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It is a known fact that AI models need massive amounts of data for training. In the medical field, the data are not necessarily available at a single site but are distributed over several sites. In the field of medical data sharing, particularly among healthcare institutions, the need to maintain the confidentiality of sensitive information often restricts the comprehensive utilization of real-world data in machine learning. To address this challenge, our study experiments with an innovative approach using federated learning to enable collaborative model training without compromising data confidentiality and privacy. We present an adaptation of the federated averaging algorithm, a predominant centralized learning algorithm, to a peer-to-peer federated learning environment. This adaptation led to the development of two extended algorithms: Federated Averaging Peer-to-Peer and Federated Stochastic Gradient Descent Peer-to-Peer. These algorithms were applied to train deep neural network models for the detection and monitoring of diabetic foot ulcers, a critical health condition among diabetic patients. This study compares the performance of Federated Averaging Peer-to-Peer and Federated Stochastic Gradient Descent Peer-to-Peer with their centralized counterparts in terms of model convergence and communication costs. Additionally, we explore enhancements to these algorithms using targeted heuristics based on client identities and f1-scores for each class. The results indicate that models utilizing peer-to-peer federated averaging achieve a level of convergence that is comparable to that of models trained via conventional centralized federated learning approaches. This represents a notable progression in the field of ensuring the confidentiality and privacy of medical data for training machine learning models. [ABSTRACT FROM AUTHOR]

Diabetes affects roughly 537 million people, and is predicted to reach 783 million by 2045. Diabetes Foot Ulcer (DFU) is a major complication associated with diabetes and can lead to lower limb amputation. The rapid evolution of diabetic foot ulcers (DFUs) necessitates immediate intervention to prevent the severe consequences of amputation and related complications. Continuous and meticulous patient monitoring for individuals with diabetic foot ulcers (DFU) is crucial and is currently carried out by medical practitioners on a daily basis. This research article introduces DFU-Helper, a novel framework that employs a Siamese Neural Network (SNN) for accurate and objective assessment of the progression of diabetic foot ulcers (DFUs) over time. DFU-Helper provides healthcare professionals with a comprehensive visual and numerical representation in terms of the similarity distance of the disease, considering five distinct disease conditions: none, infection, ischemia, both (presence of ischemia and infection), and healthy. The SNN achieves the best Macro F1-score of 0.6455 on the test dataset when applying pseudo-labeling with a pseudo-threshold set to 0.9. The SNN is used in the process of creating anchors for each class using feature vectors. When a patient initially consults a healthcare professional, an image is transmitted to the model, which computes the distances from each class anchor point. It generates a comprehensive table with corresponding figures and a visually intuitive radar chart. In subsequent visits, another image is captured and fed into the model alongside the initial image. DFU-Helper then plots both images and presents the distances from the class anchor points. Our proposed system represents a significant advancement in the application of deep learning for the longitudinal assessment of DFU. To the best of our knowledge, no existing tool harnesses deep learning for DFU follow-up in a comparable manner. [ABSTRACT FROM AUTHOR]