Zhipeng Deng

Zhipeng Deng, Luyang Luo, Hao Chen

Federated learning (FL) has been introduced to the healthcare domain as a decentralized learning paradigm that allows multiple parties to train a model collaboratively without privacy leakage. However, most previous studies have assumed that every client holds an identical label set. In reality, medical specialists tend to annotate only diseases within their area of expertise or interest. This implies that label sets in each client can be different and even disjoint. In this paper, we propose the framework FedLSM to solve the problem of Label Set Mismatch. FedLSM adopts different training strategies on data with different uncertainty levels to efficiently utilize unlabeled or partially labeled data as well as class-wise adaptive aggregation in the classification layer to avoid inaccurate aggregation when clients have missing labels. We evaluated FedLSM on two public real-world medical image datasets, including chest X-ray (CXR) diagnosis with 112,120 CXR images and skin lesion diagnosis with 10,015 dermoscopy images, and showed that it significantly outperformed other state-of-the-art FL algorithms. The code can be found at https://github.com/dzp2095/FedLSM.

Lin Fan, Yafei Ou, Zhipeng Deng et al.

Chain-of-thought (CoT) reasoning has advanced medical visual question answering (VQA), yet most existing CoT rationales are free-form and fail to capture the structured reasoning process clinicians actually follow. This work asks: Can traceable, multi-step reasoning supervision improve reasoning accuracy and the interpretability of Medical VQA? To this end, we introduce Step-CoT, a large-scale medical reasoning dataset with expert-curated, structured multi-step CoT aligned to clinical diagnostic workflows, implicitly grounding the model's reasoning in radiographic evidence. Step-CoT comprises more than 10K real clinical cases and 70K VQA pairs organized around diagnostic workflows, providing supervised intermediate steps that guide models to follow valid reasoning trajectories. To effectively learn from Step-CoT, we further introduce a teacher-student framework with a dynamic graph-structured focusing mechanism that prioritizes diagnostically informative steps while filtering out less relevant contexts. Our experiments show that using Step-CoT can improve reasoning accuracy and interpretability. Benchmark: github.com/hahaha111111/Step-CoT. Dataset Card: huggingface.co/datasets/fl-15o/Step-CoT