The Internet of Things (IoT) connects heterogeneous sensing devices with servers under the support of the network to monitor intelligent communication and real-time data transmission. The system caters well to the needs of medical services and also provides convenience for telemedicine. Many IoT-based solutions have been proposed for medical application scenarios. However, the unpredictable nature of communication links and device failures may lead to challenges in setting effective security policies for controlling these devices. Trust management has emerged as an ideal solution that can implement a dynamic management approach and regulate node connection requests. While centralized architectures require only a central node and relatively few devices, they are not suitable for large-scale medical facilities. In contrast, decentralized approaches based on blockchain technology have recently emerged as feasible solutions for IoT practices. Nevertheless, these decentralized approaches are vulnerable to potential attacks such as defaming honest nodes or improving the trust degrees of malicious nodes, which can compromise trust degrees within the system. This paper designs a blockchain-enabled trust management method for medical services based on the IoT, aiming to prevent malicious nodes from sending false trust levels. The proposed trust assessment model utilizes referees' direct experience and indirect feedback to recommend trustworthy medical services. The presented model provides a certain level of security against various types of attacks including malicious attacks, benevolent attacks, and on-off attacks. Experimental results illustrate that the model is robust and effective.

中文翻译：

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区块链赋能医疗物联网动态信任管理方法

物联网（IoT）在网络的支持下将异构传感设备与服务器连接起来，进行监控智能通信和实时数据传输。该系统很好地满足了医疗服务的需求，也为远程医疗提供了便利。针对医疗应用场景，人们提出了许多基于物联网的解决方案。然而，通信链路和设备故障的不可预测性可能会给设置有效的安全策略来控制这些设备带来挑战。信任管理已成为一种理想的解决方案，可以实现动态管理方法并调节节点连接请求。虽然集中式架构只需要一个中心节点和相对较少的设备，但它们不适合大型医疗设施。相比之下，基于区块链技术的去中心化方法最近已成为物联网实践的可行解决方案。然而，这些去中心化的方法很容易受到潜在的攻击，例如诽谤诚实节点或提高恶意节点的信任度，这可能会损害系统内的信任度。本文设计了一种基于物联网的区块链医疗服务信任管理方法，旨在防止恶意节点发送虚假信任级别。所提出的信任评估模型利用推荐人的直接经验和间接反馈来推荐值得信赖的医疗服务。所提出的模型针对各种类型的攻击提供了一定程度的安全性，包括恶意攻击、善意攻击和开关攻击。实验结果表明该模型稳健有效。