A cost-sensitive random forest framework for ARP spoofing detection in Internet of Medical Things networks.

INTRODUCTION: ARP spoofing poses a major security threat to Internet of Medical Things (IoMT) networks by enabling man-in-the-middle attacks that compromise the integrity of life-critical communications. Existing intrusion detection methods fail to simultaneously address temporal attack dynamics, unequal medical safety requirements, and explicit control of false negative rates. METHODS: This study proposes the Self-Healing IoT-Optimized Random Forest (SH-IORF) framework, which integrates temporal behavioral feature engineering, validation-guided cost-sensitive learning, and medical safety-constrained threshold optimization. To ensure methodological rigor and prevent information leakage, a stratified three-way partitioning strategy consisting of training, validation, and completely held-out testing datasets was employed. Class penalty weights and operating thresholds were determined exclusively from the validation dataset. RESULTS: Experimental evaluation on the CICIoMT2024 benchmark demonstrated that the proposed SH-IORF framework achieved 99.90% accuracy, 99.83% recall, 99.95% precision, a 0.9989 F1-score, and an AUC-ROC of 0.9996. The framework limited the false negative rate to 0.17%, satisfying the predefined medical safety constraint (FNR ≤ 0.5%), corresponding to 40 missed detections among 23,390 attack samples and 12 false alarms across 28,768 benign traffic instances. DISCUSSION: The results demonstrate that the proposed framework provides stable and safety-oriented intrusion detection capability under heterogeneous IoMT deployment conditions while maintaining strict testing independence and robust performance under rigorous evaluation settings.