Feasibility of federated learning for the development of AI solutions in laboratory diagnostics from a privacy perspective: a systematic review

Authors

  • Rodrigo Cunha Dias Programa de Educação Continuada da Escola Politécnica da USP (PECE) – Universidade de São Paulo (USP)
  • Márcia Ito Programa de Mestrado Profissional em Sistemas Produtivos – Centro Estadual de Educação Tecnológica Paula Souza (CEETEPS)

DOI:

https://doi.org/10.5753/isys.2026.7589

Keywords:

Federated Learning, Laboratory Diagnosis, Data Privacy, Artificial Intelligence in Healthcare, LGPD (Brazilian General Data Protection Law), Systematic Review

Abstract

The development of artificial intelligence solutions in laboratory diagnostics faces a structural dilemma: the requirement for large data volumes for training conflicts with strict health data protection regulations (GDPR, LGPD, HIPAA). This systematic review investigated federated learning as a methodological alternative that enables AI model training without centralizing sensitive data. Analyzing 23 articles (2021-2025), we found that 56.5% of studies demonstrated technical feasibility, although only 26.1% explicitly addressed regulatory compliance. Results reveal a technically promising field, but with a critical gap between technical maturity and regulatory adequacy.

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References

[ABRAMED 2024] ABRAMED (2024), O uso da IA na medicina diagnóstica brasileira – relatório de pesquisa, São Paulo: Abramed. Disponível em: https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:5bdd30c9-0710-47df-b8e8-ee728facb828.

[Adler et al. 2023] Adler, J., Lenski, M., Tolios, A., Fares Taie, S., Sopic, M., Rajdl, D. and et al. (2023), "Digital competence in laboratory medicine", J Lab Med, v. 47, n. 4, p. 143-148. doi: 10.1515/labmed-2023-0021. GS Search

[Aria and Cuccurullo 2017] Aria, M. and Cuccurullo, C. (2017), "bibliometrix: An R-tool for comprehensive science mapping analysis", J Informetr, v. 11, n. 4, p. 959-975. doi: 10.1016/j.joi.2017.08.007. GS Search

[Baid, U. et al. 2024] Baid, U. and et al. (2024), "Pan-Cancer Tumor Infiltrating Lymphocyte Detection based on Federated Learning", In: 2024 IEEE International Conference on Big Data (BigData), Washington, DC, USA, p. 7640-7647. doi: 10.1109/BigData62323.2024.10825083. GS Search

[Cadamuro et al. 2024] Cadamuro, J., Carobene, A., Cabitza, F., Debeljak, Z., de Bruyne, S., van Doorn, W. and et al. (2024), "A comprehensive survey of artificial intelligence adoption in European laboratory medicine: Current utilization and prospects", Clin Chem Lab Med. doi: 10.1515/cclm-2024-1016. GS Search

[Chen, B. et al. 2024] Chen, B., Zeng, H., Xiang, T., Guo, S., Zhang, T. and Liu, Y. (2024), "ESB-FL: Efficient and Secure Blockchain-Based Federated Learning With Fair Payment", IEEE Trans Big Data, v. 10, n. 6, p. 761-774. doi: 10.1109/TBDATA.2022.3177170. GS Search

[Düsing, C. et al. 2024] Düsing, C., Cimiano, P., Rehberg, S., Scherer, C., Kaup, O., Köster, C. and et al. (2024), "Integrating federated learning for improved counterfactual explanations in clinical decision support systems for sepsis therapy", Artif Intell Med, v. 157, p. 102982. doi: 10.1016/j.artmed.2024.102982. GS Search

[Fang, C. et al. 2024] Fang, C. and et al. (2024), "Decentralised, collaborative, and privacy-preserving machine learning for multi-hospital data", eBioMedicine, v. 101, p. 105006. doi: 10.1016/j.ebiom.2024.105006 . GS Search

[Fantonelli et al. 2020] Fantonelli, R. L., Celuppi, I. C., Oliveira, F. M., Burigo, F., Dalmarco, E. M. and Wazlawick, R. S. (2020), "Lei geral de proteção de dados e a interoperabilidade na saúde pública", J Health Inform, Número Especial SBIS - Dezembro, p. 166-171. Disponvel em: Lei geral de proteção de dados e a interoperabilidade na saúde pública General data protection law and interoperability in public health Ley general de protección de datos e interoperabilidad en salud pública.

