# Proximal guided hybrid federated learning approach with parameter efficient adaptive intelligence for pneumonia diagnosis

**Authors:** Keerthika P, Suresh P, Nitesh Kumar AR

PMC · DOI: 10.1038/s41598-025-32286-2 · Scientific Reports · 2025-12-21

## TL;DR

This paper introduces a new federated learning method for pneumonia diagnosis using chest X-rays, improving accuracy and reducing communication costs in low-resource settings.

## Contribution

The novel approach combines FedProx and Low-Rank Adaptation for efficient, privacy-preserving pneumonia classification in federated learning.

## Key findings

- The proposed model achieved 88.5% classification accuracy under data heterogeneity.
- It reduced communication overhead and computation costs significantly.
- Attention heatmaps enhanced model transparency and clinical trust.

## Abstract

Pneumonia remains a serious worldwide health concern, particularly in low resource countries, where prompt diagnosis is challenging. Early detection relies on chest radiography, but data privacy rules and patient data fragmentation make AI model building difficult. Federated Learning allows collaborative model training without patient data sharing, a promising solution. Standard federated learning methods like FedAvg suffer with data heterogeneity and significant communication overhead. To overcome these constraints, this research proposes an upgraded federated framework with FedProx, which mitigates client drift in non-IID contexts by proximal optimization and Low-Rank Adaptation, a parameter-efficient fine-tuning technique that minimizes communication costs. Vision Transformers are used as the backbone architecture for chest X-ray categorization because they capture the global visual context better than convolutional models. The tiny memory footprint proposed in this research, fits resource-constrained medical infrastructure. The proposed technique was validated for a pneumonia classification job utilizing the publicly available Chest X-Ray Images dataset, which was distributed across simulated clients to replicate real-world healthcare organizations. The model’s performance is measured using accuracy, precision, recall, F1-score, AUC and system-level measures including communication cost per round and convergence rate. The proposed federated model had 88.5% classification accuracy under data heterogeneity and reduced communication overhead and computation cost. Explainability research employing attention heatmaps supports the model’s clinically important pulmonary areas, boosting clinical adoption, trust and transparency.

## Linked entities

- **Diseases:** pneumonia (MONDO:0005249)

## Full-text entities

- **Diseases:** IID (MESH:C564625), Pneumonia (MESH:D011014)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

16 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12820154/full.md

## References

23 references — full list in the complete paper: https://tomesphere.com/paper/PMC12820154/full.md

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Source: https://tomesphere.com/paper/PMC12820154