## 6 Conclusions
\begin{table}
\begin{tabular}{c c c c c c} \hline \hline \multirow{2}{*}{**Metrics** **(95\% CI)**} & \multirow{2}{*}{**Standalone Learning**} & \multicolumn{4}{c}{**Federated Learning**} \\ \cline{3-6}  & & **LMECS** & **LMECS** & **LMECS** & **LMECS** \\  & & **(Loss)** & **(Accuracy)** & **(AUC)** & **FedAvg** \\ \hline Accuracy (\%) & 78.17 \(\pm\) 0.42 & 80.60 \(\pm\) 0.64 & **81.42 \(\pm\) 2.33** & 81.35 \(\pm\) 1.62 & 78.11 \(\pm\) 1.12 \\ Sensitivity (\%) & 80.70 \(\pm\) 1.55 & 82.74 \(\pm\) 0.58 & **83.44 \(\pm\) 0.63** & 83.02 \(\pm\) 0.69 & 77.56 \(\pm\) 1.93 \\ Specificity (\%) & 77.66 \(\pm\) 0.50 & 80.57 \(\pm\) 0.66 & **81.91 \(\pm\) 3.71** & 81.72 \(\pm\) 2.74 & 80.29 \(\pm\) 1.47 \\ PPV (\%) & 21.11 \(\pm\) 1.43 & 23.32 \(\pm\) 0.36 & **23.62 \(\pm\) 0.12** & 23.21 \(\pm\) 0.31 & 21.82 \(\pm\) 0.72 \\ NPV (\%) & 95.13 \(\pm\) 1.52 & 98.12 \(\pm\) 0.56 & **98.72 \(\pm\) 0.38** & 98.24 \(\pm\) 0.16 & 96.12 \(\pm\) 0.88 \\ AUC (\%) & 79.68 \(\pm\) 0.74 & 81.38 \(\pm\) 0.41 & 81.43 \(\pm\) 0.56 & **81.45 \(\pm\) 0.39** & 75.72 \(\pm\) 1.69 \\ \hline \hline \end{tabular} Bold denotes the highest performance in each Metrics.  
\end{table} 
Table 5: Comparison of local model average performance between standalone learning and federated learning. **Author Contributions:** Design and writing, Y.-g.K. and S.Y. ; conceptualizationY.-g.K., S.Y. and K.L. ; software, Y.-g.K. and S.Y. ; writing-original draft preparation, K.L. ; supervision and contribution, K.L. All authors have read and agreed to the published version of the manuscript. **Funding:** This work was supported in part by the Commercialization Promotion Agency for R&D Outcome (COMPA) Grant funded by the Korean Government (MSIT) under Grant 2022-Future research service development support-1-SB4-1, and in part the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI22C1569). (Corresponding author: [PERSON]). **Institutional Review Board Statement:** We conducted a study involving human subjects and a retrospective dataset collected from the emergency room of a South Korean hospital. This study was confirmed to be exempt from review by the Gachon University Bioethics Review Committee in Korea, under the approval number 1044396-202303-HR-044-01. The results of this study are based on the National Emergency Department Information System (N2023-27-2-06-21). **Informed Consent Statement:** This retrospective study conducted between 2017 and 2022 in South Korea utilized data from the National Emergency Department Information System. The requirement for informed consent was waived by the IRB due to the retrospective nature of the study. Patient information was anonymized prior to analysis. **Data Availability Statement:** Restrictions apply to the availability of these data. Data were obtained from national emergency medical center in South Korea and are available [[https://dw.nemc.or.kr/nemcMonitoring/data/user/DataUseInfoMain.do](https://dw.nemc.or.kr/nemcMonitoring/data/user/DataUseInfoMain.do)]([https://dw.nemc.or.kr/nemcMonitoring/data/user/DataUseInfoMain.do](https://dw.nemc.or.kr/nemcMonitoring/data/user/DataUseInfoMain.do)) with the permission of national emergency medical center in South Korea. **Conflicts of Interest:** The authors declare no conflicts of interest.