Differentially Private De-identification of Dutch Clinical Notes: A Comparative Evaluation

Protecting patient privacy in clinical narratives is essential for enabling secondary use of healthcare data under regulations such as GDPR and HIPAA. While manual de-identification remains the gold standard, it is costly and slow, motivating the need for automated methods that combine privacy guarantees with high utility. Most automated text de-identification pipelines employed named entity recognition (NER) to identify protected entities for redaction. Although methods based on differential privacy (DP) provide formal privacy guarantees, more recently also large language models (LLMs) are increasingly used for text de-identification in the clinical domain. In this work, we present the first comparative study of DP, NER, and LLMs for Dutch clinical text de-identification. We investigate these methods separately as well as hybrid strategies that apply NER or LLM preprocessing prior to DP, and assess performance in terms of privacy leakage and extrinsic evaluation (entity and relation classification). We show that DP mechanisms alone degrade utility substantially, but combining them with linguistic preprocessing, especially LLM-based redaction, significantly improves the privacy-utility trade-off.

What Does Neuro Mean to Cardio? Investigating the Role of Clinical Specialty Data in Medical LLMs

In this paper, we introduce S-MedQA, an English medical question-answering (QA) dataset for benchmarking large language models in fine-grained clinical specialties. We use S-MedQA to check the applicability of a popular hypothesis related to knowledge injection in the knowledge-intense scenario of medical QA, and show that: 1) training on data from a speciality does not necessarily lead to best performance on that specialty and 2) regardless of the specialty fine-tuned on, token probabilities of clinically relevant terms for all specialties increase consistently. Thus, we believe improvement gains come mostly from domain shifting (e.g., general to medical) rather than knowledge injection and suggest rethinking the role of fine-tuning data in the medical domain. We release S-MedQA and all code needed to reproduce all our experiments to the research community.