{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T15:11:33Z","timestamp":1767625893151,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T00:00:00Z","timestamp":1700438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Cyber-Physical Intensive Care Medical System for COVID-19 (ICU4Covid) European Project","award":["101016000"],"award-info":[{"award-number":["101016000"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JSAN"],"abstract":"<jats:p>A result of the pandemic is an urgent need for data collaborations that empower the clinical and scientific communities in responding to rapidly evolving global challenges. The ICU4Covid project joined research institutions, medical centers, and hospitals all around Europe in a telemedicine network for sharing capabilities, knowledge, and expertise distributed within the network. However, healthcare data sharing has ethical, regulatory, and legal complexities that pose several restrictions on their access and use. To mitigate this issue, the ICU4Covid project integrates a federated learning architecture, allowing distributed machine learning within a cross-institutional healthcare system without the data being transported or exposed outside their original location. This paper presents the federated learning approach to support the decision-making process for ICU patients in a European telemedicine network. The proposed approach was applied to the early identification of high-risk hypertensive patients. Experimental results show how the knowledge of every single node is spread within the federation, improving the ability of each node to make an early prediction of high-risk hypertensive patients. Moreover, a performance evaluation shows an accuracy and precision of over 90%, confirming a good performance of the FL approach as a prediction test. The FL approach can significantly support the decision-making process for ICU patients in distributed networks of federated healthcare organizations.<\/jats:p>","DOI":"10.3390\/jsan12060078","type":"journal-article","created":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T11:31:36Z","timestamp":1700479896000},"page":"78","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Federated Learning Approach to Support the Decision-Making Process for ICU Patients in a European Telemedicine Network"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3580-9232","authenticated-orcid":false,"given":"Giovanni","family":"Paragliola","sequence":"first","affiliation":[{"name":"Institute for High Performance Computing and Networking, National Research Council of Italy, 80131 Naples, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3266-9617","authenticated-orcid":false,"given":"Patrizia","family":"Ribino","sequence":"additional","affiliation":[{"name":"Institute for High Performance Computing and Networking, National Research Council of Italy, 90146 Palermo, Italy"}]},{"given":"Zaib","family":"Ullah","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Telematica Giustino Fortunato, 82100 Benevento, Italy"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,20]]},"reference":[{"key":"ref_1","unstructured":"(2023, January 23). 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