Using Zero-Knowledge Proofs Integrated with Homomorphic Encryption for Enhanced Clinical Trial Cohorts based on Blockchain-Secured Patient Data

Abstract

Protecting patient privacy in clinical trials and healthcare data management is becoming more difficult due to the growing amount of medical data. This study introduces a novel hybrid framework that combines fully homomorphic encryption (FHE) and zero-knowledge proofs (ZKPs), building on previous work that used blockchain and homomorphic encryption for secure cohort selection. By assigning result verification to effective ZKP constructs, the hybrid approach overcomes the main drawbacks of FHE, including high computational overhead and precision loss. Our tests show that this integrated approach maintains patient privacy while greatly increasing computational efficiency. We wrap up by talking about future research directions and possible healthcare applications.