Accurate diagnostic and risk-prediction models are important for supporting clinical decision-making during infectious disease outbreaks. However, privacy and governance requirements may restrict patient-level data sharing across healthcare institutions, and data distributions often vary.

Moreover, AUC is widely used to evaluate discriminative performance, motivating its direct optimization in model development. We propose geographically regularized AUC-maximizing personalized federated learning (GrAUC-PFL), which directly optimizes a smooth pairwise AUC surrogate to learn personalized models while keeping patient-level data local and accounting for institutional heterogeneity.

Graph-based regularization encourages geographically neighboring institutions to have similar coefficient vectors while retaining a personalized models. Simulations and a real-data application suggest improved discriminative performance, particularly when geographically neighboring institutions have similar data-generating characteristics.