Blood and Transplant (NHSBT), two clinical environments that differ markedly in iron deficiency prevalence, ferritin distribution, and subject populations. A frozen domain-specific haematology foundation model, DeepCBC, performs site-local representation extraction, restricting federated training to a compact downstream classifier and substantially reducing recurrent communication relative to full-encoder federation. The two clinical datasets are structurally not independent and identically distributed (non-IID), with heterogeneity arising from distinct population differences rather than sampling artefacts. Runtime governance is enforced by FLA$^3$, a healthcare-oriented FL platform providing study-scoped execution, policy-based authorisation, and signed audit logging. Standard sample-size-weighted aggregation (FedAvg) reduced the area under the receiver operating characteristic curve (ROC-AUC) at both sites relative to local-only training, as the global update was biased towards the larger AUMC distribution. FedMAP, a personalised aggregation method, raised ROC-AUC from 0.9470 to 0.9594 at AUMC and from 0.8558 to 0.8671 at NHSBT relative to local-only training, achieving the highest macro ROC-AUC of 0.9133 and the best macro balanced accuracy overall. These results support personalised aggregation in clinical federations where client sample size and task relevance diverge substantially.
format Preprint
id arxiv_https___arxiv_org_abs_2605_21563
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Embedding-Based Federated Learning with Runtime Governance for Iron Deficiency Prediction
Zhang, Fan
Deltadahl, Simon
Delouee, Majid Lotfian
Kreuter, Daniel
Taylor, Joseph
Visser, Allerdien
Consortium, BloodCounts
Rudd, James H. F.
Gleadall, Nicholas S.
Sivapalaratnam, Suthesh
Asselbergs, Folkert
Schut, Martijn C.
Roberts, Michael
Machine Learning
Recent reviews find that the vast majority of published healthcare federated learning (FL) studies never reach real-world deployment. We developed an embedding-based FL pipeline for iron deficiency prediction from routine full blood count (FBC) data and deployed it across real institutional environments at Amsterdam University Medical Centre (AUMC) and NHS Blood and Transplant (NHSBT), two clinical environments that differ markedly in iron deficiency prevalence, ferritin distribution, and subject populations. A frozen domain-specific haematology foundation model, DeepCBC, performs site-local representation extraction, restricting federated training to a compact downstream classifier and substantially reducing recurrent communication relative to full-encoder federation. The two clinical datasets are structurally not independent and identically distributed (non-IID), with heterogeneity arising from distinct population differences rather than sampling artefacts. Runtime governance is enforced by FLA$^3$, a healthcare-oriented FL platform providing study-scoped execution, policy-based authorisation, and signed audit logging. Standard sample-size-weighted aggregation (FedAvg) reduced the area under the receiver operating characteristic curve (ROC-AUC) at both sites relative to local-only training, as the global update was biased towards the larger AUMC distribution. FedMAP, a personalised aggregation method, raised ROC-AUC from 0.9470 to 0.9594 at AUMC and from 0.8558 to 0.8671 at NHSBT relative to local-only training, achieving the highest macro ROC-AUC of 0.9133 and the best macro balanced accuracy overall. These results support personalised aggregation in clinical federations where client sample size and task relevance diverge substantially.
title Embedding-Based Federated Learning with Runtime Governance for Iron Deficiency Prediction
topic Machine Learning
url https://arxiv.org/abs/2605.21563