# Probing the Efficacy of Federated Parameter-Efficient Fine-Tuning of Vision Transformers for Medical Image Classification Source: [Probing the Efficacy of Federated Parameter-Efficient Fine-Tuning of Vision Transformers for Medical Image Classification]() Collection index: [llms.txt]() Data updated: 2025-10-26T03:02:03.292Z Authors: Naif Alkhunaizi, Faris Almalik, Rouqaiah Al-Refai, Muzammal Naseer, Karthik Nandakumar Published: 2024-07-16T10:28:50.000Z ## Abstract With the advent of large pre-trained transformer models, fine-tuning these models for various downstream tasks is a critical problem. Paucity of training data, the existence of data silos, and stringent privacy constraints exacerbate this fine-tuning problem in the medical imaging domain, creating a strong need for algorithms that enable collaborative fine-tuning of pre-trained models. Moreover, the large size of these models necessitates the use of parameter-efficient fine-tuning (PEFT) to reduce the communication burden in federated learning. In this work, we systematically investigate various federated PEFT strategies for adapting a Vision Transformer (ViT) model (pre-trained on a large natural image dataset) for medical image classification. Apart from evaluating known PEFT techniques, we introduce new federated variants of PEFT algorithms such as visual prompt tuning (VPT), low-rank decomposition of visual prompts, stochastic block attention fine-tuning, and hybrid PEFT methods like low-rank adaptation (LoRA)+VPT. Moreover, we perform a thorough empirical analysis to identify the optimal PEFT method for the federated setting and understand the impact of data distribution on federated PEFT, especially for out-of-domain (OOD) and non-IID data. The key insight of this study is that while most federated PEFT methods work well for in-domain transfer, there is a substantial accuracy vs. efficiency trade-off when dealing with OOD and non-IID scenarios, which is commonly the case in medical imaging. Specifically, every order of magnitude reduction in fine-tuned/exchanged parameters can lead to a 4% drop in accuracy. Thus, the initial model choice is crucial for federated PEFT. It is preferable to use medical foundation models learned from in-domain medical image data (if available) rather than general vision models. ## Recorded benchmark results A research result applies to its stated dataset, split, metric and evaluation configuration. Compare like-for-like settings, preserve the metric's unit and direction, and distinguish paper-reported results from independent reproduction. The best result recorded here is not a claim of exhaustive, current global coverage. ## Original sources and implementation [Original paper]() [PDF]()