# Improving Learning of New Diseases through Knowledge-Enhanced Initialization for Federated Adapter Tuning

arXiv: https://arxiv.org/abs/2508.10299 · HTML: https://mlsanity.com/paper/2508.10299/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 45 of its 60 references that are in the map.
- First posted on arXiv 14 Aug 2025.

## Builds on (most cited first, 30 of 45)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
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- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Communication-Efficient Learning of Deep Networks from Decentralized Data](https://mlsanity.com/paper/1602.05629/) (2016)
- [Model-Agnostic Meta-Learning for Fast Adaptation of Deep Networks](https://mlsanity.com/paper/1703.03400/) (2017)
- [Federated Optimization in Heterogeneous Networks](https://mlsanity.com/paper/1812.06127/) (2018)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Progressive Neural Networks](https://mlsanity.com/paper/1606.04671/) (2016)
- [Efficient Lifelong Learning with A-GEM](https://mlsanity.com/paper/1812.00420/) (2018)
- [ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseases](https://mlsanity.com/paper/1705.02315/) (2017)
- [Few-Shot Parameter-Efficient Fine-Tuning is Better and Cheaper than In-Context Learning](https://mlsanity.com/paper/2205.05638/) (2022)
- [Skin Lesion Analysis Toward Melanoma Detection 2018: A Challenge Hosted by the International Skin Imaging Collaboration (ISIC)](https://mlsanity.com/paper/1902.03368/) (2019)
- [The Future of Digital Health with Federated Learning](https://mlsanity.com/paper/2003.08119/) (2020)
- [An Efficient Framework for Clustered Federated Learning](https://mlsanity.com/paper/2006.04088/) (2020)
- [A Survey on Federated Learning Systems: Vision, Hype and Reality for Data Privacy and Protection](https://mlsanity.com/paper/1907.09693/) (2019)
- [FedDG: Federated Domain Generalization on Medical Image Segmentation via Episodic Learning in Continuous Frequency Space](https://mlsanity.com/paper/2103.06030/) (2021)
- [Personalized Cross-Silo Federated Learning on Non-IID Data](https://mlsanity.com/paper/2007.03797/) (2020)
- [VinDr-CXR: An open dataset of chest X-rays with radiologist's annotations](https://mlsanity.com/paper/2012.15029/) (2020)
- [Federated Continual Learning with Weighted Inter-client Transfer](https://mlsanity.com/paper/2003.03196/) (2020)
- [Improving LoRA in Privacy-preserving Federated Learning](https://mlsanity.com/paper/2403.12313/) (2024)
- [FLoRA: Federated Fine-Tuning Large Language Models with Heterogeneous Low-Rank Adaptations](https://mlsanity.com/paper/2409.05976/) (2024)
- [Federated Class-Incremental Learning](https://mlsanity.com/paper/2203.11473/) (2022)
- [Multi-site fMRI Analysis Using Privacy-preserving Federated Learning and Domain Adaptation: ABIDE Results](https://mlsanity.com/paper/2001.05647/) (2020)
- [Overcoming Forgetting in Federated Learning on Non-IID Data](https://mlsanity.com/paper/1910.07796/) (2019)
- [Multi-Center Federated Learning: Clients Clustering for Better Personalization](https://mlsanity.com/paper/2108.08647/) (2021)
- [Improving Generalization in Federated Learning by Seeking Flat Minima](https://mlsanity.com/paper/2203.11834/) (2022)
- [FedPrompt: Communication-Efficient and Privacy Preserving Prompt Tuning in Federated Learning](https://mlsanity.com/paper/2208.12268/) (2022)
- [When Foundation Model Meets Federated Learning: Motivations, Challenges, and Future Directions](https://mlsanity.com/paper/2306.15546/) (2023)
- [VoCo: A Simple-yet-Effective Volume Contrastive Learning Framework for 3D Medical Image Analysis](https://mlsanity.com/paper/2402.17300/) (2024)

## Abstract (arXiv)

In healthcare, federated learning (FL) is a widely adopted framework that enables privacy-preserving collaboration among medical institutions. With large foundation models (FMs) demonstrating impressive capabilities, using FMs in FL through cost-efficient adapter tuning has become a popular approach. Given the rapidly evolving healthcare environment, it is crucial for individual clients to quickly adapt to new tasks or diseases by tuning adapters while drawing upon past experiences. In this work, we introduce Federated Knowledge-Enhanced Initialization (FedKEI), a novel framework that leverages cross-client and cross-task transfer from past knowledge to generate informed initializations for learning new tasks with adapters. FedKEI begins with a global clustering process at the server to generalize knowledge across tasks, followed by the optimization of aggregation weights across clusters (inter-cluster weights) and within each cluster (intra-cluster weights) to personalize knowledge transfer for each new task. To facilitate more effective learning of the inter- and intra-cluster weights, we adopt a bi-level optimization scheme that collaboratively learns the global intra-cluster weights across clients and optimizes the local inter-cluster weights toward each client's task objective. Extensive experiments on three benchmark datasets of different modalities, including dermatology, chest X-rays, and retinal OCT, demonstrate FedKEI's advantage in adapting to new diseases compared to state-of-the-art methods.