Learning Across the Divide: Personalised Federated Learning for Robust Clinical Modelling Under Data-View Heterogeneity

Federated Learning (FL) enables collaborative clinical modelling across distributed electronic health records (EHRs) without sharing sensitive patient data. However, variations in medical practice, documentation standards, and data collection across institutions create data-view heterogeneity, where clients possess different or only partially overlapping clinical feature sets. This misalignment hinders the use of standard FL methods. Existing approaches rely on complex preprocessing and manual harmonisation, which can cause information loss, reduce data utility, limit scalability, and restrict client-specific personalisation. To address these limitations, we propose Personalised Attention-based Federated Graph Network (PAFNet), a scalable FL framework that enables meaningful parameter exchange across heterogeneous clients by mapping their distinct data-views into a shared latent space through client-specific projection layers. It then applies a personalised adaptation mechanism using trainable parameter masks, allowing each client to selectively incorporate global model parameters relevant to its own feature set. This design preserves local specificity, improves generalisation, and removes the need for heavy manual preprocessing common in existing approaches. Across CURIAL, eICU, and MIMIC-III datasets, PAFNet consistently outperformed state-of-the-art data-view heterogeneity FL baselines, demonstrating strong generalisation under substantial differences in client feature sets. By enabling effective personalisation and cross-institutional knowledge sharing without extensive harmonisation, PAFNet offers a robust and scalable solution for the federated training of clinical models in data-view heterogeneous environments.