PSyGenTAB: A Privacy-Preserving Framework for Synthetic Clinical Tabular Data Generation via Constrained Optimization

The development of medical AI is constrained by limited access to high-quality clinical data due to institutional silos and strict privacy regulations such as HIPAA and GDPR. Synthetic data generation offers a potential solution, but existing methods lack principled mechanisms to explicitly manage the privacy-utility trade-off, often degrading clinically meaningful patterns or risking patient re-identification. We present PSyGenTAB, a privacy-preserving generative framework that formulates synthetic healthcare data generation as a constrained optimization problem solved using the Augmented Lagrangian Method. By embedding configurable privacy constraints directly into model training, PSyGenTAB enforces minimum privacy thresholds while maximizing clinical data utility. Across multiple clinically motivated benchmarks, PSyGenTAB preserves inter-feature clinical relationships and minority-class diagnostic patterns essential for reliable health AI. Downstream evaluation using Train-on-Synthetic, Test-on-Real and Train-on-Real, Test-on-Synthetic protocols shows that models trained on synthetic data achieve performance comparable to those trained on real patient records. Privacy auditing further demonstrates reduced exact record reproduction and strong resilience to membership inference attacks. These results establish PSyGenTAB as a principled framework for balancing privacy protection and clinical utility in synthetic healthcare data, supporting secure cross-institutional AI development.

DISCO-TAB: A Hierarchical Reinforcement Learning Framework for Privacy-Preserving Synthesis of Complex Clinical Data

The development of robust clinical decision support systems is frequently impeded by the scarcity of high-fidelity, privacy-preserving biomedical data. While Generative Large Language Models (LLMs) offer a promising avenue for synthetic data generation, they often struggle to capture the complex, non-linear dependencies and severe class imbalances inherent in Electronic Health Records (EHR), leading to statistically plausible but clinically invalid records. To bridge this gap, we introduce DISCO-TAB (DIScriminator-guided COntrol for TABular synthesis), a novel framework that orchestrates a fine-tuned LLM with a multi-objective discriminator system optimized via Reinforcement Learning. Unlike prior methods relying on scalar feedback, DISCO-TAB evaluates synthesis at four granularities, token, sentence, feature, and row, while integrating Automated Constraint Discovery and Inverse-Frequency Reward Shaping to autonomously preserve latent medical logic and resolve minority-class collapse. We rigorously validate our framework across diverse benchmarks, including high-dimensional, small-sample medical datasets (e.g., Heart Failure, Parkinson's). Our results demonstrate that hierarchical feedback yields state-of-the-art performance, achieving up to 38.2% improvement in downstream clinical classifier utility compared to GAN and Diffusion baselines, while ensuring exceptional statistical fidelity (JSD < 0.01) and robust resistance to membership inference attacks. This work establishes a new standard for generating trustworthy, utility-preserving synthetic tabular data for sensitive healthcare applications.

SynLLM: A Comparative Analysis of Large Language Models for Medical Tabular Synthetic Data Generation via Prompt Engineering

Access to real-world medical data is often restricted due to privacy regulations, posing a significant barrier to the advancement of healthcare research. Synthetic data offers a promising alternative; however, generating realistic, clinically valid, and privacy-conscious records remains a major challenge. Recent advancements in Large Language Models (LLMs) offer new opportunities for structured data generation; however, existing approaches frequently lack systematic prompting strategies and comprehensive, multi-dimensional evaluation frameworks. In this paper, we present SynLLM, a modular framework for generating high-quality synthetic medical tabular data using 20 state-of-the-art open-source LLMs, including LLaMA, Mistral, and GPT variants, guided by structured prompts. We propose four distinct prompt types, ranging from example-driven to rule-based constraints, that encode schema, metadata, and domain knowledge to control generation without model fine-tuning. Our framework features a comprehensive evaluation pipeline that rigorously assesses generated data across statistical fidelity, clinical consistency, and privacy preservation. We evaluate SynLLM across three public medical datasets, including Diabetes, Cirrhosis, and Stroke, using 20 open-source LLMs. Our results show that prompt engineering significantly impacts data quality and privacy risk, with rule-based prompts achieving the best privacy-quality balance. SynLLM establishes that, when guided by well-designed prompts and evaluated with robust, multi-metric criteria, LLMs can generate synthetic medical data that is both clinically plausible and privacy-aware, paving the way for safer and more effective data sharing in healthcare research.