The Internet of Medical Things (IoMT) transforms healthcare through interconnected medical devices but faces significant cybersecurity threats, particularly intrusion and exfiltration attacks. Centralized intrusion detection systems (IDSs) require data aggregation, presenting privacy and scalability risks. This paper proposes FedEnsemble-DP, a privacy-aware Federated Learning (FL) framework for decentralized intrusion detection in IoMT networks. The framework integrates three data balancing scenarios (Raw Imbalanced, Local SMOTE, Centralized SMOTE) with Differential Privacy (DP) and Secure Aggregation mechanisms. Extensive experiments on WUSTL-EHMS-2020 and CIC-IoMT-2024 datasets under non-IID settings (Dirichlet α = 0.3) demonstrate that models with strong privacy guarantees (ε = 3.0) frequently match or exceed non-private baselines. Key findings show Local SMOTE with ε = 3.0 achieved 94.60% accuracy and 0.9598 AUC, while Raw Imbalanced with ε = 3.0 attained 94.50% accuracy and 0.9494 AUC. Even with strict privacy (ε = 3.0), these results surpassed the non-private baseline (93.20% accuracy) in the raw scenario. Centralized SMOTE showed effectiveness but introduced training instability. These results indicate that local data balancing combined with calibrated DP noise can yield high detection performance while preserving privacy, effectively bridging security-performance and data confidentiality requirements in distributed healthcare networks.
Alsolami et al. (Tue,) studied this question.