[Feng et al. 2025] Feng, Y., Guo, Y., Hou, Y., Wu, Y., Lao, M., Yu, T., Liu, G. (2025). A survey of security threats in federated learning. Complex & Intelligent Systems. 2025 Jan 29;11:165. doi: https://doi.org/10.1007/s40747-024-01664-0. GS Search

[Fruchterman and Reingold 1991] Fruchterman, T. M. J. and Reingold, E. M. (1991), "Graph drawing by force-directed placement", Softw Pract Exp, v. 21, n. 11, p. 1129-1164. doi: https://doi.org/10.1002/spe.4380211102 . GS Search

[Guembe et al. 2024] Guembe, B., Misra, S., Azeta, A. (2024). Privacy Issues, Attacks, Countermeasures and Open Problems in Federated Learning: A Survey. Applied Artificial Intelligence. 2024;38(1):e2410504. https://doi.org/10.1080/08839514.2024.2410504. GS Search

[Gulati, S. et al. 2024] Gulati, S., Guleria, K. and Goyal, N. (2024), "Collaborative, Privacy-Preserving Federated Learning Framework for the Detection of Diabetic Eye Diseases", SN Comput Sci, v. 5, p. 1100. doi: 10.1007/s42979-024-03462-4. GS Search

[Hajder, M. et al. 2021] Hajder, M., Hajder, P., Gil, T., Krzywda, M., Kolbusz, J. and Liput, M. (2021), "Architecture and organization of a Platform for diagnostics, therapy and post-covid complications using AI and mobile monitoring", Procedia Comput Sci, v. 192, p. 3711-3721. doi: 10.1016/j.procs.2021.09.145. GS Search

[He, P. et al. 2023] He, P. and et al. (2023), "Low-Latency Federated Learning via Dynamic Model Partitioning for Healthcare IoT", IEEE J Biomed Health Inform, v. 27, n. 10, p. 4684-4695. doi: 10.1109/JBHI.2023.3298446. GS Search

[Iturry et al. 2021] Díaz Iturry, M., Alves-Souza, S. N., Ito, M. and da Silva, S. A. (2021), "Data Quality in health records: A literature review", In: 2021 16th Iberian Conference on Information Systems and Technologies (CISTI), Chaves, Portugal, p. 1-6. doi: 10.23919/CISTI52073.2021.9476536. GS Search

[Jamshidi, M. et al. 2025] Jamshidi, M., Hoang, D. T., Nguyen, D. N., Niyato, D. and Warkiani, M. E. (2025), "Revolutionizing biological digital twins: Integrating internet of bio-nano things, convolutional neural networks, and federated learning", Comput Biol Med, v. 189, p. 109970. doi: 10.1016/j.compbiomed.2025.109970. GS Search

[Jimenez-Gutierrez et al. 2025] Jimenez-Gutierrez, D. M., Falkouskaya, Y., Hernandez-Ramos, J. L., Anagnostopoulos, A., Chatzigiannakis, I., Vitaletti, A. (2025). On the Security and Privacy of Federated Learning: A Survey with Attacks, Defenses, Frameworks, Applications, and Future Directions. arXiv:2508.13730. 2025 Aug 19. https://arxiv.org/abs/2508.13730. GS Search

[Kitchenham et al. 2007] Kitchenham, B., Charters, S., Budgen, D., Brereton, P., Turner, M., Linkman, S., Jørgensen, M., Mendes, E., Visaggio, G. (2007), Guidelines for performing systematic literature reviews in software engineering, EBSE Technical Report. Software Engineering Group –Keele University, UK. Dispoível em: slr.key .

