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Updated: Jan 17, 2026

Combining Reflectance Confocal Microscopy with Optical Coherence Tomography for Noninvasive Diagnosis of Skin Cancers via Image Acquisition
Published on: August 18, 2022
Asynchronous and focal federated learning for skin lesion classification under local data scarcity and class
Shichao Ma1, Yun-Hin Chan2, Edith C H Ngai2
1School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; Laboratory of Data Discovery for Health Limited (D(2)4H), Hong Kong Science Park, Hong Kong SAR, China.
Background And Objectives:
Federated learning (FL) is an approach that enables the training of machine learning (ML) models using data from multiple data nodes without direct data transfer, hence making it a good choice for healthcare ML applications to alleviate data privacy and security concerns. Most standard FL approaches focus on the setting of a small number of nodes, with each node contributing a sizable amount of data. However, in emerging healthcare settings such as telemedicine and the Internet of Medical Things (IoMT), it is necessary to consider the situation in which there is a large number of nodes, and each contributes a relatively small number (data scarcity) of non-independent (class imbalance) data points.
Methods:
In this paper, we propose an asynchronous and focal update approach to enable FL to address this problem. In particular, we demonstrate its use in a teledermatology setting, in which a skin lesion image classifier is continuously updated based on data in a highly distributed network of mobile devices. We performed a situation experiment in which 1,268 skin lesion images across 798 mobile devices contributed to the training of a 3-class classifier in an FL framework.
Results:
We found that widely used synchronous FL methods perform poorly under conditions of data scarcity and imbalance. Specifically, using FedAvg, FedProx, and FedNova, the trained classifiers achieved AUROC values of 0.57-0.67, 0.63-0.66, and 0.64-0.67, respectively, on the held-out test set across various experimental settings. In contrast, our proposed asynchronous and focal approach achieved a test AUROC of 0.78-0.89 after 40 global training epochs. This performance is significantly closer to the optimal AUROC of 0.91, which is achievable by training a classifier with all the data on a centralised server without FL.
Conclusions:
These results demonstrate that our approach provides a useful solution to implement an efficient FL scheme under the conditions of data scarcity and class imbalance that are commonly found in realistic telemedicine and IoMT applications.
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