Generative clinical time series models trained on moderate amounts of patient data are privacy preserving

Sharing medical data for machine learning model training purposes is often impossible due to the risk of disclosing identifying information about individual patients. Synthetic data produced by generative artificial intelligence (genAI) models trained on real data is often seen as one possible solution to comply with privacy regulations. While powerful genAI models for heterogeneous hospital time series have recently been introduced, such modeling does not guarantee privacy protection, as the generated data may still reveal identifying information about individuals in the models' training cohort. Applying established privacy mechanisms to generative time series models, however, proves challenging as post-hoc data anonymization through k-anonymization or similar techniques is limited, while model-centered privacy mechanisms that implement differential privacy (DP) may lead to unstable training, compromising the utility of generated data. Given these known limitations, privacy audits for generative time series models are currently indispensable regardless of the concrete privacy mechanisms applied to models and/or data. In this work, we use a battery of established privacy attacks to audit state-of-the-art hospital time series models, trained on the public MIMIC-IV dataset, with respect to privacy preservation. Furthermore, the eICU dataset was used to mount a privacy attack against the synthetic data generator trained on the MIMIC-IV dataset. Results show that established privacy attacks are ineffective against generated multivariate clinical time series when synthetic data generators are trained on large enough training datasets. Furthermore, we discuss how the use of existing DP mechanisms for these synthetic data generators would not bring desired improvement in privacy, but only a decrease in utility for machine learning prediction tasks.

GRU-D Characterizes Age-Specific Temporal Missingness in MIMIC-IV

Temporal missingness, defined as unobserved patterns in time series, and its predictive potentials represent an emerging area in clinical machine learning. We trained a gated recurrent unit with decay mechanisms, called GRU-D, for a binary classification between elderly - and young patients. We extracted time series for 5 vital signs from MIMIC-IV as model inputs. GRU-D was evaluated with means of 0.780 AUROC and 0.810 AUPRC on bootstrapped data. Interpreting trained model parameters, we found differences in blood pressure missingness and respiratory rate missingness as important predictors learned by parameterized hidden gated units. We successfully showed how GRU-D can be used to reveal patterns in temporal missingness building the basis of novel research directions.