[Kodali et al. 2024] Kodali, R. K., Mittadoddi, V. P., Ranga, H. and Boppana, L. (2024), "Machine Learning in Laboratory Diagnosis", In: TENCON 2024 - 2024 IEEE Region 10 Conference (TENCON), Singapore, p. 1445-1449. doi: 10.1109/TENCON61640.2024.10902716. GS Search

[Kumar, D. et al. 2025] Kumar, D., Verma, C. and Illés, Z. (2025), "Federated learning with explainable AI for liver disease prediction: A privacy-preserving approach", Intell Based Med, v. 12, p. 100285. doi: 10.1016/j.ibmed.2025.100285. GS Search

[Li, Z. et al. 2024] Li, Z., Li, M., Li, A. and Lin, Z. (2024), "Blockchain-based collaborative data analysis framework for distributed medical knowledge extraction", Comput Ind Eng, v. 190, p. 110099. doi: 10.1016/j.cie.2024.110099. GS Search

[Lippi and Plebani 2025] Lippi, G. and Plebani, M. (2025), "Lights and shadows of artificial intelligence in laboratory medicine", Adv Lab Med, v. 6, n. 1, p. 1-3. doi: 10.1515/almed-2025-0024. GS Search

[Liu, X. et al. 2025] Liu, X., Li, S., Zhu, Q. and et al. (2025), "Interpretable Semi-federated Learning for Multimodal Cardiac Imaging and Risk Stratification: A Privacy-Preserving Framework", J Digit Imaging Inform Med. doi: 10.1007/s10278-025-01643-y. GS Search

[Lu, M. Y. et al. 2022] Lu, M. Y., Chen, R. J., Kong, D., Lipkova, J., Singh, R., Williamson, D. F. K. and et al. (2022), "Federated learning for computational pathology on gigapixel whole slide images", Med Image Anal, v. 76, p. 102298. doi: 10.1016/j.media.2021.102298. GS Search

[Ma, T. et al. 2025] Ma, T., Luo, X., Tan, R. and Gao, H. (2025), "Privacy and Fairness-Guaranteed Federated Preference Optimization for Large Language Models in Internet of Medical Things", IEEE Trans Consum Electron. doi: 10.1109/TCE.2025.3595092. GS Search

[Master et al. 2023] Master, S. R., Badrick, T. C., Bietenbeck, A. and Haymond, S. (2023), "Machine Learning in Laboratory Medicine: Recommendations of the IFCC Working Group", Clin Chem, v. 69, n. 7, p. 690-698. doi: 10.1093/clinchem/hvad055. GS Search

[McMahan et al. 2017] McMahan, B., Moore, E., Ramage, D., Hampson, S. and Arcas, B. A. y. (2017), "Communication-efficient learning of deep networks from decentralized data", In: Proceedings of the 20th International Conference on Artificial Intelligence and Statistics (AISTATS), Fort Lauderdale, FL, USA, p. 1273-1282. GS Search

[Mnasri, S. et al. 2025] Mnasri, S., Salah, D. and Idoudi, H. (2025), "A hybrid blockchain and federated learning attention-based BERT transformer framework for medical records management", J Supercomput, v. 81, p. 317. doi: 10.1007/s11227-024-06816-0. GS Search

[Page et al. 2021] Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D. and et al. (2021), "The PRISMA 2020 statement: an updated guideline for reporting systematic reviews", BMJ, v. 372, p. n71. doi: 10.1136/bmj.n71. GS Search

[Park, E. et al. 2022] Park, E., Nam, H. S. and Song, J. W. (2022), "Federated Learning Models using Flow Cytometry Data of Blood Test in Medical Decision Support", In: 2022 IEEE International Conference on Big Data (Big Data), Osaka, Japan, p. 6793-6795. doi: 10.1109/BigData55660.2022.10020379. GS Search

[Perales, E. et al. 2025] Perales, E., Verdy-Ricard, R., Labiod, M. A., Bendiab, G. and Chenoune, Y. (2025), "Federated Learning for Securing Medical Imaging Against Deepfakes in 6G Smart Hospitals", In: 2025 IEEE International Conference on Cyber Security and Resilience (CSR), Chania, Crete, Greece, p. 1100-1105. doi: 10.1109/CSR64739.2025.11130027. GS Search

