PLACID: Privacy-preserving Large language models for Acronym Clinical Inference and Disambiguation

Large Language Models (LLMs) offer transformative solutions across many domains, but healthcare integration is hindered by strict data privacy constraints. Clinical narratives are dense with ambiguous acronyms, misinterpretation these abbreviations can precipitate severe outcomes like life-threatening medication errors. While cloud-dependent LLMs excel at Acronym Disambiguation, transmitting Protected Health Information to external servers violates privacy frameworks. To bridge this gap, this study pioneers the evaluation of small-parameter models deployed entirely on-device to ensure privacy preservation. We introduce a privacy-preserving cascaded pipeline leveraging general-purpose local models to detect clinical acronyms, routing them to domain-specific biomedical models for context-relevant expansions. Results reveal that while general instruction-following models achieve high detection accuracy (~0.988), their expansion capabilities plummet (~0.655). Our cascaded approach utilizes domain-specific medical models to increase expansion accuracy to (~0.81). This novel work demonstrates that privacy-preserving, on-device (2B-10B) models deliver high-fidelity clinical acronym disambiguation support.

Mitigating Black-Box Adversarial Attacks via Output Noise Perturbation

In black-box adversarial attacks, adversaries query the deep neural network (DNN), use the output to reconstruct gradients, and then optimize the adversarial inputs iteratively. In this paper, we study the method of adding white noise to the DNN output to mitigate such attacks, with a unique focus on the trade-off analysis of noise level and query cost. The attacker's query count (QC) is derived mathematically as a function of noise standard deviation. With this result, the defender can conveniently find the noise level needed to mitigate attacks for the desired security level specified by QC and limited DNN performance loss. Our analysis shows that the added noise is drastically magnified by the small variation of DNN outputs, which makes the reconstructed gradient have an extremely low signal-to-noise ratio (SNR). Adding slight white noise with a standard deviation less than 0.01 is enough to increase QC by many orders of magnitude without introducing any noticeable classification accuracy reduction. Our experiments demonstrate that this method can effectively mitigate both soft-label and hard-label black-box attacks under realistic QC constraints. We also show that this method outperforms many other defense methods and is robust to the attacker's countermeasures.