Abstract:Dataset condensation (DC) learns a compact synthetic dataset that enables models to match the performance of full-data training, prioritising utility over distributional fidelity. While typically explored for computational efficiency, DC also holds promise for healthcare data democratisation, especially when paired with differential privacy, allowing synthetic data to serve as a safe alternative to real records. However, existing DC methods rely on differentiable neural networks, limiting their compatibility with widely used clinical models such as decision trees and Cox regression. We address this gap using a differentially private, zero-order optimisation framework that extends DC to non-differentiable models using only function evaluations. Empirical results across six datasets, including both classification and survival tasks, show that the proposed method produces condensed datasets that preserve model utility while providing effective differential privacy guarantees - enabling model-agnostic data sharing for clinical prediction tasks without exposing sensitive patient information.




Abstract:Ensuring the generalisability of clinical machine learning (ML) models across diverse healthcare settings remains a significant challenge due to variability in patient demographics, disease prevalence, and institutional practices. Existing model evaluation approaches often rely on real-world datasets, which are limited in availability, embed confounding biases, and lack the flexibility needed for systematic experimentation. Furthermore, while generative models aim for statistical realism, they often lack transparency and explicit control over factors driving distributional shifts. In this work, we propose a novel structured synthetic data framework designed for the controlled benchmarking of model robustness, fairness, and generalisability. Unlike approaches focused solely on mimicking observed data, our framework provides explicit control over the data generating process, including site-specific prevalence variations, hierarchical subgroup effects, and structured feature interactions. This enables targeted investigation into how models respond to specific distributional shifts and potential biases. Through controlled experiments, we demonstrate the framework's ability to isolate the impact of site variations, support fairness-aware audits, and reveal generalisation failures, particularly highlighting how model complexity interacts with site-specific effects. This work contributes a reproducible, interpretable, and configurable tool designed to advance the reliable deployment of ML in clinical settings.