[Prabh et al. 2024] Prabha, B. V., Manikanda Kumaran, K., Manikandan, S. and Murugan, S. P. (2024), "A Comparative Analysis of Machine Learning Algorithms for Healthcare Applications", In: 2024 4th International Conference on Advancement in Electronics & Communication Engineering (AECE), GHAZIABAD, India, p. 214-218. doi: 10.1109/AECE62803.2024.10911687. GS Search

[Qiu, W. et al. 2024] Qiu, W. and et al. (2024), "Heart Sound Abnormality Detection From Multi-Institutional Collaboration: Introducing a Federated Learning Framework", IEEE Trans Biomed Eng, v. 71, n. 10, p. 2802-2813. doi: 10.1109/TBME.2024.3393557. GS Search

[Sai, S.et al. 2024] Sai, S., Hassija, V., Chamola, V. and Guizani, M. (2024), "Federated Learning and NFT-Based Privacy-Preserving Medical-Data-Sharing Scheme for Intelligent Diagnosis in Smart Healthcare", IEEE Internet Things J, v. 11, n. 4, p. 5568-5577. doi: 10.1109/JIOT.2023.3308991. GS Search

[Shahnazeer, C. K. and Sureshkumar, G. 2025] Shahnazeer, C. K. and Sureshkumar, G. (2025), "Federated Transfer Learning Framework for Multi-disease Prediction", Procedia Comput Sci, v. 258, p. 830-838. doi: 10.1016/j.procs.2025.04.315. GS Search

[Sheller et al. 2020] Sheller, M. J., Edwards, B., Reina, G. A. and et al. (2020), "Federated learning in medicine: facilitating multi-institutional collaborations without sharing patient data", Sci Rep, v. 10, p. 12598. doi: 10.1038/s41598-020-69250-1. GS Search

[Wei, M. et al. 2025] Wei, M., Yu, W. and Chen, D. (2025), "AccDFL: Accelerated Decentralized Federated Learning for Healthcare IoT Networks", IEEE Internet Things J, v. 12, n. 5, p. 5329-5345. doi: 10.1109/JIOT.2024.3486122. GS Search

[Xiao 2023] Xiao, F. (2023), "Application of Computer Big Data and Cloud Computing Precision Inspection in Laboratory Treatment", In: 2023 International Conference on Telecommunications, Electronics and Informatics (ICTEI), Lisbon, Portugal, p. 779-782. doi: 10.1109/ICTEI60496.2023.00017. GS Search

[Zhang, H. et al. 2025] Zhang, H., Chen, M., Liu, Y., Luo, G. and Zhu, Y. (2025), "Non-IID Medical Image Segmentation Based on Cascaded Diffusion Model for Diverse Multi-Center Scenarios", IEEE J Biomed Health Inform, v. 29, n. 7, p. 5042-5055. doi: 10.1109/JBHI.2025.3549029. GS Search

[Zhang, L. et al. 2023] Zhang, L., Xu, J., Vijayakumar, P., Sharma, P. K. and Ghosh, U. (2023), "Homomorphic Encryption-Based Privacy-Preserving Federated Learning in IoT-Enabled Healthcare System", IEEE Trans Netw Sci Eng, v. 10, n. 5, p. 2864-2880. doi: 10.1109/TNSE.2022.3185327. GS Search

[Zhao et al. 2025] Zhao, J.C. and et al. (2025). The Federation Strikes Back: A Survey of Federated Learning Privacy Attacks, Defenses, Applications, and Policy Landscape. ACM Computing Surveys. 2025;57(9):230. https://doi.org/10.1145/3724113 . GS Search

[Zou, W. et al. 2025] Zou, W., Zhang, R. and Xun, Y. (2025), "On a Federated-Learning-Based Computation Offloading Strategy for Nonterrestrial-Network-Assisted Internet of Medical Things", IEEE Internet Things J, v. 12, n. 12, p. 21280-21289. doi: 10.1109/JIOT.2025.3546812. GS Search

Published

2026-07-11

How to Cite

Cunha Dias, R., & Ito, M. (2026). Feasibility of federated learning for the development of AI solutions in laboratory diagnostics from a privacy perspective: a systematic review. ISys - Journal of Information Systems, 19(1). https://doi.org/10.5753/isys.2026.7589

Issue

Section

Regular articles