Background: Theintegration of artificial intelligence (AI) into clinical decision support systems (CDSSs) has significantly enhanced diagnostic precision, risk stratification, and treatment planning. AI models remain a barrier to clinical adoption, emphasizing the critical role of explainable AI (XAI). Methods: This systematic meta-analysis synthesizes findings from 62 peer-reviewed studies published between 2018 and 2025, examining the use of XAI methods within CDSSs across various clinical domains, including radiology, oncology, neurology, and critical care. Model-agnostic techniques such as visualization models like Gradient-weighted Class Activation Mapping (Grad-CAM) and attention mechanisms dominated in imaging and sequential data tasks. Results: However, there are still gaps in user-friendly evaluation, methodological transparency, and ethical issues, as seen by the absence of research that evaluated explanation fidelity, clinician trust, or usability in real-world settings. In order to enable responsible AI implementation in healthcare, our analysis emphasizes the necessity of longitudinal clinical validation, participatory system design, and uniform interpretability measures. Conclusions: This review offers a thorough analysis of the state of XAI practices in CDSSs today, identifies methodological and practical issues, and suggests a path forward for AI solutions that are open, moral, and clinically relevant.

Federated learning (FL) is revolutionizing healthcare by enabling collaborative machine learning across institutions while preserving patient privacy and meeting regulatory standards. This review delves into FL’s applications within smart health systems, particularly its integration with IoT devices, wearables, and remote monitoring, which empower real-time, decentralized data processing for predictive analytics and personalized care. It addresses key challenges, including security risks like adversarial attacks, data poisoning, and model inversion. Additionally, it covers issues related to data heterogeneity, scalability, and system interoperability. Alongside these, the review highlights emerging privacy-preserving solutions, such as differential privacy and secure multiparty computation, as critical to overcoming FL’s limitations. Successfully addressing these hurdles is essential for enhancing FL’s efficiency, accuracy, and broader adoption in healthcare. Ultimately, FL offers transformative potential for secure, data-driven healthcare systems, promising improved patient outcomes, operational efficiency, and data sovereignty across the healthcare ecosystem.

Life Cycle is an international, peer-reviewed, open access general medical journal and invites submissions of any original contribution that broadens, advances, or brightens medical science or practice, or that educates or delights the Journal’s readers.

Skin cancer is one of the most lethal kinds of human illness. In the present state of the health care system, skin cancer identification is a time-consuming procedure and if it is not diagnosed initially then it can be threatening to human life. To attain a high prospect of complete recovery, early detection of skin cancer is crucial. In the last several years, the application of deep learning (DL) algorithms for the detection of skin cancer has grown in popularity. Based on a DL model, this work intended to build a multi-classification technique for diagnosing skin cancers such as melanoma (MEL), basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanocytic nevi (MN). In this paper, we have proposed a novel model, a deep learning-based skin cancer classification network (DSCC_Net) that is based on a convolutional neural network (CNN), and evaluated it on three publicly available benchmark datasets (i.e., ISIC 2020, HAM10000, and DermIS). For the skin cancer diagnosis, the classification performance of the proposed DSCC_Net model is compared with six baseline deep networks, including ResNet-152, Vgg-16, Vgg-19, Inception-V3, EfficientNet-B0, and MobileNet. In addition, we used SMOTE Tomek to handle the minority classes issue that exists in this dataset. The proposed DSCC_Net obtained a 99.43% AUC, along with a 94.17%, accuracy, a recall of 93.76%, a precision of 94.28%, and an F1-score of 93.93% in categorizing the four distinct types of skin cancer diseases. The rates of accuracy for ResNet-152, Vgg-19, MobileNet, Vgg-16, EfficientNet-B0, and Inception-V3 are 89.32%, 91.68%, 92.51%, 91.12%, 89.46% and 91.82%, respectively. The results showed that our proposed DSCC_Net model performs better as compared to baseline models, thus offering significant support to dermatologists and health experts to diagnose skin cancer.